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The intraaortic balloon pump (IABP) has been used in cardiac operations since the late 1960s. Over the years, with refinements in technology, its use has expanded; the IABP is now the most commonly used mechanical assist device in cardiac operative procedures. This review provides an evaluation of evidence for the efficacy of IABP use in different clinical(More)
BACKGROUND There is limited evidence demonstrating the effectiveness of preoperative intraaortic balloon pump (IABP) use in isolated coronary artery bypass graft (CABG) surgery. A single-center randomized trial demonstrated its benefit. We undertook a multicenter observational study to verify this finding. METHODS In 29,950 consecutive patients undergoing(More)
Case presentation: S.B. is a 48-year-old man who suffered an acute anterior myocardial infarction and received fibrinolytic therapy. The patient died 12 hours after reperfusion. K.R. is a 68-year-old diabetic woman who underwent conventional coronary artery bypass graft surgery and developed low output syndrome after reperfusion postoperatively. V.A. is a(More)
CONTEXT Atrial tachyarrhythmias after cardiac surgery are associated with adverse outcomes and increased costs. Previous trials of amiodarone prophylaxis, while promising, were relatively small and yielded conflicting results. OBJECTIVE To determine whether a brief perioperative course of oral amiodarone is an effective and safe prophylaxis for atrial(More)
BACKGROUND Increasingly, patients are being referred for coronary artery bypass grafting (CABG) for management of symptoms after prior percutaneous coronary intervention (PCI). In this study, we assessed the impact of prior PCI on inhospital mortality after CABG. METHODS Perioperative data were collected on patients who underwent first-time CABG at 2(More)
OBJECTIVES Contemporary cardioprotective strategies to prevent perioperative ischemia-reperfusion injury have focused on the l-arginine nitric oxide pathway. Tetrahydrobiopterin is an absolute cofactor required for the enzyme nitric oxide synthase and is thus a critical determinant of nitric oxide production. We hypothesized that ischemia-reperfusion(More)
OBJECTIVE To evaluate the outcomes of mitral valve surgery in octogenarians. METHODS Data were collected prospectively from January 1996 to March 2004 at two surgical centers. Of 1386 consecutive patients with mitral valve surgery, 58 (4.2%) were aged > or = 80 years. Survival data were analyzed using Cox proportional hazards modeling and Kaplan-Meier(More)
OBJECTIVES Diminished production of nitric oxide has been linked to saphenous vein endothelial dysfunction. Tetrahydrobiopterin is an obligate cofactor for the oxidation of L -arginine by nitric oxide synthase in the production of nitric oxide by endothelial cells. The objective of the present study was to examine whether the exogenous addition of(More)
BACKGROUND Angiotensin II and endothelin-1 are potent endothelium-derived contracting factors. The effects of acute endothelin antagonism on endothelial function in saphenous vein from patients treated with and without angiotensin-converting enzyme inhibitors were compared. METHODS Vascular segments of saphenous vein were obtained perioperatively from 14(More)
Homocysteine is an independent risk factor for atherosclerotic vascular disease. It impairs endothelial function via increasing superoxide production and quenching nitric oxide (NO) release. Tetrahydrobiopterin (BH4) is a critical cofactor that couples nitric oxide synthase and facilitates the production of nitric oxide (vs. superoxide anions). In the first(More)