tailieunhanh - Báo cáo y học: " “The non-ischemic repair” as a safe alternative method for repair of anterior post-infarction VSD"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: “The non-ischemic repair” as a safe alternative method for repair of anterior post-infarction VSD. | Apostolakis et al. Journal of Cardiothoracic Surgery 2010 5 6 http content 5 1 6 JOTS JOURNAL OF CARDIOTHORACIC SURGERY STUDY PROTOCOL Open Access The non-ischemic repair as a safe alternative method for repair of anterior post-infarction VSD Efstratios E Apostolakis 1 Antonios Kallikourdis2 Nikolaos G Baikoussis1 Panagiotis Dedeilias3 Dimitrios Dougenis1 Abstract Patient s myocardium with post-infarction ventricular septum defect VSD is characterized by severe dysfunction. The additive ischemia caused by the operating process of cross-clamp ischemia and reperfusion injury has a significant aggravation to the myocardium and overall negative impact to patient s outcome. We present a useful safe and advantageous methodology in order to abolish the toxic phase of ischemia-reperfusion which is adopted by most as the classic repair method of myocardial protection. This abolition is in our opinion particularly beneficial in order to reverse postoperatively the Low Cardiac Output Syndrome LOS and achieve better short and long term results. By using this method we avoid the aortic occlusion the use of systematic hypothermia and any cardioplegic arrest. Furthermore the total cardio-pulmonary bypass CPB time is significantly reduced tissue debridement and stitching is much easier and safer. We think the method is applicable for every anterior and apical case of post-infarction septum rupture. After application of method in 3 patients with anterior postmyocardial infarction VSD we are convinced that the patient will have a better postoperative haemodynamic condition and therefore a better outcome. Introduction The rupture of the interventricular septum after myocardial infarction constitutes a severe mechanical complication of the coronary artery disease with very high surgical mortality 19-50 and morbidity 1 2 . Many factors contribute to an unfavourable surgical outcome such as the emergency the coexisting 3-vessel coronary artery disease the .