Indications for and outcomes of interstage catheter interventions following the Norwood procedure: A single-institution study.

Aims: The aim of this study was to document the incidence, types, and outcome of interstage catheter interventions following the Norwood surgical palliation.

Patients And Methods: A retrospective single-center study of all patients surviving the Norwood operation was performed. All data concerning interstage catheter interventions up to the completion of the superior cavopulmonary shunt were collected.

Risk factors associated with in-hospital mortality for patients with ECLS due to postcardiotomy cardiogenic shock after isolated coronary surgery.

Objectives: Extracorporeal membrane oxygenation or extracorporeal life support (ECLS) in patients after cardiac surgery and postcardiotomy cardiogenic shock (PCS) is known to be associated with high mortality. Especially in patients after coronary artery bypass grafting (CABG) and PCS, ECLS is frequently established. The aim of this analysis was to evaluate factors associated with in-hospital mortality in patients treated with ECLS due to PCS after CABG.

Single-center experience with the frozen elephant trunk procedure in 111 patients with complex aortic disease.

Background: The frozen elephant trunk (FET) technique is increasingly used for the treatment of acute and chronic aortic arch disease. This study reports our single center experience with the FET technique in patients with complex aortic disease.

Methods: Between 2009 and 2019, 111 consecutive patients underwent aortic arch surgery in our institution using the FET technique for acute type A dissection (AAD group; n=75) or non-acute type A dissection (non-AAD group; n=36; 10 patients with chronic type A dissection; 26 patients with aneurysm), respectively.

Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure.

Background: Mortality and morbidity after surgical repair for complex congenital heart defects and severe cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO) support remain high despite significant advances in medical management and technological improvements. We report on outcomes and factors after using ECMO in our surgical pediatric population including short- and long-term survival.

Methods: A total of 45 neonatal and pediatric patients were identified who needed ECMO in our department between January 2008 and December 2016.

Impact of hypertension on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection.

Introduction: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in hypertensive patients, requiring immediate surgical repair. The aim of this study was to evaluate early outcomes and long-term survival of hypertensive patients in comparison to normotensive patients suffering from Stanford A AAD.

Methods: In our center, 240 patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015.

Impact of gender on long-term outcomes after surgical repair for acute Stanford A aortic dissection: a propensity score matched analysis.

Objectives: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events.

Axillar or Aortic Cannulation for Aortic Repair in Patients With Stanford A Dissection?

Background: The choice of an optimal cannulation site for aortic repair in patients with Stanford A acute aortic dissection remains controversial. The aim of this study was to compare the early results and long-term outcomes of axillar and direct aortic cannulation.

Methods: A total of 235 consecutive patients who underwent surgical aortic repair with the use of axillar or direct aortic cannulation from January 2006 to April 2015 were analyzed.

Preoperative risk stratification models fail to predict hospital cost of cardiac surgery patients.

Background: Preoperative risk stratification models have previously been suggested to predict cardiac surgery unit costs. However, there is a lack of consistency in their reliability in this field. In this study we aim to test the correlation between the values of six commonly known preoperative scoring systems and evaluate their reliability at predicting unit costs of cardiac surgery patients.

Prognostic value of daily cardiac surgery score (CASUS) and its derivatives in cardiac surgery patients.

Background: We aimed to validate the usefulness of CASUS derivatives for cardiac surgery patients and their reliability for daily decision making.

Methods: We included, prospectively, the data of all adult cardiac surgery patients who had an ICU stay of at least 12 hours between 20 January 2003 and 14 October 2005 in the Department of Cardiothoracic Surgery of the University of Cologne, Germany. Data were collected until ICU discharge and included initial, maximum, mean, and total CASUS values.

S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system.

Hemodynamic monitoring and adequate volume-therapy, as well as the treatment with positive inotropic drugs and vasopressors are the basic principles of the postoperative intensive care treatment of patient after cardiothoracic surgery. The goal of these S3 guidelines is to evaluate the recommendations in regard to evidence based medicine and to define therapy goals for monitoring and therapy. In context with the clinical situation the evaluation of the different hemodynamic parameters allows the development of a therapeutic concept and the definition of goal criteria to evaluate the effect of treatment.

Prediction of mortality in intensive care unit cardiac surgical patients.

Objectives: The purpose of this study was to develop a specific postoperative score in intensive care unit (ICU) cardiac surgical patients for the assessment of organ dysfunction and survival. To prove the reliability of the new scoring system, we compared its performance to existing ICU scores.

Methods: This prospective study consisted of all consecutive adult patients admitted after cardiac surgery to our ICU over a period of 5.

Effect of clopidogrel on perioperative blood loss and transfusion in coronary artery bypass graft surgery.

The effect of antiplatelet therapy (APT) on postoperative bleeding, transfusion needs and re-exploration remains unclear. This study examines the influence of APT, as well as antiplatelet mono- and combined therapy, on haemorrhage and transfusion requirements in patients undergoing coronary artery bypass on cardiopulmonary bypass (CPB). Six hundred and fifty patients were reviewed retrospectively, 325 patients received APT within seven days and 325 control patients.

Percutaneous mitral annuloplasty device leaves free access to cardiac veins for resynchronization therapy.

Objectives: To assess the feasibility to place a left ventricular lead into the coronary sinus following percutaneous mitral annuloplasty.

Background: Percutaneous coronary sinus-based mitral annuloplasty may reduce functional mitral regurgitation in chronic systolic heart failure. However, concerns have been raised whether the placement of an annular remodeling device in the coronary sinus might preclude subsequent lead placement for resynchronization therapy (CRT).

Changes on magnetic resonance tomography in the knee joints of marathon runners: a 10-year longitudinal study.

Objective: The aim of the study was to evaluate long-term damage in the internal structures of the knee joints of recreational long-distance runners.

Materials And Methods: Ten years after their participation in a baseline study concerning their knee joints, seven long-distance runners and one who had given up long-distance running were invited to participate in a repeat magnetic resonance imaging (MRI) investigation. The same evaluation criteria and the same technical equipment were used, and the results of the two investigations were compared.

Effect of thawing on nitric oxide synthase III and apoptotic markers in cryopreserved human allografts.

Background: Previous investigations suggested apoptosis as a contributing factor to early failure of allograft heart valves. As myocardial apoptosis may be induced by nitric oxide (NO) release, this study investigated NO synthase [NOS-III] activation and apoptosis induction in human cryopreserved allografts during the thawing process.

Methods: Frozen myocardial tissue from ten human allograft heart valves, unsuitable for implantation, was submitted to the following conditions: (1) thawing in paraformaldehyde (Control), thawing according to the standard clinical protocol (Standard), standard-thawing with addition of the NOS-inhibitor N-omega-nitro-l-arginine (L-NA; Standard-LNA), and standard thawing with the NOS-stimulator angiotensin II (Standard-AT-II).

Risk stratification models fail to predict hospital costs of cardiac surgery patients.

Background: The aim of this prospective study was to determine if commonly used risk stratification models can predict total hospital costs in cardiac surgical patients.

Methods: Between October 1st and December 31st 2003, all consecutive adult patients undergoing cardiac surgery on CPB at our institution were classified using seven risk stratification scoring systems: EuroSCORE, Cleveland, Parsonnet, Ontario, French, Pons, and CABDEAL. Total hospital costs for each patient were calculated on a daily basis including preoperative diagnostic tests, operating room costs, disposable materials, drugs, blood components, costs for personnel, and hospital fixed-costs.

Daily assessment of organ dysfunction and survival in intensive care unit cardiac surgical patients.

Background: The purpose of this study was to develop a specific postoperative score for intensive care unit (ICU) cardiac surgical patients for assessment of organ dysfunction and survival.

Methods: This prospective study consisted of all consecutive adult patients admitted after cardiac surgery to our ICU over a period of 3 years. Evaluation of variables was performed using the first year patients who stayed in the ICU for at least 24 hours.

The effect of preoperative antiplatelet therapy in coronary artery surgery: blood transfusion requirements for patients on cardiopulmonary bypass.

Introduction: Bleeding after heart operations remains a common complication and contributes to morbidity and death. Recent studies have suggested that antiplatelet therapy (APT) may not increase homologous blood requirements in coronary bypass surgery. The purpose of this study was to examine the influence of APT therapy on haemorrhage and transfusion requirements in patients undergoing coronary artery bypass (CABG) on cardiopulmonary bypass (CPB).

Morphology and density of initial lymphatics in human myocardium determined by immunohistochemistry.

Background: Myocardial edema is a common finding in congestive heart failure, transplant rejection, and cardiomyopathy. Although pathological alterations in the lymphatic morphology are part of the underlying disease, knowledge on these changes is limited. However, lymphatic morphology may be investigated by immunohistochemical staining for fms-like tyrosine 4 kinase (flt-4), which is specific for lymphatic endothelium in adult tissue.

[Urinary infections following bladder catheterization].

The incidence and the prophylaxis of urinary tract infection following bladder catheterization have been studied in 142 patients admitted for voiding cystourethrography (VCU). 71 children received a prophylactic treatment of 2 mg/kg nitrofurantoin daily for 4 days, while 71 received no treatment following bladder catheterization. Bacteriologic examination of the urine 4-9 days after catheterization showed significant bacteriuria in 5 untreated children.