Temporary epicardial left ventricular and biventricular pacing improves cardiac output after cardiopulmonary bypass.

Background: To evaluate, with different pacing modes, acute changes in left ventricular systolic function, obtained by continuous cardiac output thermodilution in various subsets of patients undergoing cardiopulmonary bypass surgery. Increments of mean arterial pressure and cardiac output were considered the end point.

Methods: Fifty cases electively submitted to cardiac surgery were analyzed.

A simple technique to rule out occlusion of right coronary artery after aortic valve surgery.

Mechanical occlusion of the right coronary artery during aortic valve surgery is an infrequent but serious complication. Early recognition and expeditious management are important to reduce mortality. We developed a safe, quick, and easy technique to assess right coronary artery flow after aortic valve surgery.

Fracture of epicardial resynchronization lead caused by deceleration injury.

A 50-year-old man with heart failure, systolic dysfunction, and abnormal septal motion underwent ventricular resynchronization. Postoperative clinical and echocardiographic improvement was observed. Several months later, he complained of worsening functional class after a traffic accident.

Biochemical markers of myocardial injury in the pericardial fluid of patients undergoing heart surgery.

The purpose of this study was to compare cardiac markers in the pericardial fluid and serum in order to evaluate preoperative myocardial injury. Thirty patients were divided into three groups. The first group (AVR; n=10) received an aortic valve replacement.

Apical suction leads to severe ischemia of the ventricular apex.

Objective: Apical suction devices allow displacement of the heart in off-pump coronary artery surgery. However, high vacuum pressure may injure the suctioned myocardium. It has been demonstrated that partial pressure of oxygen in the myocardium (ptiO(2)) is a sensitive and rapid indicator of myocardial ischemia.

Minimally invasive surgical implantation of left ventricular epicardial leads for ventricular resynchronization using video-assisted thoracoscopy.

Background And Objectives: Cardiac resynchronization via left ventricular or biventricular pacing is an option for selected patients with ventricular systolic dysfunction and widened QRS complex. Stimulation through a coronary vein is the technique of choice for left ventricular pacing, but this approach results in a failure rate of approximately 8%. We describe our initial experience with minimally invasive surgical implantation of left ventricular epicardial leads using video-assisted thoracoscopy.