Pulmonary artery banding in the current era: Is it still useful?

Background: The objective of this study was to assess the results of the pulmonary artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary hypertension (PH) in the current era. Methods: We analyzed data from 305 patients who underwent PA banding between April 2005 and April 2010 at our centre. All patients were approached through a left thoracotomy. Twenty percent of patients underwent PA banding based on Trusler's rule (Group 1), 55 of them underwent PA banding based on PA pressure measurement (Group 2), and the rest of them (25) based on surgeon experience (Group 3). The follow-up period was 39 ± 20 month and 75 of patients (230 cases) had definitive repair at mean interval 23 ± 10 months. Results: The rate of anatomically and functionally effectiveness of PA banding in all groups was high (97 and 92, respectively). There were no significant differences in anatomically and functionally efficacy rate between all groups (P=0.77, P=0.728, respectively). There was PA bifurcation stenosis in six cases (2), and pulmonary valve injury in one case (0.3). The mortality rate in PA banding was 2 and in definitive repair was 3. Conclusions:We believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. PA banding can be done safely with low morbidity and mortality

Effect of low-dose Dopamine on lactate level in patients undergoing coronary bypass surgery

Background: The aim of this study was to study the effect of low-dose Dopamine on the blood lactate levels as a sign of visceral perfusion in coronary artery bypass graft surgery (CABG) patients. Methods: In a double-blinded, randomized clinical trial, 100 adult patients - who were candidated for elective isolated CABG surgery - were divided equally into two groups of low-dose Dopamine group (2 μg / kg / min) and control group (n=50 in each). Lactate levels, arterial blood gas analyses, blood pressure, and heart rate were recorded intraoperatively at four time points: before the induction of anesthesia; 15 minutes after the beginning of cardiopulmonary bypass (CPB); during CPB at rewarming to 34°C; and 15 minutes after separation from CPB. These biochemical and hemodynamic parameters were compared in these four time points between the two study groups. Results: Arterial blood gas and hemodynamic parameters were similar between the two groups during surgery (p values > 0.05). There were no significant differences between the lactate levels in the Dopamine and control groups at the beginning of CPB (3.1 ± 2.5 vs. 2.6 ± 2.0 mg/dl; p value = 0.453), at the time of rewarming (3.1 ± 2.5 vs. 2.6 ± 2.0 mg/dl; p value = 0.510), and after CPB (3.1 ± 2.5 vs. 2.6 ± 2.0 mg/dl; p value = 0.551) - respectively. Conclusions: The use of low-dose Dopamine did not decrease lactate levels in our CABG patients using CPB

Demographic characteristics of the diabetic, prediabetic and healthy groups for estimation of the thyroid disease incidence.

<p>Demographic characteristics of the diabetic, prediabetic and healthy groups for estimation of the thyroid disease incidence.</p

Basal characteristics of the diabetic, prediabetic and healthy groups.

<p>Basal characteristics of the diabetic, prediabetic and healthy groups.</p

ROC curve for the comparison of baseline TSH with TPOAb as the predictive factors for the incidence of thyroid disease

<p>ROC curve for the comparison of baseline TSH with TPOAb as the predictive factors for the incidence of thyroid disease</p

Comparison of the prevalence of thyroid disease among diabetic, prediabetic and healthy groups^*.

<p>Comparison of the prevalence of thyroid disease among diabetic, prediabetic and healthy groups^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0184808#t002fn002" target="_blank">*</a>}.</p

Kaplan Meier curve for the cumulative incidence hazard of thyroid disease according to serum TPOAb and normal baseline TSH.

<p>Kaplan Meier curve for the cumulative incidence hazard of thyroid disease according to serum TPOAb and normal baseline TSH.</p

The effect of several co-variants on the incidence of thyroid dysfunction in the diabetic, prediabetic and healthy groups, based on multivariant logistic regression analysis.

<p>The effect of several co-variants on the incidence of thyroid dysfunction in the diabetic, prediabetic and healthy groups, based on multivariant logistic regression analysis.</p

Comparison of the incidence of thyroid disease in the diabetic, prediabetic and healthy.

<p>Comparison of the incidence of thyroid disease in the diabetic, prediabetic and healthy.</p