Warm Blood Cardioplegia for Myocardial Protection: Concepts and Controversies

Abstract Warm blood cardioplegia has been an established cardioplegic method since the 1990s, yet it remains controversial in regard to myocardial protection. This review will describe the physiologic and technical concepts behind warm blood cardioplegia, as well as outline the current basic and clinical research that evaluates its usefulness. Controversies regarding this technique will also be reviewed. A long history of experimental data indicates that warm blood cardioplegia is safe and effective and thus suitable myocardial protection during cardiopulmonary bypass surgeries

Use of fibrin sealants in cardiovascular surgery: a systematic review

BACKGROUND: Fibrin sealants are used for hemostasis and tissue adherence. AIM OF STUDY: This systematic review summarizes published clinical data for fibrin sealant use in cardiovascular surgery. METHODS: A literature search for the following terms was conducted using PubMed and EMBASE: (TISSEEL or Tissucol or Beriplast P or Evicel or Quixil or Crosseal or Reliseal or Fibringluraas or Bolheal or Tachosil or Vivostat or Vitagel or Artiss or fibrin glue or fibrin sealant or fibrin tissue adhesive ) and (cardiac or cardiovascular or vascular or heart or coronary or surgery). Case reports and series were excluded; although reports of controlled trials were preferred, uncontrolled trial data were also considered. RESULTS: Clinical trials and chart review analyses of fibrin sealants were identified and summarized. Although clinical trial data were available for other agents, the majority of published studies examined TISSEEL. Overall, TISSEEL and other fibrin sealants showed improvements over standard of care or control groups for a variety of predefined endpoints. Safety findings are also summarized. CONCLUSIONS: Data from these studies showed that fibrin sealants were well tolerated and provided effective hemostasis in a range of cardiac and aortic surgeries. doi: 10.1111/jocs.12099 (J Card Surg 2013;28:238-247)

A double overlap suture technique for the proximal attachment of a composite graft to the aortic annulus.

Repair of an aortic root aneurysm using a composite graft is sometimes complicated by proximal suture line bleeding, which may be very difficult to control. We adopted a previously described technique of double overlap sutures on the annulus

Entrapment of an arterial pressure catheter by a previously deployed Starclose device

Herein is a case report description of entrapment of an arterial pressure line by a previously deployed Starclose device. This device is widely used to control femoral artery puncture site following diagnostic catheterization. Copyright © 2010 Wiley-Liss, Inc

Unexpected traumatic rupture of left atrium mimicking aortic rupture

Left atrial (LA) rupture is rare following blunt chest injury. We describe a case of blunt LA rupture that was treated surgically. This report is intended to alert practitioners for a need of a close multiple disciplinary collaborations among them for optimal management of patients with this type of trauma; because other non-cardiac injuries involving the head, abdomen, or extremities are considered covariates for in-hospital mortality. As in the present case, the patient eventually died from associated extrathoracic injuries. The diagnosis of LA rupture is by exclusion. However, the initial radiological reading may be misinterpreted, because this injury can easily be mistaking for an aortic rupture. The final reappraisal of the chest imaging studies should be interpreted by a skilled radiologist to avoid misdiagnosis. Subtle radiological features can help distinguish aortic thoracic injury as illustrated in this patient. These factors may be useful to the practicing surgeon in deciding surgical approach

Is there a role for surgery in the management of giant B-cell right atrial lymphoma?

We describe a case of a giant right atrial large B-cell lymphoma treated with initial surgical excision followed by postoperative chemotherapy. The patient had no clinical evidence of recurrence through 87 months after her hospital discharge. To our knowledge, this is the first reported case of long-term survival following this method of disease management. The discussion reviews the current status of chemotherapy for cardiac lymphomas and the pros and cons of treatment option algorithms. © 2010 Wiley Periodicals, Inc

Aorto-pulmonary artery disruption following acute type-A aortic dissection repair with the use of BioGlue®.

We report an extremely rare complication of a delayed aorto-pulmonary artery wall disruption with false aneurysm formation after repair of acute type-A aortic dissection with BioGlue®. The potential role of BioGlue® in this complication is the subject of this report. © 2012 Wiley Periodicals, Inc