Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2014
Manubrium-limited sternotomy decreases blood loss after aortic valve replacement surgery.
Minimally invasive surgical approaches for aortic valve replacement (AVR) are growing in popularity in an attempt to decrease morbidity from conventional surgery. We have adopted a technique that divides only the manubrium and spares the body of the sternum. We sought to determine whether patients benefit from this less-invasive approach. ⋯ A manubrium-limited approach maintains outcomes achieved for aortic valve replacement by conventional sternotomy while significantly reducing postoperative blood loss and transfusion of blood products.
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Interact Cardiovasc Thorac Surg · Oct 2014
Multicenter Study Comparative Study Observational StudyPolytetrafluoroethylene neochordae is noninferior to leaflet resection in repair of isolated posterior mitral leaflet prolapse: a multicentre study.
Resection techniques are the established method for posterior mitral valve leaflet repair in degenerative mitral valve disease. However, implantation of expanded polytetrafluoroethylene (ePTFE) neochordae is gaining acceptance. The aim of this study was to compare the durability and clinical outcome following mitral valve repair using ePTFE neochordae or leaflet resection. ⋯ ePTFE neochordae is noninferior to resection repair for posterior mitral leaflet prolapse. Both techniques have comparable early and mid-term postoperative outcomes with low mortality, and a low incidence of reoperation and recurrent mitral regurgitation.
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Interact Cardiovasc Thorac Surg · Oct 2014
Mid-term results of aortic root replacement using a self-assembled biological composite graft.
To report the mid-term results of aortic root replacement using a self-assembled biological composite graft, consisting of a vascular tube graft and a stented tissue valve. ⋯ Aortic root replacement using a self-assembled biological composite graft is an interesting option. Haemodynamic results are excellent, with freedom from structured valve failure. Need for reoperation is extremely low, but long-term results are necessary to prove the durability of this concept.
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Interact Cardiovasc Thorac Surg · Oct 2014
Comparative StudyWhat is the extent of the advantage of video-assisted thoracoscopic surgical resection over thoracotomy in terms of delivery of adjuvant chemotherapy following non-small-cell lung cancer resection?
Video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) is a safe and effective alternative to open lobectomy. Adjuvant chemotherapy is part of the treatment recommended for patients with performance status (PS) 0-1 following resection of NSCLC of stages T1-3 N1-2 M0 and T2-3 N0 M0. If VATS reduces morbidity, does it help delivery of postoperative chemotherapy? We studied our data to compare the delivery and toxicity of chemotherapy in patients following VATS or open lung resections. ⋯ Adjuvant chemotherapy was started significantly earlier in patients following VATS lung resections for NSCLC compared with thoracotomy. There was also a trend towards improved tolerance with more complete courses and reduced haematological toxicity.
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Interact Cardiovasc Thorac Surg · Oct 2014
Case ReportsExtracorporeal membrane oxygenation as a support for emergency bronchial reconstruction in a traumatic patient with severe hypoxaemia.
Extracorporeal membrane oxygenation (ECMO) is an extracorporeal life support technique to provide cardiac and/or respiratory assistance to patients. ECMO has been demonstrated to be beneficial for the life support of selected traumatic individuals. However, the application of arteriovenous ECMO as an intraoperative support strategy in emergency operations has rarely been described. ⋯ His right main bronchus was sewn completely closed during the first operation in a local hospital, and he developed refractory hypoxaemia and haemodynamic instability. Although general anaesthesia was not applicable, arteriovenous ECMO was applied as a support to perform the second operation to reconstruct successfully his right main bronchus. As a result, he recovered from this injury.