Dexmedetomidine infusion for analgesia up to 48 hours after lung surgery performed by lateral thoracotomy.

Patients undergoing a lateral thoracotomy for pulmonary resection have moderate to severe pain postoperatively that is often treated with opioids. Opioid side effects such as respiratory depression can be devastating in patients with already compromised respiratory function. This prospective double-blinded clinical trial examined the analgesic effects and safety of a dexmedetomidine infusion for postthoracotomy patients when administered on a telemetry nursing floor, 24 to 48 hours after surgery, to determine if the drug's known early opioid-sparing properties were maintained.

Postoperative chylothorax successfully treated using conservative strategies.

The anatomy of the thoracic duct varies considerably, rendering it prone to disruption during thoracic surgery. Chylothorax complicates up to 0.5% of all intrathoracic procedures, its morbidity requiring the surgeon's vigilance throughout the entire course of the patient's illness.

Transmyocardial laser revascularization causes sustained VEGF secretion.

Transmyocardial laser revascularization (TMR) using a carbon dioxide (CO(2)) laser has been shown to relieve angina, increase vascular density, and improve myocardial contraction. A study of 28 patients receiving TMR was conducted to monitor vascular endothelial growth factor (VEGF) levels with the goal of clarifying the relationship between TMR, the amelioration of angina, and vascular density. Serum VEGF levels were measured during four periods (preoperative, postoperative, convalescence, and late) in these 28 patients who received sole therapy TMR for un-revascularizable ischemic angina and the levels were compared with the control group consisting of 10 nonischemic thoracotomy patients.

Cardiopulmonary bypass and mitral valve replacement during pregnancy.

Gravid patient cardiopulmonary bypass remains a high-risk procedure with regard to fetal preservation. Maternal mortality is similar to that of the nonpregnant female at 1.5-5%.

Epicardial atrial defibrillation: successful treatment of postoperative atrial fibrillation.

Background: Atrial fibrillation is the most common complication after cardiac surgery. Current medical treatment using antiarrhythmics and anticoagulants has a significant morbidity. The goal of this study was to determine if epicardial atrial defibrillation can be safely performed and return patients to sinus rhythm.

Clinical benefits of leukocyte filtration during valve surgery.

Background: The accumulation of activated leukocytes in the pulmonary circulation plays an important role in the pathogenesis of lung dysfunction associated with cardiopulmonary bypass (CPB). Patients undergoing valve surgery have prolonged CPB owing to the complexity of the surgery. The goal of this study is to determine if arterial leukocyte filters during CPB improve clinical outcomes after valve surgery.

Successful diagnosis of penetrating cardiac injury using surgeon-performed sonography.

Background: Patients with penetrating cardiac injuries have a high mortality. The utilization of sonography in these patients may lead to earlier diagnosis and definitive surgical intervention.

Methods: A retrospective review of all patients admitted to a level I trauma center were examined from March 1996 to March 2001 (17,241 patients).