Effect of computed tomography before cardiac surgery on surgical strategy, mortality and stroke.

Aim: To investigate whether preoperative chest computed tomography (CT) decreases postoperative mortality and stroke rate in cardiac surgery by detection of calcifications and visualization of postoperative anatomy in redo cardiac surgery which can be used to optimize the surgical approach.

Methods: The PubMed, EMBASE and Cochrane databases were searched and articles concerning preoperative CT in cardiac surgery were included. Articles not reporting mortality, stroke rate or change in surgical approach were excluded.

Correct positioning of central venous catheters using a new electric method.

Purpose: In order to find the correct final position of the tip of a central venous catheter, we have developed a new electric method (the Proximity of Cardiac Motion (PCM) method), designed to work in tandem with the existing ECG-based method.

Methods: A small, patient-safe, high-frequency current is fed through the catheter (via the saline-filled lumen of the catheter, or a stylet). Simultaneously, the resulting voltage is measured by two electrodes on the frontal thoracic skin.

Delirium detection using EEG: what and how to measure.

Background: Despite its frequency and impact, delirium is poorly recognized in postoperative and critically ill patients. EEG is highly sensitive to delirium but, as currently used, it is not diagnostic. To develop an EEG-based tool for delirium detection with a limited number of electrodes, we determined the optimal electrode derivation and EEG characteristic to discriminate delirium from nondelirium.

Crossed wiring closure technique for bilateral transverse thoracosternotomy is associated with less sternal dehiscence after bilateral sequential lung transplantation.

Objective: Bilateral transverse thoracosternotomy (clamshell incision) is a widely used approach in bilateral sequential lung transplantation, but the closure technique is associated with sternal dehiscence. This study compares the incidence of sternal dehiscence between the crossed and uncrossed closure techniques.

Methods: In 129 patients who underwent transplantation through a clamshell incision, the sternum was closed using either the crossed or the uncrossed method based on the surgeon's preference.

Staphylococcus aureus pericardial abscess presenting as a localized bulge of the heart contour.

Purulent pericarditis usually presents as an acute illness with diffuse involvement of the whole pericardium, but can rarely present as a localized effusion. Here, we present a patient with a pericardial abscess caused by Staphylococcus aureus. After surgical drainage of the abscess, the patient made a good recovery.

Hemodynamic and clinical correlates of endothelin-1 in chronic thromboembolic pulmonary hypertension.

Background: In non-thromboembolic pulmonary hypertension, endothelin (ET)-1 levels are increased and correlate with the hemodynamic severity of the disease. Whether such correlations exist in chronic thromboembolic pulmonary hypertension (CTEPH) is unknown, nor whether ET-1 levels correlate with hemodynamic outcome after pulmonary endarterectomy (PEA).

Methods And Results: ET-1 levels were determined by ELISA.