The effects of protamine overdose on coagulation parameters as measured by the thrombelastograph.

Background And Objective: Protamine is routinely administered following cardiopulmonary bypass in order to neutralize the effects of heparin. An excess of protamine can contribute to coagulopathy, hence predisposing to bleeding with associated morbidity and mortality. Thromboelastography (TEG) is recognized as an invaluable bedside tool to detect coagulation parameters; however, the effects of protamine overdose on TEG parameters have not been fully established.

Segmental mediolytic arteriopathy with post-transplant lymphoproliferative disorder of the lung: case report and review of the literature.

Segmental mediolytic arteriopathy (SMA) is an extremely rare condition of uncertain etiology causing degeneration of arterial media, intramural dissection or the rupture of aneurysms. It is recognized as a rare cause of fatal intra-abdominal bleeding. We report the first case of recurrent intra-abdominal bleeding secondary to SMA in a lung transplant patient, with a further complication of lymphoproliferative disease in the transplanted lung.

Does preoperative computed tomography reduce the risks associated with re-do cardiac surgery?

A best evidence topic was written according to the structured protocol. The question addressed was whether preoperative computed tomography (CT) scan reduces the risk associated with re-do cardiac surgery. A Medline search revealed 412 papers, of which seven were deemed relevant to the topic.

Early experience with the Levitronix Centrimag device for extra-corporeal membrane oxygenation following lung transplantation.

Extra-corporeal membrane oxygenation (ECMO) is accepted as a salvage therapy to treat life-threatening complications following lung transplantation such as primary graft dysfunction, acute rejection or airway dehiscence. Levitronix Centrimag (Levitronix LLC, Waltham, MA) is a centrifugal pump that consists of a magnetically levitated bearing-less rotor designed to reduce blood friction. ECMO using the Levitronix Centrimag pump may be an ideal medium-term support for lung transplant recipients suffering these serious complications.

Alteration in transthoracic impedance following cardiac surgery.

Introduction: Haemodynamically significant ventricular tachyarrhythmias are a frequent complication in the immediate post-operative period after cardiac surgery. Successful cardioversion depends on delivery of sufficient current, which in turn is dependent on transthoracic impedance (TTI). However, it is uncertain if there is a change in TTI immediately following cardiac surgery using cardiopulmonary bypass (CPB).

Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature.

Background: Lung transplantation (LTx) is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in these patients, serious airway complications like bronchopleural fistula (BPF) are rare, and their management is very difficult.

Case Presentation: A 47-year-old man with end-stage respiratory failure due to cystic fibrosis underwent bilateral sequential lung transplantation.

Clinical outcomes in coronary artery bypass graft surgery: comparison of off-pump and on-pump techniques.

Background: A consecutive series of patients undergoing first-time coronary artery bypass graft (CABG) surgery were analyzed and the impact of off-pump surgery was evaluated.

Methods: From January 1, 2000 to December 31, 2000, 367 patients underwent isolated first-time CABG surgery. One hundred and twenty underwent off-pump CABG (Group A, 32.