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  • ISSN: 2333-6676
    Volume 3, Issue 2
    Research Article
    Zochios V*, Klein A, Jones N, Kriz T, Dunning J, Botrill F and Hernandez-Sanchez J
    Patients after cardiac surgery are at risk of respiratory complications that may lead to prolonged hospital stay and worse outcomes. The incidence of respiratory complications is increased in patients with intrinsic respiratory disease. Continuous positive airway pressure administered prophylactically postoperatively can improve functional performance and decrease respiratory complications. However, these are poorly tolerated and their use may be limited by increased staffing and monitoring requirements. Nasal high-flow oxygen is well tolerated and can be administered on a standard postoperative ward. It also provides a low level of continuous positive airway pressure and reduces the work of breathing. In a recent randomized controlled trial we showed that high-flow nasal oxygen, administered for 24 hours after thoracic lung resection surgery, reduced hospital stay and improved functional patient-reported recovery. Routine use of high-flow nasal oxygen after extubation in patients undergoing a normal postoperative trajectory after low risk cardiac surgery is not recommended. The therapeutic effectiveness of high-flow nasal oxygen in high-risk cardiac surgical patients has not been studied before. Our hypothesis is that prophylactic use of nasal high-flow oxygen therapy for at least 24 hours in cardiac surgical patients at high-risk of developing post-operative pulmonary complications, is associated with shorter hospital length of stay (days).
    Clinical Image
    Mariana Santos Castro, Joao Abecasis*, Miguel Santos and Miguel Abecasis
    A 40 year-old female presented to the cardiology clinic complaining of progressive fatigue and effort dyspnea. Her past history was only notable for the diagnosis of an ostium secundum atrial septal defect (ASD) at the age of 14, referred for closure at the age of 16.
    Shashank Behere*, Wolfgang Radtke, Jane Vetter and Jeanne Marie Baffa
    A previously healthy 9 month old boy suffered an acute cardiac arrest at home after a few hours of irritability and inconsolability. His mother called 911 and initiated cardiopulmonary resuscitation (CPR). She continued CPR for 8-10 minutes until paramedics arrived.
    Case Report
    Jae Guk Kim and Soo Joo Lee*
    Two patients had multiple embolic infarctions in the middle cerebral artery territory. Free-floating thrombi adherent to plaques were detected in the common carotid artery near the bifurcation using duplex ultrasonography. Further strokes did not occur under anticoagulation. The free-floating thrombi disappeared on follow-up sonography. Carotid duplex ultrasonography is useful for recognizing free-floating arterial thrombi and for monitoring dynamic changes. Treatment of these thrombi remains controversial; however anticoagulation alone may be sufficient to prevent further strokes.
    Groene E. F*, Sieverding J and Krause K
    A 51-year-old patient was admitted to our hospital following detection of an over sensing of his automatic implantable cardioverter defibrillator (AICD), there appeared to be a dysfunction of the electrode due to the implantation of a vena cava-stent. After stent implantation, the lead was pressed against the SVC wall. We deactivated the ICD-function because of the disturbed signals. A stenosis persisted, so we decided to implant another stent. We bridged the time between the deactivation of the VT-detection and the implantation of the new electrode with a Life Vest. After the redilatation, we re-implanted a new right ventricular electrode.
    Himanshu Mahla*, Kavya Mallikarjun, Usha, Jayaranganath Mahimarangaiah and Cholenahally Nanjappa Manjunath
    Anatomically corrected malposition is characterized by atrioventricular and ventriculoarterial concordance. However, there is an abnormal spatial relationship of the great arteries. Here, we describe the case of a 22-year-old male with anatomically corrected malposition of the great arteries. The patient was diagnosed witha double outlet right ventricle, a closed large ventricular septal defect and malposed great arteries. This case is reported due to the rare occurrence and to highlight the importance of using a segmental approach to diagnose and differentiate the corrected malposition from DORV with malposition.
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