摘要:

The landscape of cardiac surgery is changing. Advances in endoscopic and other instrumentation procedures such as port access, video instrumentation, and computer-assisted technology are opening new vistas for cardiac surgery. On the immediate horizon is minimally invasive cardiac surgery, also known as keyhole surgery. Imagine a patient not needing a median sternotomy incision or cardiopulmonary bypass. This new type of cardiac surgery is currently being explored at some cardiac surgical centers internationally. This article explores the current state-of-the-art related to minimally invasive direct coronary artery bypass surgery. The operative procedure, implications for perioperative nursing care, likely future technologies, and the research literature on outcomes are also discussed.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Transmyocardial laser revascularization is a new treatment modality for patients with chronic angina that is refractory to traditional management. A laser is used to create full-thickness channels through areas of ischemic myocardium. Transmyocardial laser revascularization is performed in an effort to improve myocardial oxygenation, eliminate or reduce angina, and improve functional status, Transmyocardial laser revascularization currently is undergoing clinical trials. Early results have demonstrated significant reduction in anginal symptoms. Long-term efficacy of transmyocardial laser revascularization remains to be determined.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The success of cardiac surgery is due in large part to the myocardial protection techniques employed to maintain cardiac viability during the period of induced ischemic arrest. As the number of older, high-risk cardiac surgical patients increases, advances in myocardial protection have become necessary to achieve a quiet, bloodless operative field without the production of irreversible intraoperative myocardial damage. Current efforts to provide optimal myocardial protection have focused on the effects of cardioplegic perfusate temperature, distribution of cardioplegia flow, and components of the arresting solution. Minimally invasive techniques have expanded surgical options and have led to the development of new methods to protect the myocardium.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Nurses are responsible for assessing patients' pain and intervening with modalities such as opioids. However, after coronary artery bypass surgery, patients experience moderate to severe pain and receive inadequate analgesia. These practices are problematic as unrelieved acute pain is harmful and may result in negative consequences that influence recovery. Consistent with the subjectivity and multidimensionality of pain, as described in Gate Control Theory, patients need to be involved as participants in their care where possible. Pain policies and education programs need to reflect current professional guidelines and be proactive in addressing staff and patient gaps in pain knowledge and misbeliefs.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Inadequate pain relief has been identified as a common problem after coronary artery bypass surgery. Understanding the pharmacology of analgesics commonly used after cardiovascular surgery is a fundamental part of effective pain management. The pharmacologic properties for two analgesic drug classes, opioid and nonopioid, are reviewed. Major drugs in each class are discussed in terms of their pharmacodynamic and pharmacokinetic properties.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Atrial fibrillation is a common complication of heart surgery. Consequences for the patient who develops this dysrhythmia are many. It prolongs hospitalization, may induce hemodynamic compromise, and carries the risks of thromboembolism and stroke. Ongoing research for the past 30 years has identified several potential etiologies; therefore, management must be highly individualized. This article reviews current and past research on postoperative atrial fibrillation with a focus on individualized prevention and treatment of this problematic heart surgery complication.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A 75-year-old man developed heart block with intermittent conduction following mitral valve replacement. A simultaneously recorded central venous pressure (CVP) trace revealed evidence of the normal sequence of atrial and ventricular contraction, as well as episodes of ventricular contraction that preceded atrial contraction and episodes of simultaneous atrial and ventricular contraction. The dysrhythmia and CVP trace are analyzed and clinical implications relevant to this case history are discussed.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This article describes the cardiac surgery program at Baystate Medical Center. It emphasizes the importance of planning for the discharge process, early extubation, and structured activity guidelines and their effect on patient outcomes. The unique roles of the staff nurse, mid-level practitioner, and the clinical resource coordinator in facilitating the case management process are addressed.

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0889-4655    

出版商:OVID    

年代:1998

数据来源: OVID