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Ghosh S Jutley RS Wraighte P Shajar M Naik SK 《The Journal of heart valve disease》2004,13(4):622-7; discussion 627-9
BACKGROUND AND AIM OF THE STUDY: Mitral valve surgery in the presence of poor left ventricular (LV) function is associated with higher mortality. One surgeon's (S. K. N.) evolving practice of mitral valve surgery on the beating heart using normothermic cardiopulmonary bypass (CPB) in a cohort of patients is described. METHODS: Between July 2000 and December 2002, 23 patients (13 men, 10 women; mean age 68.6 +/- 4.8 years; range: 54-81 years) with mitral regurgitation and LV ejection fraction <30% undergoing isolated mitral valve repair (n = 4) or replacement (n = 19) were investigated. All patients received maximal drug therapy. Among patients, 17 were in NYHA class III, and six in class IV. RESULTS: The mean duration of follow up was 17 +/- 14 months, and was complete for all survivors. The visual field of the on-pump beating heart was equal to that of conventional valvular surgery, and technical accuracy was not compromised. The mean ICU and hospital stays were 2.4 +/- 1.3 days and 8.9 +/- 2.6 days, respectively. Mean CPB time was 74.3 +/- 14.8 min. Thirty-day mortality was significantly lower (8.7%) when compared to mean Euroscore-predicted mortality for this high-risk group (16.9%; p <0.001). The medium-term one- and two-year survivals were 87% and 78%, respectively. Mean NYHA class was improved, from 3.6 +/- 0.5 preoperatively to 1.9 +/- 0.7 at follow up (p = 0.037). CONCLUSION: On-pump, beating-heart mitral valve surgery is a good option in patients with poor LV function, and is advantageous as conditions for the heart are more physiological with a beating tonus than with cardioplegia. 相似文献
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Kanwal Afshan Ahmad Matloob Aslam Sana Naqvi Syed Ali Raza Saif Muhammad Jawwad 《Pharmaceutical Chemistry Journal》2019,53(3):179-187
Pharmaceutical Chemistry Journal - Benzimidazole ring system is well known for its potential for various biological activities. Recent research works have indicated the excellent antiviral... 相似文献
44.
Effect of a remifentanil bolus dose on the cardiovascular response to emergence from anaesthesia and tracheal extubation 总被引:9,自引:0,他引:9
We have examined the effect of remifentanil on the haemodynamic response to
emergence from anaesthesia and tracheal extubation in 40 ASA I-II female
patients undergoing diagnostic laparoscopy, in a randomized, double-blind
study. All patients received a standard general anaesthetic comprising
propofol, vecuronium and 1% isoflurane with 66% nitrous oxide in oxygen. At
the end of surgery, a bolus dose of remifentanil 1 microgram kg-1 (n = 20)
or saline placebo (n = 20) was given and tracheal extubation was performed
when standard criteria were achieved. Arterial pressure and heart rate were
recorded non- invasively at 1-min intervals from the end of surgery.
Remifentanil attenuated the increase in both mean arterial pressure (P <
0.001) and heart rate (P < 0.05) at extubation. Mean time to extubation
was 7.2 (SEM 0.6) min and 4.0 (0.5) min in the remifentanil and saline
groups, respectively (P < 0.001). There was no difference in the
incidence of coughing at extubation, time to recovery from anaesthesia or
time to fitness for discharge from the recovery room.
相似文献
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Minimal access mitral valve replacement 总被引:1,自引:0,他引:1
Richens D Jutley RS Baker M Shajar M 《Journal of the Royal College of Surgeons of Edinburgh》2002,47(5):676-680
Minimally invasive mitral valve surgery has recently been advocated as an alternative to the conventional median sternotomy approach. It has several documented advantages and requires a close relationship betweeen the surgeons, anaesthetist and perfusionist for a successful outcome. This article demonstrates our surgical technique for replacement of the mitral valve. The various aspects of the specialised equipment used are also described. 相似文献