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2020 Forum Multimedia Publishing, LLCBACKGROUND Mortality after cardiac surgery for Ebstein's anomaly ranges from 2.5% to 31%. Independent predictors for mortality and morbidity remain poorly defined because of the low incidence of this congenital anomaly. To identify potentially modifiable factors, this retrospective study investigates the prognostic value of perioperative variables for mortality and morbidity. METHODS We reviewed the charts of 171 patients with Ebstein's anomaly who were at one point in follow-up at our center. Only patients who underwent cardiac surgery for this anomaly were included. The primary endpoint was a composite of mortality or rehospitalization for cardiac reasons within 1 year of surgery. Logistic regression and Cox regression models were used to study the predictive value of various variables. RESULTS We identified 32 patients (median age 12 years; range 7 days to 70 years) who underwent a total of 49 surgical procedures for Ebstein's anomaly at our institution between November 1987 and March 2015. The following vc technical determinants. 2020 Forum Multimedia Publishing, LLCBACKGROUND The aim of this study is to compare the effects of tubing length on systemic inflammatory response syndrome and myocardial protection in a rat model of cardiopulmonary bypass (CPB) from a histological standpoint. METHODS Twelve adult male Wistar Albino rats weighing >180 g were randomly selected and divided into 2 groups. In 1 group, the pump lines were kept 1 m shorter than standard. The right jugular vein and tail artery were cannulated using a 16-gauge catheter. Animals received 500 IU/kg intravenous heparin. Cardiac index and rectal temperature were set at 2.4 mL and 36°C, respectively. Total line volume was maintained at 8 mL. A roller pump was adjusted to supply a blood flow of 6 to 28 mL/min (mean 10 mL/min), similar to the typical cardiac output of rats. CPB duration was 15 minutes throughout the experiment. After sacrifice, tissue samples were collected from heart, liver, and kidney for histomorphologic examination. RESULTS All histochemical and histomorphologic analyses, performed by 2 blinded researchers, revealed band loss in cardiomyocytes, mononuclear (MNL) cell infiltration, and impaired fibrillar organization in the standard-line group. Additionally in that group, sinusoidal dilatation in the liver, low-level congestion, focal necrosis, and periportal MNL infiltration were noted. In the shorter-line group, on the other hand, MNL cell infiltration, band loss in myofibrils, and cardiomyocyte degeneration were rarely observed. SN-38 inhibitor Higher liver congestion and lower MNL cell infiltration were observed in the shorter-line group. No significant differences were found in kidney samples. CONCLUSION In a shorter-line roller pump test model, less multiorgan damage and fewer systemic inflammatory responses were observed. It may be applicable to keep CPB lines as close to the table as possible, especially in pediatric cardiac surgery cases. 2020 Forum Multimedia Publishing, LLCA 68-year-old woman was diagnosed with scrub typhus and acute pneumonia. Acute respiratory distress syndrome (ARDS) occurred on day 4 after admission and was treated with extracorporeal membrane oxygenation (ECMO). After 7 days of ECMO assistance, her respiratory condition gradually improved, and ECMO was removed. On day 20 after admission, she was discharged without any sequelae. The results suggest that ECMO should be considered as early as possible for patients with ARDS caused by scrub typhus. 2020 Forum Multimedia Publishing, LLCOBJECTIVE Pediatric primary cardiac tumor is an extremely rare disease. The tumor can extend into the conduction system and cause malignant arrhythmias. We retrospectively reviewed 6 consecutive cases of children with primary cardiac tumor that manifested as rhythm disturbance. METHODS In our center, 6 children were enrolled from October 2009 to August 2016. Detailed operative data and follow-up information were comprehensively collected and statistically analyzed. RESULTS The patients were ages 1 to 16 years and weighed 7.9 to 44.5 kg. Preoperative ventricular tachycardia was present in 3 patients, frequent ventricular ectopic beats in 1 patient, supraventricular tachycardia in 1 patient, and atrial flutter in 1 patient. All 6 patients underwent a complete tumor resection. The tumors were localized in the left ventricular free wall (3 patients), left ventricular outflow tract (1 patient), left atrium (1 patient), and right atrium (1 patient). One patient received 2 radiofrequency ablation procedures before tumor resection. Postoperative sick sinus syndrome occurred in 1 patient because the tumor infiltrated the sinoatrial node. Tumors from 2 patients were pathologically diagnosed as fibroma and 4 as rhabdomyoma. Reoperation of mitral valve repair was performed in 1 patient 1 year after tumor resection. The mean (± SD) follow-up time was 63.7 ± 31.4 months, and all children were well, with Ross functional classification I and no signs of recurrence or metastasis. CONCLUSIONS In conclusion, cardiac tumor is a rare but nonneglectable reason for arrhythmia, and surgical resection is the optimal procedure, with satisfactory results. 2020 Forum Multimedia Publishing, LLCBACKGROUND Re-explorations soon after cardiac surgery are mostly related to bleeding or unclear hemodynamic situations possibly related to heart compression resulting from pericardial hematoma. This condition has a significant impact on mortality, morbidity, and costs. The aim of this study was to analyze indications and outcomes of re-exploration for bleeding or pericardial tamponade early after cardiac surgery in adults. METHODS The clinical data of 4790 consecutive adult patients who underwent cardiac surgery in our institution from January 2011 to May 2016 were retrospectively analyzed. RESULTS We identified 331 re-explorations performed in 231 patients. Sixty-seven of these patients had >1 re- exploration. In most cases (88%), repeat sternotomy was performed. Most procedures (57%) were performed within the first 48 hours. In two-thirds of re-explorations, active bleeding or pericardial hematoma was verified. In the remaining cases, neither bleeding nor significant pericardial hematoma leading to tamponade was found.
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