Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2012
Surgical treatment for retrograde type A aortic dissection after endovascular stent graft placement for type B dissection.
Retrograde type A aortic dissection (RTAD) is a life-threatening and underestimated complication of endovascular stent graft placement for type B dissection. Here, we retrospectively investigated our experience of surgical treatment for RTAD after endovascular stent graft placement for type B dissection. Between June 2006 and September 2011, nine patients with RTAD were transferred to our department for surgery. ⋯ The mean follow-up was 34.79 ± 19.37 months and eight patients are still alive. One patient was lost to follow-up. Surgical treatment for RTAD is a safe alternative and the results are encouraging.
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Interact Cardiovasc Thorac Surg · May 2012
Comparative StudyAccuracy of two scoring systems for risk stratification in thoracic surgery.
We investigate the suitability of the two existing risk stratification systems available for predicting mortality in a cohort of patients undergoing lung resection under a single surgeon. Data from the 290 consecutive patients who underwent pulmonary resection between January 2008 and January 2011 were extracted from a prospective clinical data base. In-hospital mortality risk scores are calculated for every patient by using Thoracoscore and ESOS.01 and were compared with actual in-hospital mortality. ⋯ ESOS was reasonably accurate at predicting the overall mortality (sensitivity 88% and specificity 67%), whereas Thoracoscore was a weaker predictor of mortality (sensitivity 67% and specificity 53%). The ESOS score had better predictive values in our patient population and might be easier to calculate. Because of their low specificity, the use of these scores should be limited to the assessment of outcomes of surgical cohorts, but they are not designed to predict risks for individual patients.
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsSuccessful thrombolysis of major pulmonary embolism 5 days after lobectomy.
Aggressive intravenous thrombolysis of pulmonary emboli after major thoracic surgery has rarely been reported and is controversial because of an assumed risk of fatal bleeding. We report a 62-year old female who underwent left upper lobectomy. Her postoperative course was complicated with symptomatic pulmonary embolism and on postoperative day 5 she was successfully treated with intravenous thrombolysis using alteplase (Actilyse(®)) without signs of bleeding. She was discharged from the hospital 12 days postoperatively.