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<1>
Accession Number
2010324203
Authors
Vaziri M.T.M. Jouibar R. Akhlagh S.H.A. Janati M.
Institution
(Vaziri, Jouibar, Akhlagh) Department of Anesthesiology, Faghihi Hospital,
Nemazee Hospital Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of.
(Janati) Department of Surgery, Division ofCardiovascular Surgery, Nemazee
Hospital Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of.
Title
The effect of lidocaine and magnesium sulfate on prevention of ventricular
fibrillation in coronary artery bypass grafting surgery.
Source
Iranian Red Crescent Medical Journal. 12(3)(pp 298-301), 2010. Date of
Publication: 2010.
Publisher
Iranian Red Crescent Society
Abstract
Background: One of the most common events, after the release of aortic
cross-clamp in patients undergoing coronary artery bypass grafting surgery
is reperfusion induced ventricular fibrillation, which occurs in 74% of
96% of patients. Regarding the controversies over the use of lidocaine or
magnesium sulfate for the prevention of ventricular fibrillation following
the release of aortic cross-clamp, this study was designed to compare the
effectiveness of magnesium sulfate and lidocaine to suppress ventricular
fibrillation. Methods: In a double blind, prospective, randomized,
controlled trial study, 76 patients who were candidates for elective
coronary artery bypass grafting surgery were divided into three groups
including Group A (lidocaine, n=26), group B (magnesium sulfate, n=25),
and group C (normal saline, n=26). Lidocaine (1.5 mg/Kg), magnesium
sulfate (30 mg/Kg) and normal saline were administered 5 minutes before
the release of aortic cross clamp. Results: The incidence of ventricular
fibrillation significantly decreased in patients receiving magnesium
sulfate (12% vs. 26.9% and 44% in patients who received lidocaine and
normal saline, respectively) There was no statistically significant
difference between the groups with respect to age, ejection fraction (L/
min), anesthetic time (min), cross-clamping time (min), PH, HCT (%), and
serum K+ level (meq). Conclusion: The administration of lidocaine and
magnesium sulfate before the release of aortic cross-clamp reduces the
incidence of postoperative ventricular fibrillation in adult patients
undergoing coronary artery bypass grafting surgery with cardiopulmonary
bypass. In our study, magnesium sulfate was more efficient in prevention
of ventricular fibrillation than lidocaine. Administration of magnesium
sulfate (30 mg/kg) caused no toxic effect and wais safe for patients
undergoing coronary artery bypass grafting surgery with cardiopulmonary
bypass. copyright Iranian Red Crescent Medical Journal.
<2>
Accession Number
2010320725
Authors
Auer J. Leitner A. Berent R. Lamm G. Lassnig E. Krennmair G.
Institution
(Auer) General Hospital Braunau, Austria.
(Auer, Leitner, Lassnig) General Hospital Wels, Austria.
(Auer) General Hospital Simbach, Germany.
(Berent) Center for Cardiovascular Rehabilitation, Bad Schallerbach,
Austria.
(Lamm) General Hospital St. Polten, Austria.
(Krennmair) Medical University Vienna, Austria.
Title
Long-term outcomes following coronary drug-eluting- and bare-metal-stent
implantation.
Source
Atherosclerosis. 210(2)(pp 503-509), 2010. Date of Publication: June
2010.
Publisher
Elsevier Ireland Ltd
Abstract
Background: Although drug-eluting stents (DES) reduce restenosis rates
relative to bare-metal stents (BMS), recent reports have indicated that
the use of DES may be associated with an increased risk of stent
thrombosis. Our study focused on the effect of stent type on clinical
outcomes in a " real world" setting. Methods: 889 patients undergoing
percutaneous coronary intervention (PCI) with either DES (Cypher or Taxus;
n= 490) or BMS (n= 399) were enrolled in a prospective single center
registry. The outcome analysis covered a period of up to 3.2 years (mean
2.7 years +/- 0.5 years) and was based on 65 deaths, 27 myocardial
infarctions, 76 clinically driven target lesion revascularizations (TLR),
and 15 angiographically confirmed cases of definite stent thrombosis and
was adjusted for differences in baseline characteristics. Results: In
total 1277 stents (613 BMS and 664 DES) were implanted in 1215 lesions.
Despite a significantly different unadjusted death rate (10.1% and 5.1% in
BMS and DES patients, respectively; p<. 0.05), the patient groups did not
differ significantly in the risk of myocardial infarction during 2.7 years
of follow-up. After adjustment for differences in baseline characteristics
between groups, the difference in the cumulative incidence of death did
not remain statistically significant (p= 0.22). Target lesion
revascularizations occurred significantly less frequently in patients with
DES compared to individuals after BMS implantation (5.9% and 11.8% in
patients with DES and BMS, respectively; p<. 0.05). The rate of
angiographically confirmed stent thrombosis was 2.1% in patients with DES
and 1.1% in BMS patients (p= 0.31). There was a significantly lower
unadjusted event rate (including deaths, myocardial infarction, target
lesion revascularization, and stent thrombosis) in patients with
drug-eluting stents than in those with bare-metal stents (16.4% and 25.8%,
respectively), with 9.4 fewer such events per 100 patients (unadjusted
hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.46 to 0.87).
After adjustment, the relative risk for all outcome events in patients
with drug-eluting stents was 0.79 (95% CI, 0.67 to 0.95). However, the
adjusted relative risk for death and myocardial infarction did not differ
significantly between groups (adjusted relative risk in patients with
drug-eluting stents 0.94 (95% CI, 0.77 to 1.37)). Conclusions: In this
real-world population, the beneficial effect of first generation DES in
reducing the need for new revascularization compared with BMS extends to
more than 2.5 years without evidence of a worse safety profile. The minor
risk of stent thrombosis and myocardial infarction within this period
after implantation of DES seems unlikely to outweigh the benefit of these
stents. copyright 2009 Elsevier Ireland Ltd.
<3>
Accession Number
2010355528
Authors
Jain S. Vaidyanathan B.
Institution
(Jain, Vaidyanathan) Department of Pediatric Cardiology, Amrita Institute
of Medical Sciences, Kochi, India.
Title
Oral anticoagulants in pediatric cardiac practice: A systematic review of
the literature.
Source
Annals of Pediatric Cardiology. 3(1)(pp 31-34), 2010. Date of
Publication: 01 Jan 2010.
Publisher
Medknow Publications and Media Pvt. Ltd
Abstract
Recent advances in the pediatric heart surgery, especially the Fontan
procedure, has necessitated an increased use of oral anticoagulants in
pediatric cardiac patients. Warfarin is the standard agent used for most
pediatric indications, though there are very few randomized control
studies in children regarding its use. This review summarizes the current
indications and evidence base regarding the use of oral anticoagulants in
the pediatric age group.
<4>
Accession Number
2010308610
Authors
Shah A.J. Liu X. Jadidi A.S. Haissaguerre M.
Institution
(Shah, Liu, Jadidi, Haissaguerre) Hopital Cardiologique du Haut-Levque,
University Hospital of Bordeaux, Avenue de Magellan, 33604 Pessac, France.
Title
Early management of atrial fibrillation: From imaging to drugs to
ablation.
Source
Nature Reviews Cardiology. 7(6)(pp 345-354), 2010. Date of Publication:
June 2010.
Publisher
Nature Publishing Group
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and is
responsible for the highest number of rhythm-related disorders and
cardioembolic strokes worldwide. Early management of this condition will
lower the risk of AF-associated morbidity and mortality. Targeted drug
therapy has an important role in preventing the progression of AF through
modification of the substrate. Discovery of the role of pulmonary veins as
a trigger has been an important breakthrough, leading to the development
of pulmonary vein ablationan established curative therapy for
drug-resistant AF. Identifying the underlying reasons for the abnormal
firing of venous cardiomyocytes and the widespread progressive alterations
of atrial tissue found in persistent AF are challenges for the future.
Novel imaging techniques may help to determine the right time for
intervention, provide specific targets for ablation, and judge the
efficacy of treatment. If new developments can successfully address these
issues, the knowledge acquired as a result will have a vital role in
preclinical and early management of AF. copyright 2010 Macmillan
Publishers Limited. All rights reserved.
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