Introduction. Perioperative myocardial injuries are one of the most frequent causes of morbidity and mortality after cardiac surgery, the most common etiology being the poor myocardial protection during aortic crossclamp. During aortic crossclamp progressive accumulation of lactate and intracellular acidosis are well-known phenomena, and are associated with alteration of myocardial contractile function. Our objective was to study the coronary sinus lactate levels as a predictor of postoperative hemodynamic outcome in open-heart surgical patients.
Material and methods. We performed a prospective clinical trial, including 142 adult patients with elective cardiac surgery. Anterograde cardioplegia was administered in 82 patients, retrograde cardioplegia in 60 (in 30 patients it was administrated intermittently and in 30 continuously). Blood was collected simultaneously from the aortic cardioplegic line (inflow) and from coronary sinus or the aortic root (outflow) before aortic crossclamp, after crossclamp at every 10 minutes and after crossclamp removal at 0 and 10 minutes. All patients were operated on cardiopulmonary bypass with cardiac arrest, using warm-blood cardioplegia for cardioprotection.
Results. Lactate levels showed increasing values during aortic crossclamp, and a rapid decline after crossclamp removal. The incidence of low cardiac output was significantly higher in patients with lactate levels that exceeded 4 mmol/L. In patients who died in the postoperative period, lactate level was even higher (5 mmol/L), with only a modest recovery after crossclamp removal.
Conclusion. Monitoring lactate level in coronary sinus blood is a reliable method and has a good prognostic value regarding postoperative morbidity and mortality in open heart surgery
Introduction: Tooth impaction is defined as the absence of a tooth on the arch, after its normal eruption age. The main reason canines are impacted is the lack of space required for the tooth to erupt.
Aim of study: The main objective of this study is to determine the types of malocclusions associated with canine impaction (Lindauer classification). A secondary objective is to establish the correlation between these parameters and identification of subjects with high risk of canine impaction based on pre-existing malocclusion.
Material and methods: This study was performed on a sample of 20 patients, 9 men and 11 women. The dental casts were subject to Angle classification and various measurements such as arch perimeter, Pont’s index, sum of the mesiodistal width of the incisor and arch length were performed. The Lindauer sectorial classification was determined based on the patients’ panoramic radiography.
Results: According to the data collected, the Class II /2 malocclusion is more frequent, and it is associated with the impacted canine (approximately 50%). According to the Lindauer classification higher frequency of the impacted canines was found in Sector IV.
Conclusion: The diagnosis for impacted canines is often associated with Class II /2 malocclusion, and according to the Sector classification, it is often localised in Sector IV.