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B Radomir

Publications and source records attributed to B Radomir.

5 recordsLinked to original sources
PubMed2002

[Role of the Swan-Ganz pulmonary artery (PA) catheter in evaluation of hemodynamic changes during myocardial revascularization in patients with low left ventricular function].

Coronary artery bypass surgery in patient with bad left ventricular function is a challenge for surgical time. Specially important is monitoring of haemodynamics. We performed this open, prospective, randomized study with the aim to assess haemodynamics and oxygen profile monitoring. 34 pts for coronary surgery (EF < 40%) were divided in two groups. Group A, 17 pts. Received glucose-insulin-potassium (GIK) solution. Group B, 127 pts. Received Ringer solution. Haemodynamic and oxygen metabolism parameters were measured in four time points. I after the induction in anesthesia; II after the operation; III 6 hours post op.; IV 24 hour post op. Data are expressed as mean +/- SD, Anova for repeated measures followed by Newman-Keuls testing were used. In both groups were evident deterioration of cardiac function during first 6 h as well as VO2 and DO2, more prominent in Group B. Significant recovery and improvement of cardiac function were evident in Group A after 24 h. CI during the time in Group A improves significantly (2.14 +/- 0.36 v. 3.05 +/- 0.55; p = 0.0002) and difference during the time between groups was p = 0.005. LVSWI improved significantly during the time him Group A (AIII vs. AIV) p = 0.007. Simultaneously. VO2 improves significantly in Group A (103 +/- 21 vs. 164 +/- 30, p = 0.00001) while difference between groups in DO was p = 0.037. Importance of oxygen metabolism monitoring for both, left ventricular function and haemodynamics assessment was evident in our study.

Cardioplegic Solutions↗
PubMed2001

[Assisted circulation. I. Systems with short-term mechanical circulatory support].

The concept of artificial circulatory support has been established almost 200 years ago. It has only been within the last four decades that physicians and engineers have developed mechanical assist devices that can temporarily support the circulation until the native heart recovers from a reversible injury. If the heart does not recover sufficient function to maintain adequate hemodynamics, long-term circulatory support or permanent replace (biologically--heart transplant or permanent mechanical circulatory support) is needed. In this paper we describe the devices (intraaortic balloon pump, roller, centrifugal and axial pumps), that are in current clinical use for temporary (short-term) mechanical circulatory support.

Assisted Circulation↗
PubMed1984

A technique of myocardial protection during aorto-coronary bypass in high-risk patients.

In the authors' opinion, profound myocardial hypothermia is imperative in myocardial protection while the aorta is cross-clamped. They based their own protection method, beside using a single dose of crystalloid cardioplegic solution, on very efficient topical cooling, by which myocardial temperature is reduced to below 15 degrees C. Very efficient topical cooling is achieved by a high flow (2 l/min) of continuously cooled fluid (0 degrees C- +2 degrees C). The great temperature-reducing capacity of the cooling system is due to 10-15 metres long metal coil tubing which is immersed in an ice-salt cold bath. The water pump placed in the bath makes heat exchange even more efficient. The described method of myocardial protection with stable profound myocardial hypothermia safely prolongs the ischaemic time during operation to more than two hours.

Coronary Artery Bypass↗
PubMedDate not supplied

[Use of the internal thoracic artery in patients with stenosis of the left main branch of the coronary artery].

UNLABELLED: Internal thoracic artery (ITA) is the graft of choice in myocardial revascularization. However, superiority of the ITA graft in patients (pts) with left main coronary artery disease is still a matter of debate. PATIENTS: In the period from November 1986 through February 1999, ITA graft was used for myocardial revascularization in 2860 pts. Stenosis of the left main stem was present in 229 patients (8.0%); there were 39 women (17.0%) and 26 diabetics (11.4%). Severely depressed left ventricular function was present in 32 pts (14.0%), while the average age was 56.4 +/- 7.2 years. RESULTS: Operative mortality was 1.3% and postoperative morbidity was 5.2%. Average postoperative hospital stay was 7.9 days (6-29). There were no differences in analyzed parameters between patients who received ITA graft and similar group of 240 patients who received vein grafts only, during the same period of time. All 16 patients operated on in the period 1986-1992 (6-12 years follow-up) are alive. CONCLUSION: It is safe to use ITA graft for myocardial revascularization in patients with left main coronary artery stenosis. Early operative results are favorable and these patients should not be denied the benefit of the ITA graft, since long-term results are proved to be good as well.

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