Comparison of a coronary bypass surgery using a combination of both on-pump beating heart and cardioplegic arrest with conventional coronary bypass surgery using cardioplegic arrest on-pump.

Objective: Antegrade cardioplegia may cause maldistribution in patients with multivessel coronary artery disease. Surgically bypassing large epicardial vessels before the cross-clamp and then administering cardioplegia from both the aortic root and the anastomosed grafts significantly prevent maldistribution and provide better cardiac protection.

Methods: This study included 80 patients, all older than 70 years with an ejection fraction between 25 and 35%.

Circumflex coronary artery revascularization at the proximal atrioventricular groove.

Proximal circumflex coronary artery in the atrioventricular groove usually has large diameters. Arterial diameters in this region vary from 2.5 to 5 mm.

Mitral ring annuloplasty by biological material.

Mitral annuloplasty is an integral part of mitral valve repair. Several types of techniques have been described for mitral annuloplasty. The autologous pericardium is used for mitral annuloplasty to allow mitral annular flexibility.

Can Right Ventricular Branch Bypass Alleviate Right Ventricular Dysfunction?

Background: Right ventricle (RV) dysfunction after a coronary artery bypass grafting procedure is a challenge that adversely affects RV filling pressure and contraction. This study sought to determine whether additional bypass of an RV branch would lessen RV dysfunction.

Methods: Patients with severe right coronary artery (RCA) stenosis were divided into 2 groups.

Repair of Gerbode defect and aortic neocuspidization by using bovine pericardium in aortic valve endocarditis.

Aortic valve endocarditis may be destructive and cause an acquired Gerbode-type defect. The use of biological material in the closure of the Gerbode defect and reconstruction of the aortic valve is essential for both early and long-term survival. Herein, we present a 62-year-old male patient whose Gerbode defect was repaired with bovine pericardium.

Pericardial patch closure of left atrial appendage orifice.

Seven patients underwent pericardial patch closure of the left atrial appendage orifice in our clinic. Usually 5-to-7 U-sutures with 4-0 prolene were placed to the left atrial appendage orifice. These sutures were stretched out to measure exact sizes of the left atrial appendage orifice.

Retractor in retractor technique.

Placing retractor and stabilization devices during open heart surgery can be difficult in obese patients due to extremely short neck and excessive breast tissue. Off-pump coronary bypass operations in these patients can be particularly technically demanding. To overcome this difficulty, we have used two retractors concomitantly.

Pulsatile oropharyngeal and neck mass caused by bilateral tortuous internal carotid artery: a case report.

The cervical course of the internal carotid artery is almost straight in contrast to the intracranial portions which are highly tortuous. The incidence of variations in the cervical course of the internal carotid artery of the population is approximately 10-40 percent. In this case report, a 76-year-old female patient with a pulsatile mass at the posterior oropharyngeal wall and anterior neck was presented.

Partial resection of mitral leaflets during mitral valve replacement.

Usually, after mitral leaflet tissue is resected, artificial chordae are used to obtain papillary muscle-to-mitral annulus continuity so as to preserve left ventricular performance. A modified technique that does not require resection of the posterior mitral leaflet and permits implantation of an adequate size of prosthesis is described.

Superior vena cava clamping for brachiocephalic vein cannulation during heart surgery.

A new central venous catheterization during open heart surgery is seldom required. Clamping of superior vena cava (SVC) causes adequate brachiocephalic vein distension which facilitates vein puncture. In our experience, approximately 20 s is enough for adequate brachiocephalic vein distension.

Massive systemic air embolism during off-pump coronary artery surgery.

In OPCAB (off-pump coronary artery bypass) operations, development of cardiac arrest during the distal anastomosis to obtuse marginal coronary artery leads to significantly low blood pressure in the ascending aorta. Therefore, blowing of compressed air in high flow on not-slinged coronary artery may cause air mobilization from the coronary artery system into the ascending aorta that may result in severe brain damage.

The concentration-dependent contractile effect of methylene blue in the human internal mammary artery: a quantitative approach to its use in the vasoplegic syndrome.

Objective: To quantitate the contractile effect of methylene blue on isolated human internal mammary artery (IMA) as used in the vasoplegic syndrome.

Design: An in vitro experimental study.

Setting: Cardiovascular Pharmacology Laboratory, Department of Medical Pharmacology.

Does continuous insulin therapy reduce postoperative supraventricular tachycardia incidence after coronary artery bypass operations in diabetic patients?

Objective: To compare continuous insulin infusion (CII) and intermittent subcutaneous insulin therapy for preventing supraventricular tachycardia. The authors propose that continuous insulin therapy is more effective to reduce supraventricular tachycardias.

Design: A prospective randomized study.

A new internal cardiac massage technique.

Classical internal cardiac massage mostly can increase systolic blood pressure to maintain sufficient brain and systemic organ perfusion but diastolic blood pressure commonly remains below 10 mmHg. To be able to increase the diastolic blood pressure sufficiently, the surgeon grabs the distal part of the ascending aorta between the thumb and index finger of the left hand and squeezes it during the diastolic time period to increase the diastolic pressure. Ascending aorta is released during ventricular squeezing, and subsequently ascending aorta is squeezed during the ventricular relaxation.

Surgical challenges for urgent approach in penetrating heart injuries.

Unlabelled: The aim of this clinical study is to assess the characteristics of penetrating heart injury and its surgical challenges for urgent surgical approach.

Materials And Methods: Seventeen patients suffering from penetrating heart wounds were evaluated retrospectively in the department of cardiovascular surgery between 1996 and 2004. All patients were male, with ages ranging from 19 to 36 years, with a mean age of 23.

Reinsertion predictors of intraaortic balloon pumps.

The reinsertion rate of intraaortic balloon pumps (IABP) has not been clearly reported. We evaluated the use of left-ventricular ejection fraction (LVEF), fractional shortening (FS), and cardiac index (CI) values to asses cardiac performance as weaning criteria for IABP in a prospective study performed in 100 patients who required IABP. Patients were randomly divided into 2 groups of 50 patients.

Anticoagulation after coronary artery surgery in patients with polycythemia vera: report of two cases.

Polycythemia vera is a myeloproliferative disorder associated with the thromboembolic events. Normalization of the hematocrit and elevated platelet counts is obligatory to reduce the thrombotic risk of patients with PV. Therapeutic strategies include phlebotomy, myelosuppressive agents, and, more recently, interferon-alpha.

A concealed penetrating cardiac injury.

We present the case of a 29-year-old man who had been the victim of a stab wound. The cardiac wound was localized in the left ventricular apex and the posterior side of the left ventricle. When he was brought to the emergency department, he had no significant symptoms related to the cardiac wound regardless of ECG changes in the V(2)-V(4) precordial derivation.

Do N-acetylcystein, beta-glucan, and coenzyme Q10 mollify myocardial ischemia-reperfusion injury?

Background: N-acetylcysteine, beta-glucan, and coenzyme Q10 have been shown to have antioxidant and anti-inflammatory effects on reperfusion injury. The aim of our study was to determine and evaluate the effects of these agents on myocardial ischemia-reperfusion injury.

Methods: Forty-four New Zealand white rabbits, all female, weighing 2.