Methemoglobin as a marker of acute anemic stress in cardiac surgery.

Biological evidence supports plasma methemoglobin as a biomarker for anemia-induced tissue hypoxia. In this translational planned substudy of the multinational randomized controlled transfusion thresholds in cardiac surgery (TRICS-III) trial, which included adults undergoing cardiac surgery requiring cardiopulmonary bypass with a moderate-to-high risk of death, we investigated the relationship between perioperative hemoglobin concentration (Hb) and methemoglobin; and evaluated its association with postoperative outcomes. The primary endpoint was a composite of death, myocardial infarction, stroke, and severe acute kidney injury at 28 days.

Mechanical Versus Bioprosthetic Valve Replacement in the Tricuspid Valve Position: A Systematic Review and Meta-Analysis.

Background: The ideal prosthesis for tricuspid valve replacement (TVR) continues to be debated. There are few published data comparing mechanical and bioprosthetic valves, and all are retrospective studies with relatively small sample sizes.

Aim: This study was conducted to compare mechanical and bioprosthetic valves for TVR.

Should Moderate Functional Tricuspid Regurgitation Be Repaired During Surgery for Rheumatic Mitral Valve Disease?

Background: Surgical repair of concomitant functional moderate tricuspid valve (TV) regurgitation at the time of mitral valve (MV) surgery remains controversial.

Aim: The objective of this study was to evaluate the outcomes of concomitant repair of functional moderate tricuspid regurgitation (TR) during MV surgery for rheumatic valve disease.

Method: From 1998 to 2016, 1,240 patients had rheumatic MV disease associated with moderate functional TR: 974 patients had MV surgery and concomitant TV repair (group 1) and 266 patients had MV surgery alone (group 2).

Can posterior pericardiotomy reduce the incidence of postoperative atrial fibrillation after coronary artery bypass grafting?†.

Objectives: Atrial fibrillation (AF) is a common complication that increases the morbidity after open heart surgery. The pathophysiology is uncertain, and its prevention remains suboptimal. The aim of this study was to assess the efficiency of posterior pericardiotomy in decreasing the incidence of pericardial effusion and postoperative AF.

Sternal plate fixation for sternal wound reconstruction: initial experience (retrospective study).

Background: Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4-5.1% of cardiac procedures.

Are chest compressions safe for the patient reconstructed with sternal plates? Evaluating the safety of cardiopulmonary resuscitation using a human cadaveric model.

Background: Plate and screw fixation is a recent addition to the sternal wound treatment armamentarium. Patients undergoing cardiac and major vascular surgery have a higher risk of postoperative arrest than other elective patients. Those who undergo sternotomy for either cardiac or major vascular procedures are at a higher risk of postoperative arrest.

Complete mapping of the tricuspid valve apparatus using three-dimensional sonomicrometry.

Objective: Many surgeons consider the tricuspid valve to be a second-class structure. Our objective was to determine the normal anatomy and dynamic characteristics of the tricuspid valve apparatus in vivo and to discern whether this would aid the design of a tricuspid valve annuloplasty ring model.

Methods: Sixteen sonomicrometry crystals were placed around the tricuspid annulus, at the bases and tips of the papillary muscles, the free edges of the leaflets, and the right ventricular apex during cardiopulmonary bypass in 5 anesthetized York Hampshire pigs.

Impact of clopidogrel use on mortality and major bleeding in patients undergoing coronary artery bypass surgery.

Patients who received clopidogrel prior to coronary bypass surgery are at increased risk for bleeding that must be balanced with risk of ongoing ischemia if coronary artery bypass grafting is delayed. This study aimed to evaluate the impact of clopidogrel on mortality and major bleeding in patients undergoing urgent coronary bypass surgery. We reviewed 451 consecutive patients who underwent urgent isolated coronary bypass surgery; 262 had not received clopidogrel, whereas 189 received clopidogrel < or = 5 days preoperative.

Can local application of Tranexamic acid reduce post-coronary bypass surgery blood loss? A randomized controlled trial.

Background: Diffuse microvascular bleeding remains a common problem after cardiac procedures. Systemic use of antifibrinolytic reduces the postoperative blood loss. The purpose of this study was to examine the effectiveness of local application of tranexamic acid to reduce blood loss after coronary artery bypass grafting (CABG).

Predictors of packed red cell transfusion after isolated primary coronary artery bypass grafting--the experience of a single cardiac center: a prospective observational study.

Background: Preoperative patients' characteristics can predict the need for perioperative blood component transfusion in cardiac surgical operations. The aim of this prospective observational study is to identify perioperative patient characteristics predicting the need for allogeneic packed red blood cell (PRBC) transfusion in isolated primary coronary artery bypass grafting (CABG) operations.

Patients And Methods: 105 patients undergoing isolated, first-time CABG were reviewed for their preoperative variables and followed for intraoperative and postoperative data.

Sternal plating for primary and secondary sternal closure; can it improve sternal stability?

Background: Sternal instability with mediastinitis is a very serious complication after median sternotomy. Biomechanical studies have suggested superiority of rigid plate fixation over wire cerclage for sternal fixation. This study tests the hypothesis that sternal closure stability can be improved by adding plate fixation in a human cadaver model.

Harvesting of the radial artery for coronary artery bypass grafting: comparison of ultrasonic harmonic scalpel dissector with the conventional technique.

Objectives: Use of the radial artery for coronary artery bypass grafting is getting more popular. We started routine use of the ultrasonic dissecting scalpel in harvesting radial arteries aiming to minimize harvesting time, improve graft quality, and reduce wound complications.

Methods: Radial artery harvesting technique using harmonic scalpel (HS; 43 patients) was compared with the conventional technique (Hemostatic clips and scissors; 53 patients).

Predictive value of EuroSCORE and Parsonnet scoring in Saudi population.

Background: There is no previously published report on the applicability of risk stratification systems to adult cardiac patients in Saudi Arabia.

Aim: We have tried to verify the predictive value of Parsonnet and EuroSCORE in Saudi patients.

Methods: Data of 194 consecutive adult patients operated in our unit over the period of last few years, was obtained retrospectively.

Comparison of pulmonary gas exchange in OPCAB versus conventional CABG.

Background: Cardiopulmonary bypass has been implicated as a cause of acute lung injury in cardiac surgical patients. This could be avoided with off-pump coronary artery bypass surgery. Aim.