2016年12月20日 星期二

2016年12月19日 星期一

Clinical Results of Single-Vessel versus Multiple-Vessel Infrapopliteal Intervention

根據鹿特丹醫療團隊的研究
對於膝下的 CLI (critical limb ischemia)治療
multi-vessel intervention 並沒有比 single-vessel intervention 的 outcome 好

Journal of Vascular Surgery
Vol.64 , No.6

2016年12月12日 星期一

case report : TE fistula with ASD occluder and mitral disc impingement after TAVI

case 1. the small TEF was treated with Gore ASD occluder successfully
case 2. single disc mitral prosthesis was malfunctioned after TAVI procedure

2016年12月5日 星期一

SYNTAX score and decision making b/w PCI and CABG

cardiac death from MI is 10 times higher in PCI group than CABG group in high risk patients.
surgery is recommended for 3VD patients with intermediate to high SYNTAX score.
surgery is recommended for LM patients with high SYNTAX score.

 J of thoracic and cardiovascular surgery, volume 152, Nov 5

comment : 我們應該強裂建議  1. heart team approach
                                                    2. SYNTAX score

2016年11月28日 星期一

Comparison b/w antegrade and retrograde cerebral perfusion or profound hypothermia as brain protection strategies during repair of type A aortic dissection

from university of Iowa hospitals and clinics :

During surgical repair of type A aortic dissection, ACP,RCP, or DHCA have acceptable morbidity and mortality in selected patients.

The presence of hemodynamic instability prior to surgery and prolonged CPB time increases the risk of early and late mortality regardless of cerebral protection strategy.

Ann Cardiothoracic Surg 2016;5(4): 328-335

comment : selective antegrade brain perfusion 目前為本院使用模式,請大家要熟悉

2016年11月14日 星期一

Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

Transamin in CABG

1. lower risk of bleeding
2. without higher risk of death or thrombo-embolic events in 30 days post-op
3. higher risk of post-op seizure

Oct 23,2016 Doi:0.1056
NEJM oa1606424

comment: 本院 CPB使用 transamin 的時機為 pre- and post- CPB
                  dosage : 20mg/kg each