Transcaval migration of an acupuncture needle from the abdominal cavity to the heart.

We report the case of a patient who was noted to have inserted an acupuncture needle into his abdomen. The needle migrated to the heart and was removed from the right ventricle using cardiopulmonary bypass.

Have improvements in myocardial protection influenced a surgeon's choice of coronary artery bypass surgery?

The aim of this study is to determine whether improvements in myocardial protection strategy have influenced the surgeon's choice of coronary artery bypass surgery. Between February 2002 and April 2009, a total of 662 patients underwent coronary artery bypass surgery under the provision of a single consultant surgeon. Operative mortality was defined as in-hospital death and comparison was made based on both the observed and expected mortalities as derived from the logistic EuroSCORE.

Long term results and functional outcomes following cardiac surgery in octogenarians.

Objective: Cardiac surgery for patients >80 years has seen a dramatic increase in the last decade. The aim was to assess the long term survival and quality of life in this patient population.

Method: Patients who underwent cardiac surgery between 1995 and 2007 were identified and case notes reviewed.

Benefits of the preemptive intra-aortic balloon pump: an audit of practice in a regional cardiothoracic center.

Background: Recent evidence suggests that preemptive use of an intra-aortic balloon pump (IABP) is associated with better outcomes in high-risk patients undergoing cardiac surgery. This retrospective study compares preemptive (planned) use of the IABP to emergency (unplanned) use in a regional cardiothoracic center.

Methods: All patients who required an IABP from February 2003 to June 2006 were identified from theater records.

Myocardial revascularization by off pump coronary bypass surgery (OPCABG): a ten year review.

Background: The use of cardiopulmonary bypass (CPB) may contribute to post-operative complications and organ dysfunction. Off pump coronary artery bypass grafting (OPCABG) avoids the use of CPB and hence is proposed to reduce these complications. We present the results of OPCABG in Northern Ireland over ten years.

Complete mechanical circulatory support using ventricular assist devices for post-cardiotomy biventricular failure.

Cardiopulmonary bypass (CPB) allows operations on the heart in a motionless and bloodless field while reducing cardiac workload and sustaining systemic and coronary perfusion. Failure to wean from CPB remains a significant problem. Results from recent large registry data have shown dramatic improvement in the survival following ventricular assistance for post cardiotomy failure if instituted early.

Acute aortic dissection following non-structural failure of a prosthetic aortic valve.

Malfunction of a prosthetic aortic valve is associated with a spectrum of potentially life threatening complications. In addition, the risk of aortic dissection increases following aortic valve replacement, which relates principally to aortic root pathology rather than prosthetic type or its functional status (Circulation 100 (1999) II-287). We report a case in which a high velocity turbulent jet in the proximal aorta, resulting from prosthetic leaflet entrapment caused intimal injury with subsequent type I dissection.

Patients with Klippel-Feil syndrome should have imaging of the subclavian artery and its branches prior to coronary artery bypass grafting.

Patients with Klippel-Feil syndrome have increased incidence of subclavian artery anomalies. We report a case of a patient with this syndrome undergoing coronary artery bypass grafting. Intra-operatively, the patient was found to have the left internal mammary artery arising from the second intercostal space and the decision was taken to use it as a free graft.

Management of a catheter-induced pulmonary artery rupture: early presentation after off-pump coronary artery bypass surgery.

A frail, 79-year-old woman with small body habitus was admitted for elective coronary artery bypass surgery. She was known to have long-standing chronic stable angina with recent deterioration. Her only risk factor for coronary artery disease was that she was an ex-smoker of 6 years.

Cell salvage alters the systemic inflammatory response after off-pump coronary artery bypass grafting surgery.

Background: Retransfused cardiotomy suction blood contains elevated inflammatory markers and is a bypass independent source of inflammatory mediators. We hypothesized that, during off-pump coronary artery bypass (OPCAB) grafting surgery, avoiding retransfusion of unwashed cardiotomy suction blood would beneficially alter both urinary and plasma cytokine concentrations and be renoprotective.

Methods: Thirty-seven OPCAB surgery patients were randomly allocated to control (retransfusion of unwashed shed blood) and treatment (retransfusion of washed shed blood or discarding of unwashed blood) groups.

The influence of prosthesis size and design on exercise dynamics after aortic valve replacement.

Background And Aim Of The Study: Residual gradient following aortic valve replacement (AVR) may adversely affect clinical outcome. The size and design of the valve may influence these characteristics. The study aim was to determine the influence of prosthesis physical size and leaflet design on hemodynamic performance after mechanical AVR.