scholarly journals I-gel viršgerklinio vamzdelio naudojimas esant sudėtingai endotrachėjinei intubacijai

2011 ◽  
Vol 9 (1-2) ◽  
Author(s):  
Karolis Urbonas ◽  
Robertas Samalavičius
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Pain Management ◽  
Tracheal Intubation ◽  
Difficult Airway ◽  
University Hospital ◽  
Elective Cardiac Surgery ◽  
First Case ◽  
Difficult Airways ◽  
Vilnius University

Karolis Urbonas1, Robertas Samalavičius2 1 II Reanimacijos ir intensyviosios terapijos skyrius, Anesteziologijos, intensyviosios terapijos ir skausmo gydymo centras, Vilniaus universiteto ligoninė Santariškių klinikos,Santariškių g. 2, LT-08661 Vilnius2 II Anesteziologijos ir reanimacijos skyrius, Anesteziologijos, intensyviosios terapijos ir skausmo gydymo centras, Vilniaus universiteto ligoninė Santariškių klinikos,Santariškių g. 2, LT-08661 VilniusEl. paštas: [email protected] Nesėkminga trechėjos intubacija yra reta, tačiau grėsminga komplikacija, ji net gali sukelti mirtį ar hipoksinį smegenų pažeidimą. Užtikrinti ventiliaciją ir oksigenaciją yra nepaprastai svarbu šioje situacijoje. Straipsnyje nagrinėjame du klinikinius sudėtingos intubacijos atvejus ligoniams, kuriems buvo atliekamos planinės kardiochirurginės operacijos. Abiem atvejais nepavykus intubuoti ligonio taikant laringoskopiją, kvėpavimo takų praeinamumas užtikrintas I-gel viršgerkliniu vamzdeliu. Per šį prietaisą pirmajam pacientui fibrobronchoskopu, o antrajam akluoju būdu į trachėją įkištas endotrachėjinis vamzdelis. Aprašyti atvejai rodo, kad ši naujoviška kvėpavimo takų preinamumą užtikrinanti priemonė gali būti sėkmingai taikoma esant sudėtingai intubacijai. Reikšminiai žodžiai: kvėpavimo takai, pasunkėjusi intubacija, viršgerklinis vamzdelis. Intubation through an i-gel supraglottic device in cardiac surgery patients with difficult airway Karolis Urbonas1, Robertas Samalavičius2 1 II Department of Intensive Care, Centre of Anaesthesia, Intensive Care and Pain Management, Vilnius University Hospital Santariškių klinikos, Santariškių Str. 2, LT-08661 Vilnius, Lithuania2 II Department of Anaesthesia, Centre of Anaesthesia, Intensive Care and Pain Management, Vilnius University Hospital Santariškių klinikos, Santariškių Str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Failed tracheal intubation and prolonged attempts at intubation are the major causes of morbidity or mortality directly associated with anaesthesia. The management of difficult airway and the maintenance of oxygenation are very important. In this article, we present two cases of airway rescue management in patients undergoing elective cardiac surgery. In both cases, the failed tracheal intubation with conventional laryngoscopy was managed with the I-gel, a novel supragllottic device. The mechanical ventilation after insertion of a supraglottic tube was effective. Intubation after visualization of the vocal cords with a fibrobronchoscope through the I-gel in the first case and blind intubation with a tube through the device in the second case were successfully performed. I-gel can be used as an alternative rescue technique in cases of difficult airways. Keywords: airway, difficult intubation, supraglottic device

Esmolol before cardioplegia and as cardioplegia adjuvant reduces cardiac troponin release after cardiac surgery. A randomized trial

Perfusion ◽  
2016 ◽  
Vol 32 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Elena Bignami ◽  
Marcello Guarnieri ◽  
Annalisa Franco ◽  
Chiara Gerli ◽  
Monica De Luca ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Placebo Group ◽  
Cardiopulmonary Bypass ◽  
Hospital Stay ◽  
Troponin T ◽  
Mechanical Activity ◽  
Double Blind ◽  
Elective Cardiac Surgery

Background: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero. Materials and methods: This was a single-centre, double-blind, placebo-controlled, parallel-group phase IV trial. Adult patients undergoing elective valvular and non-valvular cardiac surgery with end diastolic diameter >60 mm and ejection fraction <50% were enrolled. Patients were randomly assigned to receive either esmolol, 1 mg/kg before aortic cross-clamping and 2 mg/kg with Custodiol® crystalloid cardioplegia or equivolume placebo. The primary end-point was peak postoperative troponin T concentration. Troponin was measured at Intensive Care Unit arrival and at 4, 24 and 48 hours. Secondary endpoints included ventricular fibrillation after cardioplegic arrest, need for inotropic support and intensive care unit and hospital stay. Results: We found a reduction in peak postoperative troponin T, from 1195 ng/l (690–2730) in the placebo group to 640 ng/l (544–1174) in the esmolol group (p=0.029) with no differences in Intensive Care Unit stay [3 days (1-6) in the placebo group and 3 days (2-5) in the esmolol group] and hospital stay [7 days (6–10) in the placebo group and 7 days (6–12) in the esmolol group]. Troponin peak occurred at 24 hours for 12 patients (26%) and at 4 hours for the others (74%). There were no differences in other secondary end-points. Conclusions: Adding esmolol to the cardioplegia in high-risk patients undergoing elective cardiac surgery reduces peak postoperative troponin levels. Further investigation is necessary to assess esmolol effects on major clinical outcomes.

scholarly journals Republication: All India Difficult Airway Association 2016 Guidelines for Tracheal Intubation in the Intensive Care Unit

2017 ◽  
Vol 21 (3) ◽  
pp. 146-153 ◽  
Author(s):  
Sabyasachi Das ◽  
Pankaj Kundra ◽  
Amit Shah ◽  
Syed Moied Ahmed ◽  
Venkateswaran Ramkumar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Difficult Airway

scholarly journals Kairiosios širdies hipoplazijos sindromo pirmo chirurginio gydymo etapo pradinė patirtis

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Virgilijus Tarutis ◽  
Virgilijus Lebetkevičius ◽  
Kęstutis Versockas ◽  
Asta Bliūdžiūtė ◽  
Žydrė Jurgelienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Surgical Treatment ◽  
Hypoplastic Left Heart Syndrome ◽  
University Hospital ◽  
Norwood Procedure ◽  
Initial Experience ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Vilnius University ◽  
Left Heart Syndrome

Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis versockas2, Asta Bliūdžiūtė2, Žydrė Jurgelienė2, Solveiga Umbrasaitė1, Rita Sudikienė3, Daina Liekienė1, Kęstutis Lankutis3, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Anesteziologijos,intensyviosios terapijos ir skausmo gydymo centras3 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Kairiosiosios širdies hipoplazijos sindromas (KŠHS) yra viena sunkiiausių įgimtų širdies ydų. KŠHS turi 1 iš 4000–6000 naujagimių. Negydant mirštamumas pirmaisiais gyvenimo metais būna didesnis kaip 90%. Apžvelgiame pradinę KŠHS chirurginio gydymo patirtį. Ligoniai ir metodai Nuo 2005 m. iki dabar operuoti 9 naujagimiai, turintys KŠHS. 6 pacientai operuoti stabilizavus jų būklę, 3 operuoti nestabilios būklės esant kraujotakos nepakankamumui. 4 pacientams atlikta klasikinė Norwoodo operacija su modifikuota Blalocko ir Taussig jungtimi, likusiems 5 atlikta Norwoodo operacijos Sano modifikacija. Rezultatai Pirmas Norwoodo korekcijų etapas buvo sėkmingas 5 (55,6%) naujagimiams: 3 buvo padaryta modifikuota B-T jungtis, 2 – Sano jungtis. Išvada KŠHS chirurginis gydymas mūsų centre kol kas yra vadinamosios mokymosi kreivės laikotarpio. Norwoodo I etapo korekcijos rezultatai turėtų gerėti padidėjus operacijų skaičiui ir griežčiau atrenkant pacientus, atsižvelgiant į rizikos veiksnius. Pagrindiniai žodžiai: kairiosios širdies hipoplazijos sindromas, Norwoodo operacija Initial experience in first-stage surgical treatment of hypoplastic left heart syndrome Virgilijus Tarutis1, Virgilijus Lebetkevičius1, Kęstutis versockas2, Asta Bliūdžiūtė2, Žydrė Jurgelienė2, Solveiga Umbrasaitė1, Rita Sudikienė3, Daina Liekienė1, Kęstutis Lankutis3, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“,Anesthesiology, Intensive Care and Pain Management Center3 Vilnius University Hospital „Santariškių klinikos“,Cardiac Surgery Centre Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objective Hypoplastic left heart syndrome (HLHS) is one of the most complex congenital heart defects. The incidence of HLHS is 1 in 4000 to 6000 live births. The mortality rate exceeds 90% without treatment in the first year of life. We review the initial experience in the surgical treatment of HLHS at our Centre. Patients and methods There were 9 children operated on for HLHS from the year 2005 till now. Six of them went to operation in hemodinamically stable condition and three had a substantial insufficiency of systemic circulation. Four underwent Norwood I procedure with modified Blalock–Taussig shunt and five had Sano modification. Results The first-stage Norwood procedure was successful in five (55.6%) cases – three with B-T shunt and 2 with Sano. Conclusions Surgical treatment of HLHS remains in the learning curve period at our institution. We expect the rise of survival rate with the increase of case load and a more selective approach considering the risk factors. Key words: hypoplastic left heart syndrome, Norwood procedure

scholarly journals Pain management in intensive care unit patients after cardiac surgery with sternotomy approach

2019 ◽  
Vol 26 (1) ◽  
pp. 51-63
Author(s):  
Baiba Vilīte ◽  
Eva Strīķe ◽  
Katrīna Rutka ◽  
Roberts Leibuss
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pharmacological Treatment ◽  
Pharmacological Therapy ◽  
Cross Sectional ◽  
Intensive Care Patients ◽  
Vas Score

Background. Postoperative pain is a common problem among intensive care patients. Pain management includes pain assessment and documentation, patient care, and pharmacological treatment. Materials and methods. The study used a prospective, cross-sectional design. Nineteen intensive care nurses and 72 intensive care patients after cardiac surgery with sternotomy approach were studied. Toronto Pain Management Inventory was used to assess nurses and the 2010 Revised American Pain Society Patient Outcome Questionnaire was used to assess the patients. A research protocol was used to document pharmacological treatment data and Visual Analog Scale (VAS) pain measurements. The pharmacological therapy data was available for 72 patients, but patient satisfaction measurements were acquired from 52 patients. Results. Postoperative pain for intensive care patients after cardiac surgery is mostly mild (68.66%). Pain intensity had a tendency to decrease over time, from a mean VAS score of 4.66 two hours after extubation to a mean VAS score of 3.12 twelve hours after extubation. Mostly opioids (100%) and nonsteroidal anti‑inflammatory drugs (NSAIDs, 77.8%) were used for pharmacological treatment, and treatment was adjusted according to pain levels and patient needs. Patient satisfaction regarding pain management in the first 24 hours after surgery was high (94.2%), even though the nurses’ pain knowledge was average (X = 60.6 ± 7.3%). Conclusions. An individualized pain management plan requires pain documentation and ensures high patient satisfaction. Pain levels after cardiac surgery with sternotomy approach are mostly mild and patient satisfaction is high.

scholarly journals Spontaneous Breathing for Panendoscopy? Retrospective Cohort and Results of a French Practice Survey

OTO Open ◽  
2022 ◽  
Vol 6 (1) ◽  
pp. 2473974X2110650
Author(s):  
Pierre Habrial ◽  
Maxime Léger ◽  
Fabienne Costerousse ◽  
Julie Debiasi ◽  
Renaud Breheret ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tracheal Intubation ◽  
Spontaneous Breathing ◽  
Odds Ratio ◽  
Face Mask ◽  
University Hospital ◽  
Mask Ventilation ◽  
French Society ◽  
Laryngeal Tumor ◽  
History Of

Objective Avoiding tracheal intubation by using general anesthesia with spontaneous breathing (GASB) is attractive for upper airway panendoscopy. The aim of this study was to estimate the incidence of adverse events during panendoscopy under GASB and to assess the practices of French anesthesiologists. Study Design Two-phase study: monocentric retrospective study and national survey. Setting University hospital center. Methods Patients who underwent a panendoscopy under GASB at the University Hospital of Angers between January 1 and December 31, 2014, were reviewed. Failure of GASB was defined as an episode of hypoxemia (SpO2 ≤88%) or the need for face mask ventilation with or without tracheal intubation. Then, we sent an electronic survey to all members of the French Society of Anaesthesia and Intensive Care. Results Among the 95 included patients, 22 (23%) experienced a failure of GASB: 3 tolerated hypoxemia, 15 had face mask ventilation episodes, and 4 were intubated. Three factors were associated with failure: obesity (odds ratio, 11.94; 95% CI, 3.20-44.64), history of difficult intubation defined as a Cormack score ≥3 (odds ratio, 6.20; 95% CI, 1.51-25.41), and laryngeal tumor (odds ratio, 2.81; 95% CI, 1.04-7.56). Among the 3930 members of the French Society of Anaesthesia and Intensive Care in 2018, 662 (16.8%) responded to the survey. The 2 preferred techniques to perform panendoscopy were intubation (62%) and intravenous sedation with spontaneous breathing (37%). Conclusion Although general anesthesia with orotracheal intubation remains the preferred technique for panendoscopy in France, GASB is an attractive alternative with a low failure rate. Risk factors for failure are obesity, history of difficult intubation, and laryngeal tumor.

AR SEZONIŠKUMAS TURI ĮTAKOS ŪMINIO MIOKARDO INFARKTO SERGAMUMUI BEI MIRTINGUMUI?

2013 ◽  
Vol 23 (2) ◽  
pp. 104-109
Author(s):  
Pranas Šerpytis ◽  
Jonas Misiūra ◽  
Egidijus Berūkštis ◽  
Simona Pelanytė
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Fatality ◽  
University Hospital ◽  
Men And Women ◽  
Four Seasons ◽  
Significant Seasonal Variation ◽  
Vilnius University

Aim of study: to evaluate possible seasonal variantion in men and women hospitalization and case-fatality rates of acute myocardial infarction in Vilnius University Hospital Santariskes Clinics, Cardiologic Reanimation and Intensive Care unit during the 2000 – 2010 years period. Materials and methods: we analysed 15333 hospitalized due to acute myocardial infarction patients cases. Median age was 72 ± 1,5 years. 931 patients deaths were caused by the acute myocardial infarction during the exploring period. There were estimated hospitalization and deaths from acute myocardial infarction rates through the four seasons. Results: there were observed 7 % - 10% more men died from acute myocardial infarction in spring and 8% - 11% more in autumn, rather than number of the deaths in winter or summer. In the women group 10% – 11% more died in spring and 12% – 13% in autumn, compare with other seasons. Conclusions: study demonstrated the significant seasonal variation in the hospitalizations rates and deaths from acute myocardial infarction, with more common morbidity in March – April – May and higher mortality rate in March - April and in September – October – Noverber months. Patients older than 55 years have approximately 3,5 – 4,5 times higher mortality due to acute myocardial infarction risk, compare with younger patients.http://dx.doi.org/10.5200/sm-hs.2013.054Article in LIthuanian

scholarly journals Etiology, incidence and mortality in patients with ventilator-associated pneumonia in adult general surgery and cardiac surgery intensive care units in University Hospital Dubrava

2020 ◽  
Vol 39 (4) ◽  
pp. 124-128
Author(s):  
Andrea Karin ◽  
Andrej Šribar ◽  
Marko Pražetina ◽  
Katerina Bakran ◽  
Jasminka Peršec
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Units ◽  
General Surgery ◽  
University Hospital ◽  
Ventilator Associated Pneumonia ◽  
Timely Initiation ◽  
Incidence And Mortality ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Ventilator-associated pneumonia (VAP) and hospital acquired pneumonia (HAP) strongly contribute to morbidity and mortality in intensive care units. Hospital acquired pneumonia (HAP) is pneumonia occurring 48 hours upon admission and appears not to be incubating at the time of admission. Ventilator-associated pneumonia (VAP) is a type of HAP developing in intubated patients after more than 48 hours upon mechanical ventilation. HAP and VAP are common and serious complications present in hospitalized patients. Since the diagnosis of VAP and HAP are rarely documented, we wanted to assess the incidence of VAP in General Surgery and Cardiac Surgery Intensive Care Units in 2018 and analyse the patients and procedures related factors. Patients intubated and ventilated more than 96 hours during 2018 were included. Our findings have shown that incidence of VAP in two analysed ICUs in UH Dubrava is in line with VAP incidence found in literature due to successful preventive strategies and timely initiation of antimicrobial therapy and other adjunctive procedures.

Feasibility and acceptability of hand massage therapy for pain management of postoperative cardiac surgery patients in the intensive care unit

Heart & Lung ◽  
2014 ◽  
Vol 43 (5) ◽  
pp. 437-444 ◽  
Author(s):  
Géraldine Martorella ◽  
Mădălina Boitor ◽  
Cécile Michaud ◽  
Céline Gélinas
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Pain Management ◽  
Massage Therapy ◽  
Hand Massage

Returning home after intensive care: A comparison of symptoms of anxiety and depression in ICU and elective cardiac surgery patients and their relatives

2004 ◽  
Vol 31 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Ellen Young ◽  
Jane Eddleston ◽  
Sarah Ingleby ◽  
Janice Streets ◽  
Lucy McJanet ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Anxiety And Depression ◽  
Elective Cardiac Surgery ◽  
Returning Home

scholarly journals Kairiojo skilvelio geometrijos ir tūrio atkūrimo operacija: priešoperaciniai ir operaciniai rizikos veiksniai

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Gintaras Kalinauskas ◽  
Robertas Samalavičius ◽  
Arūnas Valaika ◽  
Gediminas Norkūnas ◽  
Jurgis Verižnikovas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Emergency Surgery ◽  
Left Ventricular ◽  
University Hospital ◽  
Dor Procedure ◽  
Vilnius University

Gintaras Kalinauskas1, Robertas Samalavičius2, Arūnas Valaika1, Gediminas Norkūnas1, Jurgis Verižnikovas3, Giedrius Uždavinys11 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikos, Anesteziologijos,intensyviosios terapijos ir skausmo gydymo centras, Santariškių g. 2, LT-08661 Vilnius3 Vilniaus universiteto ligoninės Santariškių klinikos Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Ligoniams, kuriems yra poinfarktinė kairiojo skilvelio remodeliacija, reikalinga kairiojo skilvelio geometrijos ir tūrio atkūrimo operacija (Dor procedūra). Parenkant ligonius operacijai svarbu išsiaiškinti, kurie iš priešoperacinių ir operacinių rizikos veiksnių labiausiai turi įtakos operaciniam mirštamumui. Ligoniai ir metodai Tai retrospektyvus tyrimas. Ligoniai buvo operuoti laikotarpiu nuo 2000 metų sausio 1 dienos iki 2006 metų gruodžio 31 dienos. Išnagrinėti 88 ligonių, 69 vyrų ir 19 moterų, kurių amžiaus vidurkis 64,5±9,8 metų ir jiems atliktos aortos vainikinių arterijų jungčių suformavimo ir kairiojo skilvelio geometrijos ir tūrio atkūrimo operacijos (Dor procedūra), priešoperaciniai ir operaciniai duomenys. Rezultatai Iš 88 operuotų ligonių šeši ligoniai mirė, mirštamumas 6,8%. Mirusių ligonių priešoperacinės būklės EuroSCORE įvertinimo balas reikšmingai skyrėsi nuo išgyvenusiųjų (p = 0,0180), tai buvo sunkesni, didesnės rizikos ligoniai. Išaiškėjo, kad mirę ligoniai buvo dažniau operuoti skubos tvarka (p = 0,0077). Jų operacijos truko ilgiau, ilgesnė buvo ir jų dirbtinė kraujo apytaka. Išvados EuroSCORE balais vertinamas priešoperacinės būklės sunkumas, skubi operacija, ilgas operacijos ir dirbtinės kraujo apytakos laikas yra gana reikšmingi veiksniai vertinant operacijos riziką. Pagrindiniai žodžiai: kairiojo skilvelio geometrijos ir tūrio atkūrimo operacija Left ventricular reconstruction: preoperative and operative risk factors Gintaras Kalinauskas1, Robertas Samalavičius2, Arūnas Valaika1, Gediminas Norkūnas1, Jurgis Verižnikovas3, Giedrius Uždavinys11 Vilnius University, Cardiac Surgery Centre, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Centre of Anaesthesiology,Intensive Therapy and Pain Management, Santariškių str. 2, LT-08661 Vilnius, Lithuania3 Vilnius University Hospital „Santariškių klinikos“,Cardiac Surgery Centre,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objective The dor procedure is a surgical option in patients with coronary artery disease and postinfarction left ventricular aneurysm. The aim of this study was to evaluate our clinical experience in this procedure and determine risk factors for in-hospital mortality. Patients and methods This was a retrospective investigation. From January 1, 2000 to December 31, 2006, surgical ventricular restoration was performed in 88 patients (69 males), mean age 64.5 ± 9.8 (42–80) years. Patient with valve repair or replacement were excluded from the study. Results All patients underwent the Dor procedure with coronary artery bypass grafting. Crude mortality rate was 6.8%. Higher EuroSCORE, longer operation and cardiopulmonary bypass time and emergency surgery were univariate predictors of in-hospital mortality. Conclusions The Dor procedure with myocardial revascularization can be performed with acceptable mortality in this high risk group of patients. Higher EuroSCORE, longer operation and cardiopulmonary bypass time and emergency surgery increase the risk of in-hospital mortality. Key words: Dor procedure

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