Abstract:
OBJECTIVES:Transfusions of blood products can be lifesaving, but they are also associated with considerable risks and adverse effects, including immune response and infections. In cardiac surgery, transfusions have also been associated with increased mortality. We prospectively studied the effects of a structured programme to reduce transfusions and transfusion-associated costs in cardiac surgery. METHODS:The programme included: (i) education of all staff about the risks and benefits of blood transfusions; (ii) revised guidelines for transfusions; and (iii) a transfusion log where indication for transfusion, status of the patient and prescribing physician were registered. Transfusion prevalence, complications and costs for blood products were registered for all acute and elective cardiac operations during a 12-month period before (n = 1128) and after (n = 1034) the programme was started. The two time periods were compared. In addition, the prevalence of transfusions was registered for 2 more years after the programme was initiated. RESULTS:The first year after the programme was initiated the proportion of patients transfused with red blood cell concentrate decreased by 21.8% (from 58.2 to 45.5%, P <0.001), plasma by 37.4% (from 30.8 to 19.3%, P <0.001) and platelets by 21.0% (from 20.5 to 16.2%, P = 0.010). Reoperations for bleeding (5.8 vs 5.0%), early complication rate and 30-day mortality (2.5 vs 2.6%) were not significantly different before and after the start date. Based on the 2009 institutional prices for red blood cell concentrate (102 €/unit), plasma (35 €/unit) and platelets (290 €/unit), the savings on blood products were €161,623 during the first 12 months after the programme was launched. The proportion of patients transfused with any blood product was 60.9% before the programme was started and 48.3, 54.0 and 50.7% 1-3 years after its start (all P <0.001), respectively. CONCLUSIONS:A structured blood conservation programme reduces transfusions and costs for blood products in cardiac surgery, without any signs of compromised medical safety. The effects of introducing such a programme are maintained over at least 3 years.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Ternström L,Hyllner M,Backlund E,Schersten H,Jeppsson Adoi
10.1093/icvts/ivu266subject
Has Abstractpub_date
2014-11-01 00:00:00pages
788-94issue
5eissn
1569-9293issn
1569-9285pii
ivu266journal_volume
19pub_type
杂志文章abstract::Cystic echinococcosis is an endemic parasitic infestation caused by the larval stage of Echinococcus granulosus. Although infestation of any part of human body can occur, isolated cardiac involvement is uncommon. We present a case of isolated hydatidosis involving the ascending aorta. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv153
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to assess the learning curve (LC) of robot-assisted lung segmentectomy and to evaluate hospital-related costs. METHODS:We conducted a retrospective study of Robot-assisted thoracic surgery (RATS) segmentectomies performed by 1 surgeon during 5 years. Perioperative and medical...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz246
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:In-stent restenosis (ISR) remains a major complication of percutaneous coronary intervention, even in the current era of drug-eluting stents (DESs). We reviewed the clinical and angiographic outcomes of coronary endarterectomy with stent removal using an off-pump technique in patients with ISR in the left an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv210
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:If mitral valve repair is not feasible, mitral valve replacement remains the only option. Based on our overall experience with the On-X mitral valve, the aim of this study was to investigate early and late outcomes after mitral valve replacement using this latest generation prosthesis. METHODS:From 1998 to ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy184
更新日期:2018-12-01 00:00:00
abstract::This study presents a novel way to perform the mini-maze procedure through the left atrial appendage. By this way, the usual additional incision of the intra-atrial groove is avoided, especially in patients receiving coronary artery bypass grafting (CABG) or aortic valve replacement without mitral valve disease. We re...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu035
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was developed to improve the overestimation of surgical risk associated with the original (additive and logistic) EuroSCOREs. The purpose of this study was to evaluate the significance of the EuroSCORE II by comparing its performance wi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt524
更新日期:2014-04-01 00:00:00
abstract::We prospectively audited the implementation of a protocol for management of air-leaks and intercostal drains after thoracic surgical procedures. Out of the 99 patients who underwent thoracic surgical procedures during a 3-month period, 41 presented a postoperative air-leak on day 1. The protocol was strictly followed ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00054-9
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVES:This study aimed to investigate the characteristics of a reduced right ventricular distensibility after heart transplant. METHODS:This study enrolled 64 adult patients who underwent heart transplant at our institution. The degree of right ventricular distensibility was quantified by calculating the differen...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa222
更新日期:2021-01-01 00:00:00
abstract::Spontaneous aneurysm in the axillary artery is extremely rare. The standard treatment for axillary artery aneurysm has been surgical repair, but endovascular management of select aneurysms using stent grafts has become more prevalent with the development of endoluminal technology. We report the case of a 36-year old m...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu308
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-his...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy026
更新日期:2018-08-01 00:00:00
abstract::When a stented bioprosthetic valve is used for aortic valve replacement, the valve stents protruding to the aortic side can interfere with suture tying. To resolve this problem, we developed a novel knot pusher for use on the index finger. This device has a short push rod appropriate for replacing bioprosthetic aortic...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.238188
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVES:To explore the rule of subcarinal lymph node metastasis in thoracic oesophageal cancer and its clinical significance in the radical resection of oesophageal cancer. METHODS:We retrospectively analysed 2223 patients with oesophageal cancer who were admitted to Henan Cancer Hospital during 2004-2011 and under...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt070
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Postoperative infections are still an important problem in cardiac surgery, especially in the paediatric population, and may influence the final outcome of congenital heart disease treatment. Postoperative infections with fungi are uncommon. The aetiology is poorly understood, and the proper diagnosis and tr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw156
更新日期:2016-09-01 00:00:00
abstract::Atrial fibrillation (AF) is a common arrhythmia that occurs postoperatively in cardiac surgery. There is evidence for the role of oxidative stress in the etiology of AF. In our study, we examined whether antioxidant ascorbic acid (vitamin C), could help in the reduction of the incidence of postoperative AF. Patients w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1510/icvts.2010.240473
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:A prosthetic system to repair secondary tricuspid valve regurgitation was developed. The conceptual engineering of the current device is based on 3D segmental remodelling of the tricuspid valve annulus in lieu of reductive annuloplasty. This study was designed to investigate the operational safety of the cur...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx102
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:Absent pulmonary valve syndrome (APVS) is a rare cardiac malformation that is usually associated with aneurysmal dilatation of pulmonary arteries and respiratory distress. The surgical mortality of neonates and infants with APVS has decreased tremendously, from 60% in 1980s to 10-20% recently. This study ret...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt050
更新日期:2013-06-01 00:00:00
abstract::We herein report an emergency technique of composite Bentall operation using a fast release valve. The technique was successfully performed in 2 emergency cases after failed supracoronary ascending aortic replacement in acute Type A aortic dissection. The speed and ease of execution are the main advantages of the proc...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx435
更新日期:2018-06-01 00:00:00
abstract::American Heart Association recommendations have changed preoperative management of patients with antiplatelet therapy (APT). We assessed safety and outcomes of surgery in patients who were receiving APT. A prospective study of patients operated on while receiving APT was matched with those with no APT (ratio 1:4), usi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr005
更新日期:2012-02-01 00:00:00
abstract::Transcatheter device closure of atrial septal defects (ASDs) is a minimally invasive technique that offers an alternative to conventional surgical repair. There are risks imposed by this technique; however, they compare favourably with risks of surgical closure. Here, we present a case of a 59-year old male with late ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu271
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:We sought to evaluate the effect of centre volume on survival when extracorporeal membrane oxygenation (ECMO) is used as a bridge to lung transplantation (LTx). METHODS:We performed a retrospective analysis of the United Network for Organ Sharing data on adult lung transplantations performed between 2000 an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv379
更新日期:2016-04-01 00:00:00
abstract::Acute aortic dissection frequently causes life-threatening organ ischemia. The optimal therapy for acute type-B aortic dissection is still controversial. Early surgery for acute dissections with organ malperfusion is known to carry a high morbidity and mortality. Endovascular treatment, such as stent placement for bra...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.191361
更新日期:2009-02-01 00:00:00
abstract::Few studies have described video-assisted thoracic surgery (VATS) to bronchoplasty with pulmonary resection. Here, we report the successful implementation of VATS bronchoplasty, as determined retrospectively. Between 2005 and 2010, 362 patients underwent elective lung resection for malignant or benign lung tumors. Of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.258228
更新日期:2011-04-01 00:00:00
abstract::The aim of this retrospective study was to assess the success rates of limb salvage, and the primary and secondary patency rates of reconstructions of critical limb ischemia (CLI) patients undergoing combined infrainguinal reconstruction and intraluminal angioplasty of crural arteries. In 2000-2005, infrainguinal reco...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.204867
更新日期:2009-08-01 00:00:00
abstract::Cervical aortic arch (CAA) is a rare congenital anomaly. An aneurysm developed on a CAA is even rarer and a life threatening condition. We report the diagnosis and surgical treatment of an aneurysm on a CAA associated with an anomalous origin of the left main coronary artery. The surgical procedure consisted in the re...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.219352
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to develop a score to predict the complexity of video-assisted thoracoscopic surgery (VATS) lobectomies preoperatively. METHODS:One hundred and thirty-nine consecutive patients undergoing VATS lobectomy operated on by a single surgeon as the first operator were included. Comple...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy319
更新日期:2019-05-01 00:00:00
abstract::In patients undergoing total arch replacement with protruding or mobile atheroma in the proximal aorta, we isolate cerebral circulation from systemic one by starting selective cerebral perfusion (SCP) before systemic arterial perfusion to prevent aortogenic embolic stroke. We disclose the safety of this isolation tech...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.164137
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:The percutaneous coronary artery angioplasty is routinely being used worldwide for the management of short and discrete coronary artery stenosis. The purpose of this report is to address the potentially lethal complication among the variety of surgical problems in conjunction with this procedure. The case al...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.140194
更新日期:2007-02-01 00:00:00
abstract::We report a case of primary recurrent mediastinal dedifferentiated liposarcoma with unusual long-term survival. A woman who complained of dyspnea showed on imaging features a bulky posterior mediastinal mass which was completely excised and initially misdiagnosed as an angiomyolipoma. She recurred 15 months later and ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.209494
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:Does a structured follow-up, after cardiac surgery in an adult, provide additional information on the operation related mortality especially if mortality is used as an outcome parameter within the quality control? METHOD:Mortality data of 1132 patients undergoing cardiac surgery in 2003 and 2004 in the Acad...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.171678
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To conduct a meta-analysis of available comparative studies evaluating hybrid arch repair versus open surgical repair of aortic arch aneurysm. METHODS:A literature search was performed using PubMed, Embase and Web of Science to identify any studies comparing the results of hybrid arch repair with open surgic...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivw305
更新日期:2017-01-01 00:00:00