Cardiothoracic Surgery

The use of left ventricular assist devices (LVADs) has gained significant importance for treatment of end-stage heart failure. Fast-track procedures are well established in cardiac surgery, whereas knowledge of their benefits after LVAD implantation is sparse. We hypothesized that ultra-fast-track anesthesia (UFTA) with in-theater extubation or at a maximum of 4 h. after surgery is feasible in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 3 and 4 patients and might prevent postoperative complications. From March, 2010 to March, 2012, 53 LVADs (50 Heart Mate II and 3 Heart Ware) were implanted in patients in our department. UFTA was successfully performed (LVAD ultra ) in 13 patients. After propensity score matching, we compared the LVAD ultra group with a matched group (LVAD match ) receiving conventional anesthesia management. Patients in the LVAD ultra group had significantly lower incidences of pneumonia (p = 0.031), delirium (p = 0.031) and...

Cardiac surgery in Jehovah's Witnesses may be challenging during the operation and postoperative period given their refusal of blood products. The aim of this study was to document our center's experience with Jehovah's Witnesses undergoing major cardiac surgery and to compare surgical outcomes with a matched control group. We retrospectively reviewed the demographic, perioperative, and in-hospital postoperative data for 31 Jehovah's Witness patients undergoing surgery from 1991 to 2012 and compared findings with a control group of 62 patients of the same sex and age, who underwent the same type of operations in the same period. Early mortality, major in-hospital morbidity, laboratory findings, and hospital stays were compared between groups. Demographic data were similar between groups, except that more patients in the Jehovah's Witness group had extracardiac arteriopathy compared with controls (p = 0.04). There was no difference in predicted mortality, calculat...

The American Society of Neurophysiologic Monitoring (ASNM) and American Society of Neuroimaging (ASN) Guidelines Committees formed a joint task force and developed guidelines to assist in the use of transcranial Doppler (TCD) monitoring in the surgical and intensive care settings. Specifically, these guidelines: (1) delineate the objectives of TCD monitoring; (2) characterize the responsibilities and behaviors of the sonographer during monitoring; (3) describe methodological and ethical issues uniquely relevant to monitoring. The ASNM and ASN strongly support the positions that (1) acquisition and interpretation of intraoperative TCD ultrasonograms be performed by qualified individuals, (2) service providers define their diagnostic criteria and develop on-going self-validation programs of these performance criteria in their practices. We agree with the guidelines of other professional societies regarding the technical and professional qualifications of individuals responsible for TCD signal acquisition and interpretation (Class III evidence, Type C recommendation). On the basis of current clinical literature and scientific evidence, TCD monitoring is an established monitoring modality for the: (1) assessment of cerebral vasomotor reactivity and autoregulation; (2) documentation of the circle of Willis functional status; (3) identification of cerebral hypo-and hyperperfusion, recanalization and re-occlusion; and (4) detection of cerebral emboli (Class II and III evidence, Type B recommendation). Adequate transcranial insonation of intracranial vessels generally requires ultrasonic probes with crystals operating at 2 MHz or less. Monitoring services should establish local probe performance standards and regularly document that each probe in current use meets these criteria. The crowded surgical/critical

A 71-year-old man with a history of heart failure due to nonischemic cardiomyopathy, a left ventricular ejection fraction of less than 20%, hypertension, atrial fibrillation, and type 2 diabetes presented with substernal chest pressure of 1-hour duration, radiating to his left arm and occurring at rest. The electrocardiogram (ECG) at presentation revealed atrial fibrillation: concave upward ST-segment elevations of more than 1 mm in the inferior leads, more prominent in lead III than lead II, along with reciprocal ST-segment depressions in the anterior precordial leads. This was suggestive of an acute inferoposterior myocardial infarction (MI), likely from complete occlusion of the right coronary artery (RCA). The coronary angiogram (Figure 1A) confirmed this finding. The left main, the left anterior descending, and the left circumflex coronary arteries were normal. A percutane-ous coronary intervention (PCI) of the mid-RCA occlusion just distal to the right ventricular branch was performed. After the PCI, the chest pain resolved, but the patient's blood pressure was 90/60 mm Hg. Another ECG (Figure 1B) demonstrated resolution of the ST-segment elevations in the inferior leads with a new rSR′ pattern with concave upward ST-segment elevations in leads V 1 to V 3 .

This presentation was prepared by RUTAYISIRE François Xavier and ISHIMWE Diane, Medical students in Year 4(Doctorate 2) at University of RWANDA school of medicine and Pharmacy, Department of Medicine and Surgery. we did the work under supervision of Dr Ntakiyiruta Georges,Mmed,FCSECSA

In this clinical study hyperbaric ropivacaine in spinal anaesthesia for lower limb and hip surgery was evaluated and results obtained were compared with those using hyperbaric bupivacaine. Methodology: Two hundred patients scheduled for lower limb and hip surgery were randomly divided into two groups of 100 patients each. These patients received a spinal injection of either 3ml (15mg) of 0.5% hyperbaric ropivacaine or 3ml (15mg) of 0.5% hyperbaric bupivacaine using 25G Quincke type spinal needle. The parameters studied were -onset and total duration of sensory block, onset and total duration of motor block, quality of intraoperative anaesthesia, hemodynamic alterations, and any intraoperative and postoperative complications. Results: The mean onset of sensory block (6±1.3min vs. 3±1.1min; p value<0.05) and motor block (13±1.6min vs. 9±1.3min; p value< 0.05) was significantly slower in ropivacaine group as compared to bupivacaine group. The total duration of sensory block was significantly shorter in ropivacaine group (160±12.9min) than in bupivacaine group (260±16.1min; p value <0.05). The mean duration of motor block was also shorter in ropivacaine group compared to bupivacaine group (126±9.2min vs. 174±12.6min; p value<0.05). Conclusion: The quality of anaesthesia was excellent in both the groups. In conclusion, a solution of ropivacaine (hyperbaric) can be used for spinal anaesthesia and is comparable with hyperbaric bupivacaine in terms of quality of block, but has shorter recovery profile.

Un tema que preocupa en gran medida a los sistemas de salud, además de la batalla frente al diagnóstico positivo, son las secuelas ocasionadas por el SARS-CoV-2, ya que según se ha reportado, puede afectar al corazón, riñones, intestino, sistema vascular e incluso al cerebro, pero se resaltara en el presente documento las secuelas pulmonares.

Muchas personas experimentan síntomas persistentes y una disminución en la calidad de vida relacionada con la salud después de la enfermedad por coronavirus 2019 (COVID-19). Los estudios existentes se han centrado en  personas hospitalizadas de 30 a 90 días después del inicio de la enfermedad y han informado síntomas hasta 110 días después de la enfermedad.

Las secuelas a más largo plazo en pacientes ambulatorios no han sido bien caracterizadas. Entre los supervivientes de COVID-19 se ha informado de un espectro de manifestaciones pulmonares, que van desde disnea (con o sin dependencia crónica de oxígeno) hasta destete difícil del ventilador y daño pulmonar fibrótico. Al igual que los supervivientes del síndrome de dificultad respiratoria aguda (SDRA) de otras etiologías, la disnea es el síntoma persistente más común más allá del COVID-19 agudo.

Hasta 2 meses después de la aparición de los síntomas, dos tercios de los adultos con COVID-19 no crítico tenían quejas, principalmente anosmia / ageusia, disnea o astenia. Un seguimiento médico prolongado de los pacientes con COVID-19 parece fundamental, sea cual sea la presentación clínica inicial. Los síntomas posteriores al COVID-19 agudo son comunes y pueden predecirse por factores durante la fase aguda de la enfermedad. La fatiga y los síntomas neuropsiquiátricos ocuparon un lugar destacado.

Se sabe que los pacientes con la indicación de la ventilación mecánica en el paciente con COVID19 es la falla respiratoria y posterior a sus salidas, se ven secuelas desde los 90 a los 180 días. Pero se es claro que la vida se prioriza versus las desventajas menores que se presentan al finalizar la ventilación mecánica que permitió no llegar al colapso pulmonar y la muerte.

Se observaron cambios fibróticos en la tomografía computarizada del tórax, que consisten principalmente en reticulaciones o bronquiectasias por tracción, con rangos de tiempo de 3 meses después del alta hospitalaria en aproximadamente el 25 y el 65% de los supervivientes de casos leves, moderados, sin dejar de lado las estimaciones de prevalencia de las secuelas de COVID-19 pos aguda de estos estudios sugieren que los pacientes con mayor gravedad de COVID-19 agudo (especialmente aquellos que requieren una cánula nasal de alto flujo y ventilación mecánica no invasiva o invasiva) tienen el mayor riesgo de Complicaciones pulmonares a largo plazo, que incluyen deterioro persistente de la difusión y anomalías pulmonares radiográficas (como fibrosis pulmonar).

Secuelas pulmonares: Su médico puede sugerir una espirometría, a fin de valorar la curación de los infiltrados pulmonares intersticiales y valorar si quedan secuelas de fibrosis pulmonar. También se sugiere una radiografía de tórax y el mejor tiempo es de 3 a 6 meses ante el alta, de acuerdo a seguimiento, criterio médico.

CONTINÚA…..

VER AQUÍ EL ARTÍCULO COMPLETO ➤ Secuelas pulmonares-Rehabilitación Post-covid-19

FUENTE: Cleveland Clinic. Center for Excellence in Healthcare Communication*

LIvro institucional que descreve a criação deste importante serviço e estrutura dos Hospitais da Universidade de Coimbra, desde a sua criação até aos nossos dias. Destaca a acção do Prof. Norberto Canha, Prof. Manuel Antunes, e equipa médico-cirurgica que os auxiliou. Contém depoimentos de várias personalidades e foi editado pelos Amigos do Centro de Cirurgia Cardiotorácia no âmbito dos 25 anos de actividade daquele serviço

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis. Case presentation A 40 year old man underwent dual chamber right infraclavicular pacemaker implantation for malignant vasovagal syndrome in 1988. This was complicated by two further reexplorations, one for a slipped atrial lead, and the second for primary wound dehiscence which required a pulse generator change. This was followed, in 1993, by infection of the pacemaker pocket by Staphylococcus epidermidis requiring pacemaker removal. However, only the pulse generator could be removed, and the percutaneous removal of the leads by traction had to be abandoned on account of cardiac arrest, in all probability, and with

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection.

Background: This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which patients were predicted to benefit from mitral valve repair and which from replacement. Methods: A total of 218 consecutive patients underwent either mitral valve repair (MVP, n = 112) or mitral valve replacement (MVR, n = 106). We retrospectively reviewed the clinical material, operation methods, echocardiography check during operation and follow-up. Patients details and follow-up outcomes were compared using multivariate and Kaplan-Meier analyses.

Background: Worldwide people of all ages are affected by the Noncommunicable Diseases (N.C.D.) and it
is a leading cause of death globally. According to the World Health Organization (WHO), 41 million people
die due to noncommunicable diseases which is equal to 71% of all death globally in which cardiovascular
diseases are the most common cause for death. The International Institute of Population Sciences stated that
from 1990 to 2016, the contribution rate of mortality of cardiovascular diseases is increased by 34.3% in India.
The more common leading cause of cardiovascular diseases are Coronary Artery Disease (CAD) and Stroke,
also WHO says in 2017, CAD is the leading cause of death and which is 15.6%. To treat these critical
conditions of coronary artery disease patients should undergo cardiac surgery which is known as Coronary
Artery Bypass Grafting Surgery (CABG). According to the A.H.A., Cardiac Rehabilitation is a
comprehensive exercise, education and behavioural modification program design to improve the physical and
emotional condition of patients with heart disease. Early mobilization includes an active range of motion,
thoracic mobility, bedside sitting, chair sitting, hall ambulation (chair sitting). With all these techniques, there
are mechanical devices available to improve oxygenation they known as positive pressure devices such as
Acapella, Flutter, Bubble-PEP, RC-Cornet. Bubble P.E.P. also used to prevent pulmonary complications in
postoperative open-heart surgery patient. On the other hand, the therapist-made bubble-PEP device which is
made from inexpensive and easily accessible materials consisting of a container (e.g. bottle) and tubing.
Therefore, the bubble P.E.P. is relatively cheaper and readily accessible.
Aim: To compare the effect of BBPEP Device and Acapella on Oxygenation and PEFR among patients with
open-heart surgery.
Objectives:
1. To compare the effect of BBPEP Device and Acapella on FiO2 and SpO2 among patients with openheart surgery.
2. To compare the effect of BBPEP Device and Acapella on PEFR among patients with open-heart
surgery.
Methodology: The study done on 54 samples. Samples were randomly divided into two groups, i.e. BBPEP
and Acapella group. Both the group received intervention from P.O.D. 1 to 3 twice a day. FiO2, SpO2 and
PEFR were taken pre- and post-treatment in every session. Data were collected and analysis was done.
Statistical analysis: normality was checked by using Kolomogrov-Smirnov Test. Data did not pass the
normality test, so a non-parametric test was used for data analysis.
Result: There was no significant difference between both groups.
Conclusion: The BBPEP and Acapella is equally effective in improving oxygenation and PEFR in the patient
who undergo open-heart surgery.
Keywords: BBPEP, Acapella, PEFR, FiO2, SpO2, Open Heart Surgery

La posibilidad de inducir el desarrollo de cardiomiocitos en el corazón adulto es una estrategia prometedora en el tratamiento de enfermedades como la insuficiencia cardiaca, la hipertrofia o la cardiopatía isquémica. Así, en los últimos años, el número de publicaciones en esta área se ha multiplicado sin embargo el conocimiento parece no haber avanzado mucho, aun se requiere de más estudios y de implementar toda la evidencia en conjunto.

La terapia celular vincula múltiples procesos fisiológicos asociados a la interacción célula- matriz, lo que permite generar un tejido con la capacidad de responder al implante y de esta manera sustituir o regenerar los tejidos lesionados o isquémicos. El conocer las bases fisiopatológicas permite descubrir nuevas alternativas de tratamiento y mejorar el pronóstico y sobrevida de los pacientes.

Vasquez A. Review of JAMA Cardiology’s 2018 “Associations of Omega-3 Fatty Acid Supplement Use with Cardiovascular Disease Risks”. Video presentation (http://www.ichnfm.org/jama2018n3) and official transcript (https://www.academia.edu/35935996) 2018 February.

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, a...

The sternalis muscle is an accessory muscle located in the anterior thoracic region, which is relatively unfamiliar to clinicians and surgeons. To date, no data from the Iranian population have been published. Here, a rare case of a sternalis muscle is presented. In addition, this anomalous muscle was observed along with other visceral and vascular anomalies. This case is unique and provides significant information to radiologists, angiologists and surgeons seeking to apply safer interventions. It is also imperative for better interpretation of mammographic images and in reconstructive surgery.

The purpose of the present study was to evaluate the safety and the costeffectiveness of using preoperative IABP as support compared with postoperative IABP treatment in coronary patients with severe left ventricular dysfunction (SLVD) who is undergoing off-pump coronary artery bypass surgery (OPCAB), including early outcomes, hospital mortality and morbidity, and mid-term follow-up outcomes.

The Toronto General Hospital, Division of Cardiovascular Surgery, has enjoyed an enviable history of academic achievement and clinical success. The foundations of this success: innovation, creativity and excellence in patient care continue to influence the current members of the division.

Background: Although off-pump coronary artery bypass (OPCAB) surgery has many beneficial effects compared with on-pump surgery, switch to on-pump surgery has significantly higher risks of operative mortality. Benefits of OPCAB over on-pump surgery strategies concerning myocardial revascularization are still debatable. We have aimed to develop an "algorithm of off-pump surgical strategy" on preventing conversion to on-pump. This clinical study reports our clinical outcome of OPCAB in patients with acute coronary syndrome. patients with acute coronary syndrome were enrolled in the study. Decision of OPCAB (142 patients) or on-pump surgery (56 patients) was made according to patients' present clinical status and our surgical background. Cardiac enzymes, duration of the surgery, graft numbers, stay in intensive care unit were recorded.

The BTS pleural procedures audit collected data over a 2-month period in June and July 2011. In contrast with the 2010 audit, which focussed simply on chest drain insertions, data on all pleural aspirations and local anaesthetic thoracoscopy (LAT) was also collected. Ninety hospitals submitted data, covering a patient population of 33 million. Twenty-one per cent of centres ran a specialist pleural disease clinic, 71% had a nominated chest drain safety lead, and 20% had thoracic surgery on site. Additionally, one-third of centres had a physician-led LAT service.

Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Emphysema is a component of COPD characterised by hyperinflation resulting in reduced gas exchange and interference with breathing mechanics. Endoscopic lung volume reduction using one-way valves to induce atelectasis of the hyperinflated lobe has been developed and studied in clinical trials over the last decade.

Objective: To determine if the Revised Cardiac Risk Index (Lee) is useful for stratification of patients by risk of both perioperative cardiac morbidity and long-term all-cause mortality in the setting of endovascular repair of abdominal aortic aneurysms.

This systematic review examines the role pre-admission clinics (PACs) in the preparation of patients for surgery and whether there is an optimal skill-mix profile of nurses, doctors or professions allied to medicine (PAMs) for them. The stage pre-operatively which patients are assessed for admission is considered and the length of time patients can be expected to spend at PACs. The format of documentation offering optimal communication between PAC and ward/operating theatre is evaluated together with whether this alters repeat investigations ordered before surgery. Finally whether patients benefit from the information given at PACs and if this results in improved discharge-planning for the patient.
The original aim of most PACs appear to have been to achieve a reduction in post-admission cancellations of surgery; however, this single aim appears lost amongst the advantages of quality improvements offered to patients and the potential financial savings if day of admission surgery is implemented. PACs have become an essential part of quality surgical care, to admit a patient without knowing they are fit to proceed for surgery is wasteful of both human time and financial resources. Nursing appears to offer the most holistic option, particularly with nurses who practise advanced assessment skills within evidence-based protocols appear in other respects to be as effective as the doctors with whom they work.
The ideal time for the pre-admission assessment is between one and three weeks pre-operatively; however, this does not coincide with the optimal time for patient education and behaviour modification (smoking etc.) which should be at least six weeks prior to surgery. Multidisciplinary documentation offers significant advantages in terms of cross professional communication however traditional boundaries remain and implementation of integrated care plan’s can meet obstruction from some individuals. The investigations requested pre-operatively may be slightly higher in nurse-led PACs however they conform more closely to evidence based protocols. Patients are better prepared for discharge with a combination of education and assessment prior to surgery.

Agriculture is different from industry and plays a significant role in the economic development of a nation. India"s prosperity depends upon the agricultural prosperity. There are many kinds of agricultural products produced in India and the marketing of all these farm products generally tends to be a complex process. Agricultural marketing involves many operations and processes through which the food and raw materials move from the cultivated farm to the final consumers. Agriculture provides goods for consumption and exports and manufacturing sectors. The suitable marketing system should be designed so as to give proper reward or return to the efforts of the tiller of the soil. Market information is a means of increasing the efficiency of marketing system and promoting improved price formation. It is crucial to the farmers to make informed decisions about what to grow, when to harvest, to which market produce should be sent and whether or not to store it. Awareness of farmers on different components of market information and its utility was very poor (11 to 37 %) as compared to that of traders (75%). Out of the expectations of farmers on grades, quality, prices in potential markets, price projections; only real time arrivals and prices were documented and disseminated with traditional approach. Hence there is a need to create awareness among the farmers through the agricultural extension agencies like the State Department of Agriculture, Krishi Vigyan Kendras so that the marketing information on agriculture commodities are incorporated in the extension services along with production aspects to the farmers.

Objective: Pericardiectomy is associated with a high prevalence of morbidity and mortality. We evaluated the predictors of in-hospital complications and outcome for pericardiectomy procedure for patients with constrictive pericarditis (CP) in a single-center in China. Methods: One-hundred sixty-five patients who underwent pericardiectomy for CP between January 1990 and December 2012 at our hospital were evaluated. Results: The mean age of the study cohort was 36.79 ± 18.52 years. The approach was through a median sternotomy in 91.5% of patients. Cardiopulmonary bypass was used in 14.5% (24/165 patients). Unadjusted rates of mortality and complication were approximately 5.4% and 23%, respectively. The main cause of death was severe low cardiac output syndrome. Major complications were postoperative low cardiac output syndrome, reoperation for bleeding, pneumonia, mediastinitis, chylothorax and cerebral infarction. One-year survival was 92%. One-year follow-up revealed that New York Heart Association functional class III or IV, age, intraoperative use of cardiac pulmonary bypass and hemodialysis were associated with increased mortality and morbidity. Conclusions: Total pericardiectomy is associated with lower perioperative and late mortality, and the extent of pericardial resection should be decided according to individual conditions. Perioperative management and complete release of the thickened pericardium of the left ventricle should prevent postoperative complications.

Objective: The aim of this study was to compare the anesthetic efficacy of prilocaine infiltration and a eutectic mixture of local anesthetics (EMLA) in cream for femoral vessel catheterization during pediatric cardiac catheterization and to evaluate whether EMLA cream application improves cannulation success.

In this work modelling and control of Perfusion system is presented. The Perfusion system simultaneously
controls the partial pressures during Extra Corporeal Membrane Oxygenation (ECMO) support. The
main Problem in ECMO system is exchange of Blood Gases in the Artificial Lung (Oxygenator).It is a
highly Nonlinear Process comprising time-varying parameters, and varying time delays, it is currently
being controlled manually by trained Perfusionist. The new control strategy implemented here has a
feedback linearization routine with time-delay compensation for the Partial pressuresof Oxygen and
Carbon dioxide. The controllers were tuned robustly and tested in simulations with a detailed artificial
Lung (Oxygenator) model in Cardiopulmonary bypass conditions. This Automatic control strategy is
proposed to improve the patient’s safety by fast control reference tracking and good disturbance rejection
under varying conditions.

Background: Limited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following cardiac surgery. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden.

Objectives: Afterdrop in core temperatures after discontinuation of cardiopulmonary bypass (CPB) is reported to be a sign of inadequate total body rewarming on CPB. The purpose of this study was to compare the effects of three different druE', regimens on hemodynamic stability and the uniformity of rewarming during the rewarming period of CPB.