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Schneeberger Y, Schäfer A, Gulbins H, Reiter B, Sill B, Schoen G, Geronne P, Bernhard M, Reichenspurner H. Surgeons' Experience in Off-Pump Coronary Artery Bypass Grafting: Is There a Difference in the Acute 30-Day Outcome. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Y. Schneeberger
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - A. Schäfer
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - H. Gulbins
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - B. Reiter
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - B. Sill
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - G. Schoen
- Department of Medical Biometry and Epidemiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - P. Geronne
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - M. Bernhard
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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Gherli R, Reichart D, Gulbins H, Reichenspurner H, Biancari F. Ticagrelor Compared with Aspirin Alone in Acute Coronary Syndrome Patients Undergoing Isolated Coronary Artery Bypass Grafting. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- R. Gherli
- Camillo-Forlanini Hospital, Rome, Italy
| | - D. Reichart
- University Heart Center Hamburg, Hamburg, Germany
| | - H. Gulbins
- University Heart Center Hamburg, Hamburg, Germany
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Schönebeck J, Reiter B, Schneeberger Y, Schäfer A, Reichenspurner H, Gulbins H. Does the Choice of Arterial Graft Influence the Outcome in Long-Term Follow-up? Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Harmel E, Schönebeck J, Gulbins H, Reichenspurner H, Reiter B. Coronary Artery Bypass Grafting: The Usefulness of Neurological Screening. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kloth B, Schietsch O, Sill B, Schönebeck J, Reichenspurner H, Gulbins H. Does Cardiac Surgery Affect Quality of Life? An Update of More than 200 Patients. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vogel B, Heinemann A, Gulbins H, Reichenspurner H, Püschel K, Vogel H. Post Mortem Imaging of Complications after Transcatheter Aortic Valve Implantation. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schaefer A, Sill B, Schoenebeck J, Gulbins H, Reichenspurner H. Preoperative Ticagrelor Implementation Leads to a Higher Risk of Bleeding during and after Coronary Bypass Surgery in a Case Matched Analysis. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vogel B, Naqschbandi Z, Reichenspurner H, Gulbins H. Women are More Complex: Analyzing Gender-Related Differences in Coronary Artery Pathology in Patients Scheduled for CABG Using the SYNTAX-Score. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kloth B, Schietsch O, Sill B, Schönebeck J, Reichenspurner H, Gulbins H. Does Cardiac Surgery Affects Quality of Life? Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vogel B, Heinemann A, Gulbins H, Treede H, Reichenspurner H, Puschel K, Vogel H. 226 * POST-MORTEM COMPUTED TOMOGRAPHY AND POST-MORTEM COMPUTED TOMOGRAPHY ANGIOGRAPHY FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Felkel KW, Kubik M, Gulbins H, Reichenspurner H, Wagner F. Atrial ablation in combined mitral and tricuspid valve surgery - associated with increased pacemaker implantation rate? Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Felkel KW, Kubik M, Gulbins H, Reichenspurner H, Wagner F. Does the new 3D tricuspid ring improve outcome after tricuspid valve reconstruction (TVR)? Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Felkel KW, Kampmann K, Hahnel F, Reichenspurner H, Gulbins H. Surgical technique does not influence the long term mortality after tricuspid valve surgery. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vogel B, Gulbins H, Reichenspurner H, Heinemann A, Vogel H. Congenital heart malformation of new born in post mortem computed tomography. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gulbins H, Malkoc A, Reichenspurner H, Ennker J, Ennker IC. Cardiac surgery in octogenarians – closing the gender gap? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vogel B, Gulbins H, Reichenspurner H, Heinemann A, Vogel H. Transcatheter aortic valve implantation in post mortem computed tomography. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gulbins H, Malkoc A, Reichenspurner H, Ennker J, Ennker IC. Gender-related differences in cardiovascular risk factors in more than 10000 coronary artery bypass patients. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gulbins H, Conradi L, Seiffert M, Diemert P, Blankenberg S, Treede H, Reichenspurner H. Socioeconomic aspects of TAVI-procedures – modelling the QALY-concept on published data and a 5-year, single center experience. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wilbring M, Petzoldt M, Gulbins H, Goetz AE, Reichenspurner H. Successful Weaning from Extracorporal Circulation Using a Pumpless Extracorporal Lung Assist Device in a Patient with Intraoperative Hypercapnic Lung Failure during Aortic Valve Replacement. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0030-1271163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gulbins H, Malkoc A, Ennker IC, Reichenspurner H, Ennker J. Preoperative CRP-elevation is a risk factor for perioperative mortality. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Baum C, Garlichs CD, Achenbach S, Gulbins H, Reichenspurner H, Daniel WG. The pathophysiological relevance of systemic cytokines for the development of coronary artery calcification. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Baum C, Garlichs CD, Achenbach S, Gulbins H, Reichenspurner H, Daniel WG. The role of Fetuin-A for the development and progress of coronary artery calcification in a 12-months Follow-Up. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Baum C, Garlichs CD, Achenbach S, Gulbins H, Reichenspurner H, Daniel WG. The alteration of cytokine concentration and the resulting progress of coronary artery calcification: a two-year Follow-Up study. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gulbins H, Malkoc A, Ennker IC, Reichenspurner H, Ennker J. Cram-plot analysis for quality assessment – experience with 17592 patients. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hahnel F, Gulbins H, Blankenberg S, Reichenspurner H. Carcinoid tumor with carcinoid heart disease: Tricuspid valve and pulmonary valve replacement in patients with Hedinger Syndrome and hepatic metastases. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Wilbring M, Petzoldt M, Gulbins H, Goetz AE, Reichenspurner H. Successful weaning from extracorporal circulation using a pumpless extracorporal lung assist device in a patient with intraoperative hypercapnic lung failure during aortic valve replacement. Thorac Cardiovasc Surg 2011; 60:299-301. [PMID: 21442582 DOI: 10.1055/s-0030-1270945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We present a case of a 59-year-old female suffering from massive pulmonary edema with consecutive hypercapnic lung failure immediately following elective aortic valve replacement. Due to severe restrictive ventilation disorder, mechanical ventilation was inadequate. A pumpless lung assist (PECLA, iLA, Novalung®, Talheim, Germany)--a device for extracorporeal carbon dioxide elimination--was used for successful weaning from extracorporeal circulation (ECC). Within 24 hours respiratory function had normalized and the patient could be extubated. The further clinical course and follow-up at 3 months remained uneventful. This report describes the first intraoperative use of the PECLA device in a cardiac surgery patient to promote weaning from ECC.
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Affiliation(s)
- M Wilbring
- Department for Cardiac Surgery, Center for Cardiology and Cardiovascular Surgery, Martinistrasse 51, Hamburg, Germany.
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Schönebeck J, Baustian S, Gulbins H, Reichenspurner H. Quality of life of octogenarians after cardiac surgery. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Treede H, Conradi L, Franzen O, Seiffert M, Baldus S, Schirmer J, Gulbins H, Meinertz T, Reichenspurner H. Impact of interventional MitraClip therapy on secondary mitral valve surgery. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1268949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schönebeck J, Gulbins H, Baustian S, Reichenspurner H. Sinus rhythm is predicting outcome in midtermfollow-up in octogenarians. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arunagirinathan U, Grüning A, Gulbins H, Reichenspurner H. Cognitive outcomes and quality of life after on-pump versus off-pump coronary artery bypass grafting. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hahnel F, Wilbring M, Gulbins H, Reichenspurner H. Tricuspid valve surgery at five year follow up - which determinants of outcome remain? Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1268972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wilbring M, Petzold M, Gulbins H, Goetz AE, Reichenspurner H. Successful weaning from extracorporal circulation using a pumpless extracorporal lung assist device in a patient with intraoperative hypercapnic lung failure during aortic valve replacement. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brickwedel J, Alassar Y, Salman M, Reiter B, Gulbins H, Reichenspurner H. Influence of different brain protection strategies for the treatment of acute type A aortic dissection. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
INTRODUCTION Female gender has been identified as an independent risk factor for perioperative mortality in several risk scores for cardiac surgery. Since no explanation has been given for this, this study aimed to evaluate potential differences in the distribution of other risk factors between the genders. PATIENTS AND METHODS 10 714 consecutive coronary bypass patients were analyzed retrospectively. The distribution of the risk factors as used in the EuroSCORE was evaluated. Diabetes mellitus was added to the analysis as an additional risk factor. Patients aged between 60 and 70 years without any additional risk factors were directly compared in a subgroup analysis. Statistical analysis was done using the T-test or chi-square test where appropriate. RESULTS Female patients were significantly older compared to male ones (69.1 ± 8.5 vs. 65.4 ± 4 years, P < 0.05). The distribution of the analyzed risk factors did not differ except for diabetes mellitus: female patients were more likely to present with diabetes (42 % vs. 29 %, P < 0.05) and in diabetic patients, the incidence of insulin dependency was higher in female patients (50 % vs. 33 %, P < 0.05). Overall perioperative mortality was higher in female patients (2.7 % vs. 1.8 %, P < 0.05). This difference increased when diabetes was present (3.9 % vs. 1.8 %, P < 0.05) and was even higher in insulin-dependent patients (4.9 % vs. 1.9 %, P < 0.05). However, when adjusting for age and diabetes, the differences were reduced. This was most evident when subgroups of age-adjusted patients without any additional risk factors were analyzed: no gender-specific difference in perioperative mortality was observed. CONCLUSIONS Female gender itself did not present as an independent risk factor. The presence of diabetes mellitus increased the risk in female patients significantly more than in male patients. The higher prevalence of diabetes in female patients in combination with the older age at presentation might result in the higher overall mortality observed in female patients compared to men.
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Affiliation(s)
- H Gulbins
- Cardiac Surgery, University Heart Center, Hamburg, Germany.
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Schönebeck J, Reiter B, Baustian S, Gulbins H, Reichenspurner H. Quality of life of octogenarians after cardiac surgery. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Diaz Vazquez DM, Rosendahl U, Gulbins H, Bauer S, Ennker I, Ennker J. Short and long term follow up after repair of postinfarction left ventricular aneurysm. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1247096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arunagirinathan U, Ohdah S, Treede H, Gulbins H, Marscek P, Ismail M, Sprathoff N, Reichenspurner H. Coronary bypass surgery in the elderly: results of a randomized single center study comparing on-pump vs. off-pump bypass surgery in patients ≥75y. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gulbins H, Ennker I, Malkoc A, Ennker J. Gender does not influence perioperative outcome in aortic valve replacement. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gulbins H, Malkoc A, Ennker I, Ennker J. Preoperative Platelet Inhibition with ASA Does Not Influence Postoperative Blood Loss Following Coronary Artery Bypass Grafting. Thorac Cardiovasc Surg 2009; 57:18-21. [DOI: 10.1055/s-2008-1038791] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brickwedel J, Döring V, Ismail M, Marcsek P, Gulbins H, Reichenspurner H. Long term experience with cryopreserved homograft in aortic and pulmonary position. Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Diaz Vazquez DM, Rosendahl UP, Gulbins H, Ennker IC, Ennker JC. Left ventricular aneurysmectomy in patients with ejection fraction of 30% or less. Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gulbins H, Ennker IC, Ennker JC, Malkoc A. Coronary artery bypass grafting – is gender really an issue? Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
INTRODUCTION The number of patients with an indication for cardiac surgery in their ninth decade of life is increasing. This study analyses the single-center results with combined and redo cardiac surgical procedures in octogenarians retrospectively. PATIENTS AND METHODS Three groups were evaluated: (I) Two hundred and thirty six patients with combined cardiac surgical procedures, mean age 83.1 +/- 2.5 years, 107 male (129 female). Combined aortic valve replacement (AVR) and aorto coronary bypass (ACB) was done in 215, double valve replacement (DVR) in 21. (II) AVR + ACB-group: 215 patients out of group I. (III) Control group consisting of 124 patients with a mean age of 74.1 +/- 2.8 years (range 70-79.9 years) who received combined AVR and ACB. Risk stratification was done using the additive and logistic Euro-score; values are given as mean +/- standard deviation and were compared using either the t-test or the Chi-square test. RESULTS The observed mortality in group I was 9.3%. Re-intubation was observed in 10.2% and was one major risk factor for in-hospital mortality. As second risk factor, DVR could be identified. 14.8% required hemodialysis postoperatively, but this affected only the length of stay on intensive care unit (ICU) but not mortality. When comparing group II with group III, mortality was higher (10% vs. 4%), the need for hemodialysis was more frequent (16.3% vs. 4.9%), and the incidence of postoperative psycho-syndromes was also higher (26% vs. 8.1%, all: P < 0.05). The duration of ventilation (2.7 +/- 7.7 vs. 1.6 +/- 4.3 days) and the length of stay on ICU (8.2 +/- 8.8 vs. 5.7 +/- 6.4) were longer without reaching statistical significance (P > 0.05). The Euro-score overestimated the real mortality in all groups. CONCLUSIONS Octogenarians requiring combined cardiac surgical procedures required more resources and had a higher in-hospital mortality compared to younger patients. The observed in-hospital mortality was much lower than the predicted justifying the indication for surgical therapy in these patients. Patient selection, however, seems to be important but the Euro-score alone was rather ineffective in predicting poor outcome.
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Affiliation(s)
- H Gulbins
- Department of Cardiac Surgery, Heart Institute Lahr, Lahr, Germany.
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Gulbins H, Malkoc A, Ennker IC, Ennker J. Continuation of preoperative aspirine therapy does not increase blood loss in coronary bypass patients. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pritisanac A, Gulbins H, Abugameh A, Rosendahl U, Bauer S, Ennker J. Outcome in octogenarians undergoing open heart surgery – a single center experience. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1038074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tiete A, Rassoulian D, Sodian R, Groetzner J, Gulbins H, Sachweh J, Kozlik-Feldmann R, Reichart B, Däbritz S. Biventricular repair in right-dominant AVSD with hypoplastic left sided structures. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Díaz-Vázquez DM, Gulbins H, Rosendahl U, Bauer S, Albert A, Bauer K, Dalladaku F, Ennker IC, Ennker J. Short term follow up after repair of postinfarction left ventricular aneurysm: a comparison of two surgical techniques. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1038075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gulbins H, Pritisanac A, Ennker I, Ennker J. Safety of a Cardiac Surgical Training Program over a Twelve-Year Period. Thorac Cardiovasc Surg 2007; 55:494-9. [DOI: 10.1055/s-2007-965632] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sachweh JS, Tiete AR, Mühler EG, Groetzner J, Gulbins H, Messmer BJ, Daebritz SH. Mechanical Aortic and Mitral Valve Replacement in Infants and Children. Thorac Cardiovasc Surg 2007; 55:156-62. [PMID: 17410500 DOI: 10.1055/s-2006-924627] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to evaluate early and late outcomes after mechanical systemic heart valve replacement in pediatric patients. METHODS Between October 1981 and December 2003, 32 children (mean age 7.2 +/- 5.4 years; 4 months - 15.9 years) underwent mechanical mitral (MVR, n = 17), aortic (AVR, n = 13) or double valve replacement (DVR, n = 2) with St. Jude Medical valves. Twenty-two patients (69 %) had undergone previous cardiac surgery. Anticoagulation self-management was used since 1995. RESULTS The operative mortality was 3.1 %. Perioperative complications were complete heart block (n = 5), ventricular fibrillation (n = 1) and myocardial infarction (n = 1) and were exclusively related to patients with MVR. Mean calculated valve size ratio (geometric prosthesis orifice area/normal valve size area) was 1.72 (1.07 - 2.85) for AVR and 1.4 (0.88 - 3.12) for MVR. Mean follow-up was 9.1 +/- 6.6 years (range 0.4 - 23.2 years, cumulative 283 patient-years). There were two late deaths in patients with MVR. Actuarial survival after 10 years was 93.8 %. Late complications were endocarditis (n = 2), minor hemorrhagic event (n = 1), and stroke (n = 1). Anticoagulation self-management is well accepted by all patients/parents. Overall 10-year freedom from any anticoagulation-related adverse event with phenprocoumon was 89.1 % (1.2 %/patient year). Nine patients required reoperations: redo-MVR (outgrowth of prostheses (n = 3), pannus overgrowth (n = 2), closure of paravalvular leak after AVR (n = 2), partial aortic valve thrombosis (n = 1) and redo-DVR (n = 1 for endocarditis). Freedom from reoperation after 10 years was 80.9 %. CONCLUSIONS Mechanical valve prostheses are a valuable option for left-sided heart valve replacement in pediatric patients. Perioperative morbidity was exclusively related to patients with MVR. Oversizing was often possible to avoid early reoperation for outgrowth. The operative mortality and long-term morbidity are acceptable. Anticoagulation self-management is safe and well accepted.
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Affiliation(s)
- J S Sachweh
- Department of Thoracic and Cardiovascular Surgery, Pediatric Cardiac Surgery, RWTH Aachen University Hospital, Aachen, Germany.
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