Perioperative use of iloprost in cardiac surgery patients diagnosed with heparin-induced thrombocytopenia-reactive antibodies or with true HIT (HIT-reactive antibodies plus thrombocytopenia): An 11-year experience.

Thrombocytopenia and thromboembolism(s) may develop in heparin immune-mediated thrombocytopenia (HIT) patients after reexposure to heparin. At the Onassis Cardiac Surgery Center, 530 out of 17,000 patients requiring heart surgery over an 11-year period underwent preoperative HIT assessment by ELISA and a three-point heparin-induced platelet aggregation assay (HIPAG). The screening identified 110 patients with HIT-reactive antibodies, out of which 46 were also thrombocytopenic (true HIT).

Clinical event rates with the On-X bileaflet mechanical heart valve: a multicenter experience with follow-up to 12 years.

Objective: The aim of the study was to establish clinical event rates for the On-X bileaflet mechanical heart valve (On-X Life Technologies Inc, Austin, Tex) using an audit of data from the 3 centers within Europe with the longest history of implanting.

Methods: All patients receiving the On-X valve between March 1, 1998, and June 30, 2009, at 3 European centers were studied. Data were collected using questionnaire and telephone surveys augmented by outpatient visits and examination of clinical records.

Alterations in biomarkers of endothelial function following on-pump coronary artery revascularization.

Background: Cardiopulmonary bypass (CPB) has been associated with activation and injury of endothelial cells, probably responsible for the systemic inflammatory response syndrome (SIRS) taking place in these patients.

Methods: We measured plasma concentrations of soluble P-selectin (sP-s), E-selectin (sE-s), tetranectin (TN), vonWillebrand factor (vWF) levels, and angiotensin-converting enzyme (ACE) activity in 31 adult patients undergoing elective coronary artery bypass grafting, just before and up to three days after surgery, and in 25 healthy volunteers.

Results: Patients showed higher plasma sP-s and sE-s and ACE concentrations, just before surgery, but significantly lower TN levels, compared with controls.

Carotid angioplasty in asymptomatic patients undergoing CABG surgery.

Aim: Although there are studies reporting that carotid endarterectomy (CEA) is recommended before or concomitant to coronary artery bypass grafting (CABG) in patients with severe carotid stenosis, controversies still exist. Carotid artery stenting (CAS) has been recently introduced as an alternative revascularization therapy in high-risk patients. The aim of this study was to demonstrate, whether CAS is safe as an alternative treatment to carotid CEA, in asymptomatic candidates for CABG surgery.