XXXX in cardiac surgery.

@entity1 @entity712 @entity64 @entity11986 @entity301 @entity63 @entity344 @entity887 @entity715 @entity204 @entity130
BACKGROUND: @entity11986 is a recognized complication of cardiac surgery, but its incidence and various outcomes have not been completely described. A retrospective study was undertaken to better characterize the syndrome. METHODS: Records of 49,377 autopsies and surgical specimens from the Johns Hopkins Hospital between 1973 and 1995 were reviewed. Three hundred twenty-seven @entity1 (0.7%) had an identifiable @entity11986 on histologic examination. Of these @entity1 , 29 (0.2%) had undergone a cardiac surgical procedure within 30 days of autopsy or surgical resection. @entity1 charts and pathology specimens were reviewed for operative findings, postoperative outcomes, and histology. RESULTS: Six of the 29 @entity1 (21%) had @entity11986 to the heart, 7 @entity1 (24%) had @entity887 to the central nervous system, 19 @entity1 (66%) had @entity887 to the gastrointestinal tract, 14 @entity1 (48%) had @entity887 to one or both kidneys, and 5 @entity1 (17%) had @entity887 to a lower extremity. Sixteen @entity1 (55%) had @entity11986 in two or more areas. In 6 @entity1 (21%), @entity204 was directly attributable to @entity11986 , including intraoperative @entity712 from @entity301 (n = 3), massive @entity64 (n = 2), and extensive @entity344 (n = 1). CONCLUSIONS: @entity11986 in cardiac surgery has a broad spectrum of clinical presentations, including devastating @entity130 and @entity204 . Although the true incidence is probably underestimated in this retrospective study, the high attendant mortality and morbidity of @entity11986 have been documented. Improvements in outcome are likely to be associated with preoperative identification of @entity1 at high risk, modifications of perfusion technique, and interventions to minimize secondary @entity715 and progressive @entity63 .
