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The activated coagulation time (ACT) is widely used to monitor adequacy of anticoagulation during cardiopulmonary bypass despite absence of data establishing an ACT below which adverse outcomes occur. For anticoagulation before cardiopulmonary bypass, we administered a single dose of heparin (300 U/kg) to 193 patients and measured ACT and heparin levels at(More)
BACKGROUND The aim of this study was to evaluate pain and quality of life after minimally invasive cardiac operations in comparison with conventional cardiac operations. METHODS From October 1996 to May 1997 a total of 338 patients were interviewed daily using standard scoring systems (myocardial revascularization, n = 160; mitral valve reconstruction or(More)
The enzyme-linked immunosorbent assay (ELISA) using HLA class I molecules purified from pooled platelets has the potential to detect HLA antibodies with increased efficiency without sacrificing sensitivity or specificity. This test, which was originally developed in our institution, has been independently validated by recent studies and is now commercially(More)
BACKGROUND In minimally invasive cardiac surgery use of a lateral minithoracotomy is associated with early postoperative rehabilitation but also relatively high pain levels during the first 3 postoperative days. Cryoablation therapy was evaluated prospectively. METHODS From April 1999 until September 1999, 57 patients underwent lateral minithoracotomy for(More)
Benefits from the use of glucose-containing intravenous and priming solutions during coronary artery bypass operation have not been documented, but an increased risk of postoperative neurologic deficit by hyperglycemia has been suggested. To determine benefits, 107 patients undergoing coronary artery bypass operation were managed identically except that one(More)
BACKGROUND This prospective clinical trial focuses on pain and quality of life (QOL) after minimally invasive direct coronary artery bypass (MIDCAB) grafting versus conventional coronary artery bypass grafting (CABG). METHODS Group A consisted of 65 consecutive MIDCAB patients using an anterolateral mini-thoracotomy and the "off-pump" technique. Group B(More)
OBJECTIVE Evaluation of less invasive aortic valve replacement to minimize surgical trauma and achieve a better postoperative quality of life. METHODS Thirty-three patients had aortic valve replacement using a 4-6 cm small incision and partial sternotomy only. Partial sternotomy was performed proximal (16), S-shaped (14) or horizontal (3). Access for(More)
Cassidy for helpful comments on earlier drafts of this monograph. All remaining shortcomings are, of course, despite their best efforts. The views expressed in this report are those of the authors and do not necessarily refl ect the offi cial policy or position of the Department of the Army, the Department of Defense, or the U.S. Government. This report is(More)