Safety and Efficiency of Percutaneous Dilatational Tracheostomy With Direct Bronchoscopic Guidance for Thoracic Transplant Recipients.

Background: Percutaneous dilatational tracheostomy (PDT) is the standard airway access in critically ill patients who require prolonged mechanical ventilation. However, the literature lacks reports about the effectiveness and safety of this procedure in thoracic organ transplant recipients, who have increased risks of bleeding and infection.

Methods: We retrospectively reviewed the records of subjects who underwent thoracic organ transplantation at our institution between January 2004 and March 2011 followed by PDT (using the Ciaglia Blue Rhino technique with direct bronchoscopic guidance).

Tracheostomy After Cardiac Surgery With Median Sternotomy and Risk of Deep Sternal Wound Infections: Is It a Matter of Timing?

Objective: To assess the impact of timing of percutaneous dilatational tracheotomy (PDT) on incidence of deep sternal wound infections (DSWI) after cardiac surgery with median sternotomy.

Design: Retrospective study between 2003 and 2013.

Setting: Single-center university hospital.

[S3-Guideline: Recommendations for intra-aortic balloon pumping in cardiac surgery].

Although intra-aortic balloon pumping (IABP) is the most frequently used mechanical cardiac assist device in cardiothoracic surgery, there are only guidelines for substantive sections of aortic counterpulsation including prophylactic and postoperative use. In contrast, evidence-based recommendations are still lacking concerning intraoperative use, management, contraindication and other relevant issues. According to international surveys, important aspects of IABP usage show a wide variation in clinical practice.

[Extracorporeal heart and lung replacement procedures].

The use of extracorporeal support systems in cardiac and/or pulmonary failure is an established treatment option. Although scientific evidence is limited there is an increasing amount of data from individual studies, e.g.

Six-year experience with a hybrid stent graft prosthesis for extensive thoracic aortic disease: an interim balance.

Objectives: To avoid a two-stage surgical approach for complex thoracic aortic disease with its additive mortality and morbidity, a hybrid stent graft prosthesis was introduced 6 years ago for simultaneous treatment of the ascending, arch and descending aortas, relying proximally on a surgical suture line with an integrated distal stent graft for downstream splinting. We report the mid-term single-centre experience.

Methods: Between January 2005 and March 2011, 77 patients (mean age 59 years, male 75%) with acute (AAD, n = 39) or chronic aortic dissection (CAD, n = 23) DeBakey type I or an extensive thoracic aortic aneurysm (TAA, n = 15) underwent one-stage repair.