RESUMEN
PURPOSE: To show the effects on lung function of the opening pleura in patients undergoing cardiac surgery. SUBJECTS AND METHODS: 66 patients were included. Patients were allocated into two groups. In group 1 (n=21) pleura was intact, in group 2 (n=45) pleura was opened. Both groups were compared prospectively in terms of preoperative and on the post-operative 5th day pulmonary function tests (PFT), preoperative, postoperative first and fifth day arterial blood gas analysis, preoperative and postoperative first day mixt venous oxygen saturation, bleeding, operation periods, pulmonary complications, intensive care and hospital stay period and mortality. RESULTS: There was significant decrease in all PFT indicators on 5th post-operative day in group 2 (p < 0.01). Although there was a significant decrease in FEV1 on 5th post-operative day in group 1 (p < 0.001), other pulmonary functions parameters were not change significantly (p > 0.025). In group 2 much more decline in pulmonary function test parameters than group 1 were observed (p < 0.05). There was not statistically significant difference in blood gas analysis and mixed venous oxygen saturation values in group 1 (p > 0.05). But in group 2 except pH and PaCO2, other blood gas measurements were significantly decreased on the postoperative first and fifth day (p < 0.008). In group 2 except pH and PCO2, other parameters were less than the other Group (p < 0.01). The drained amount was still significantly higher in group 2 (p < 0.001). The frequency of the revision due to bleeding was observed much more in group 2. CONCLUSIONS: Protection of the integrity of pleura may have positive effects on pulmonary functions in cardiac surgery.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Enfermedades Pulmonares/etiología , Pleura/metabolismo , Complicaciones Posoperatorias/epidemiología , Adulto , Anciano , Análisis de los Gases de la Sangre , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Femenino , Estudios de Seguimiento , Hospitalización , Humanos , Concentración de Iones de Hidrógeno , Unidades de Cuidados Intensivos , Tiempo de Internación , Enfermedades Pulmonares/fisiopatología , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Estudios Prospectivos , Pruebas de Función RespiratoriaRESUMEN
Chylomediastinum is a rare but potentially serious complication. There is as yet no definitive treatment. We present an exceptional case of chylomediastinum due to mitral valve replacement. The patient was successfully treated using a conservative approach with total parenteral nutrition, nothing by mouth, and mediastinal tube drainage.
Asunto(s)
Quilotórax/etiología , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Enfermedades del Mediastino/etiología , Insuficiencia de la Válvula Mitral/cirugía , Estenosis de la Válvula Mitral/cirugía , Anciano , Quilotórax/terapia , Drenaje , Femenino , Humanos , Enfermedades del Mediastino/terapia , Nutrición Parenteral Total , Resultado del TratamientoRESUMEN
Surgical repair of postductal aortic coarctation associated with severe coronary artery disease is in most cases a difficult decision to make. As staged procedures are associated with a higher rate of morbidity and mortality, simultaneous operative management of both pathologies is desirable. We describe a case of a 51-year-old man who was referred to our department for surgical treatment of postductal aortic coarctation and concomitant coronary artery disease, which we managed with single-stage surgery through median sternotomy.