www ctspap gr Cardiothoracic surgery Dept G Papanikolaou
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Cardiothoracic surgery Dept “G. Papanikolaou” vs STS national averages, 30 -d mortality isolated CABG
Cardiothoracic surgery Dept “G. Papanikolaou” vs STS national averages, 30 -d mortality CABG, VALVES, CABG+VALVES
Cardiothoracic surgery Dept “G. Papanikolaou” vs STS national averages On-pump isolated CABG, major complications or operative mortality observed rate
Cardiothoracic surgery Dept “G. Papanikolaou” vs STS national averages On-pump isolated CABG, renal failure observed rate
Cardiothoracic surgery Dept “G. Papanikolaou”, perioperative MI • • 2011 STS data PMI – elevation of biomarkers (CK or Troponine) to > 5 of the normal during the first 72 h after a CABG plus i. new Q waves or LBBB or ii. Angiographically documented or iii. Imaging evidence of new loss of viable myocardium
Cardiothoracic surgery Dept “G. Papanikolaou” vs STS national averages On-pump isolated CABG, reoperation for bleeding • 7/109 - 6. 4% • CABG - 5/74 6. 7%
ΣΥΓΓΡΑΦΙΚΗ ΔΡΑΣΤΗΡΙΟΤΗΤΑ Neutrophil Gelatinase-Associated Lipocalin as emerging biomarker of acute renal failure in renal transplant patient after coronary artery bypass surgery. Ampatzidou F, Koutsogiannidis C, Ananiadou O, Liosi M, Asteri T, Drossos G. J Cardiovasc Surg (Torino). 2012 Jan 17. [Epub ahead of print] Acute renal injury (AKI) is a serious complication, which increases the risk of death after cardiac surgery. Although serum Cre is typically used for diagnosis of AKI, there are disadvantages in its use as renal marker. Neutrophil gelatinase-associated lipocalin (NGAL) is a protein of the lipocalin family and is expressed by neutrophils and other epithelial cells including segments of proximal collecting tubule (PCT). We present an interesting case of renal transplant patient under long term immunosuppressive therapy. He had already renal impairment of the transplant kidney (GFR 29, 3 ml/min/1, 73 m 2). He suffered from coronary artery disease without history of myocardial infraction and underwent elective coronary artery bypass grafting (CABG). Renal function was monitored also with NAGL, in order to avoid potential renal graft failure postoperatively. IF 1. 352
ΣΥΓΓΡΑΦΙΚΗ ΔΡΑΣΤΗΡΙΟΤΗΤΑ Noninvasive positive pressure ventilation for post-pneumonectomy early acute respiratory distress syndrome. Koutsogiannidis C, Ampatzidou F, Ananiadou O, Karaiskos T, Drossos G. Respir Care. 2012 Feb 17. [Epub ahead of print] Acute respiratory distress syndrome (ARDS) remains a lethal complication after major lung resections. The reported mortality ranges from 50% to 100%, with increased incidence and mortality rates in pneumonectomy patients. The pathogenesis of early ARDS is still not fully understood and the majority of patients will require mechanical ventilation. A review of the literature reveals that the role of noninvasive positive pressure ventilation (NPPV) in ARDS after lung resection is unclear, in contrast to its well established benefits in other types of respiratory failure. NPPV is a technique of augmenting alveolar ventilation delivered by facemask, without introducing endotracheal tube. NPPV may reduce the need for endotracheal mechanical ventilation and improve clinical outcome in patients with acute respiratory failure after lung resection, avoiding complications related to intubation. We present a case of early ARDS following left-sided pneumonectomy, where Bi-level Positive Airway Pressure ventilation prompted a successful outcome. IF 1. 52
ΣΥΓΓΡΑΦΙΚΗ ΔΡΑΣΤΗΡΙΟΤΗΤΑ Aortic root aneurysm in an adult patient with aortic coarctation: a single stage approach. Olga G Ananiadou, Charilaos Koutsogiannidis, Fotini Ampatzidou, George E Drossos Interact Cardiovasc Thorac Surg. (accepted) Coarctation of the aorta is a common congenital defect that may be undiagnosed until adulthood. Moreover, coarctation is associated with congenital and acquired cardiac pathology that may require surgical intervention. Management of an adult patient with aortic coarctationand an associated cardiac defect poses a great technical challenge since there are no standard guidelines forthe therapy of such complex pathology. Several extra-anatomic bypass grafting techniques have been described, including methods in which distal anastomosis is performed on descending thoracic aorta, allowing simultaneous intracardiac repair. We report herein a 37 -year-old man who was diagnosed with aortic root aneurysm and aortic coarctation. The patient was treated electively with a single-stage approach through a median sternotomy, that consisted of valve-sparing replacement of the aortic root and ascending-to-descending extra-anatomic aortic bypass, using a 18 -mm Dacron graft. Firstly, the aortic root was replaced with Yacoubremodeling procedure, and then the distal anastomosis was performed to the descending aorta, behind the heart, with the posterior pericardial approach. The extra-anatomic bypass graft was brought laterally from the right atrium and implanted in the ascending graft. Postoperative recovery was uneventful and a control computed tomographic angiogram one month after complete repair showed good results.
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