ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The impact of left internal mammary to left anterior descending coronary bypass grafting in enhancing long-term patient survival has led to a widespread interest in arterial grafting over the past decade. It is now accepted that the internal mammary artery is a biologically superior coronary bypass graft compared with the traditional saphenous vein. Experience with other arterial grafts-the right gastroepiploic artery, the inferior epigastric artery and the radial artery-has shown compelling evidence that they share the same biologic advantage. With the judicious use of some or all of these conduits, all regions of the heart can be reached, and total arterial revascularization is a feasible and desirable objective on a routin basis. As long-term results become available, it is inevitable that it will become the operation of choice.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The advancement of myocardial protection techniques is considered to be the most instrumental in achieving successful cardiac surgical outcomes. Although many issues complicate the efficacy of myocardial protection, warm cardioplegla is instituted more often as a better myocardial protection method for patients undergolng cardiac surgery. Understanding differences in patient response between warm and cold cardioplegla is essential for development of appropriate nursing intervention strategies and prevention of postoperative complications. Advanced practice nurses in cardiac surgical settings must continue to evaluate metabolic, functional, and hemodynamic variations of patients with different cardioplegia for positive patient outcomes.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Transmyocardial laser revascularization is an investigational cardiovascular surgical procedure that has been trialed in the United States since 1991. The procedure involves the use of a high-energy carbon dioxide < CO2) laser to penetrate ischemic myocardium of the left ventricle. The successful formation of patent leaser channels results in the formation of a new circulation within the myocardium. This anglogenesis has shown to improve perfusion to the previously oxygendeprived tissue. To date, more than 500 patients have undergone this procedure in the United States, and approximately 1,1500 cases have been performed in Europe, Asia, and the Middle East. The perioperative nursing care for these patients is multifaceted, including, but not limited to, the need for noninvasive assessment skills, effective pain management, and thorough discharge teaching. Unlike other cardiovascular procedures, this surgery does not immediately repair the Ischemic areas; recovery is an insidious process. A reallstic understanding of this surgery is needed to assist the patient throughout his or her hospitalization and to properly prepare the individual for expectations of recovery after discharge

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Anesthetic care for patients undergoing cardiac surgery has change dramatically in the past 10 years. Examples of such change include sameday admissions, “fast-track” protocols, selective use of pulmonary artery catheters, lransesophageal echocardiography, and the introduction of new drugs such as phosphodiesterase inhibitors and antifibrinolytic agents. Under pressure from our peers and those funding health care, we are making major efforts to reduce costs and the length of hospitalization while maintaining high cuality of care.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This is the first of a series of articles that discusses the pertinent issues involved in caring for patients undergoing surgery who belong to special populations. Octogenarians have higher mortaity, more comorbidities, and special needs regarding convalescence. Patients with neuropsychiatric disorders may have exacerbations of their mental illness after surgery and require special care and patience by the nurse. Survival after cardiac surgery is similar in black and white patients, but the number of blacks having cardiac surgery is significantly and proportionately lower than whites, suggesting either a referral bias or a problem with access to care. Subsequent articles discuss cardiac surgery in women, during pregnancy, in Jahovah's Witnesses, and in patients with Down's Syndrome.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This is the second in a series of articles that discusses cardiac surgery in patients who belong to special populations. Women are often the victims of sex bias regarding their referral to cardiac testing, and are consequently sicker when they present for heart surgery. Pregnant women undergoing cardiac surgery require vigilant care while undergoing surgery, with anticoagulant administration and valve selection to achieve positive maternal and fetal outcomes. Progressive improvements in technology, perioperative care, and pharmaceutical development has made cardiac surgery in Jehovah's Witnesses safer than in the past.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Patients with cognitive dysfunction, usually Down's syndrome, frequently require corrective cardiac surgery for congenital cardiac anomalles. The most common cardiac anomalies in Down's syndrome are patent ductus arteriosus, atrial septal defect, ventricular septal defect, atrioventricular canal defects, and Tetralogy of Fallot. This article, the third and last in a series, discusses the physiology of the defects and the nursing care required for comprehensive care of the patient with delayed development.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

“Not vain the weakest, if their force unite.” Homer,lliad(9th century, B.C.) In today's evolving health-care environment, the cardiac surgical intensive-care nurse is required to provide care to patients whose acuity levels are increasing. Simultaneously, these nurses are asked to use more technologically complex devices to deliver that care. In addition, practice protocols are being integrated into hospitals' clinical information systems. To meet these challenges, cardiac surgical intensive-care nurses must collaborate with clinical engineers on the evaluation and installation of new products and on the automation and refinement of clinical pathways and other outcomes measurement tools. Each discipline also must ensure that the other keeps pace with and maintains its level of proficiency in the technology used to care for patients undergoing cardiac surgery.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The aggressive changes in the health-care system are mandating revolutionary new approaches in patient-care delivery. Cardiovascular care, in particular, is under scrutiny due to its high cost and wide variation in outcome. The need to comprehensively coordinate cardiac surgical care and aggressively manage complex cases has resulted in growing interest in using cardiovascular advanced practice nurses (APNs) to ensure highquality, yet cost-effective patient care. The unique skills of the cardiovascular APN as practitioner, consultant, educator, researcher, and change agent ensure optimal outcomes for patients and their famllies as well the staff, physicians, and the hospital's bottom line.

ISSN:1079-0713    

出版商:OVID    

年代:1997

数据来源: OVID