Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyUniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery?
Although the standard video-assisted thoracoscopic surgery (VATS) approach is generally performed through two to four incisions, uniportal VATS pulmonary resection has recently been reported to be a promising, less invasive alternative. To evaluate the adequacy of uniportal VATS lobectomy as an alternative to conventional VATS lobectomy in lung cancer, we analysed and compared the outcomes of uniportal and conventional VATS lobectomies. ⋯ The similar perioperative results of uniportal VATS lobectomy compared with conventional VATS lobectomy suggest that uniportal VATS is a viable alternative approach to the conventional VATS approach in selected patients, especially in patients with early peripheral lung cancer with good anatomy and in good general condition.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyFull sternotomy versus right anterior minithoracotomy for isolated aortic valve replacement in octogenarians: a propensity-matched study †.
Surgical aortic valve replacement (AVR) is increasingly performed in elderly patients with good perioperative outcomes and long-term survival, resulting in significant health-related quality-of-life benefits. This study aimed to evaluate the outcome of patients aged ≥ 80 years undergoing isolated AVR through a right anterior minithoracotomy (RAMT) and compare it with a full sternotomy (FS). ⋯ Minimally invasive AVR through right anterior minithoracotomy can be safely performed in patients aged ≥80 years with acceptable morbidity and mortality rates. It is an expeditious and effective alternative to full sternotomy AVR and might be associated with lower postoperative stroke incidence, earlier extubation and shorter hospital stay.
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Interact Cardiovasc Thorac Surg · Jun 2015
A new tissue-engineered biodegradable surgical patch for high-pressure systems †.
Ideal alternatives for replacing native arteries, which have biocompatibility such as growth potential, anti-thrombogenesis and durability, have yet to be discovered. We previously demonstrated the utility of tissue-engineered vascular autografts; however, the use of these autografts is limited to low-pressure conditions. The aim of this study was to create the tissue-engineered arterial patch (TEAP) that could be used in high-pressure systems, and to evaluate the maturation in this regenerative tissue. ⋯ We demonstrated the maturation of endothelial and smooth muscle cells in TEAP, suggesting that this biodegradable polymer scaffold could be used as an alternative vascular material even in high-pressure systems.
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Interact Cardiovasc Thorac Surg · Jun 2015
Multicenter StudyClinicopathological characteristics and lymph node metastasis pathway of non-small-cell lung cancer located in the left lingular division.
The purpose of this study is to assess the clinicopathological characteristics of non-small-cell lung cancer (NSCLC) occurring in the left lingular division (LLD) in association with a proposal of the LLD-specific regional lymph node stations. ⋯ An intraoperative pathological examination using our proposed LLD-specific regional lymph node stations may accurately diagnose the status of node metastasis, and appropriately lead to selective or complete MLND in LLD-NSCLC patients with c-T2N1M0 or lower stage disease.
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Interact Cardiovasc Thorac Surg · Jun 2015
ReviewWhat is the best approach in a patient with a failed aortic bioprosthetic valve: transcatheter aortic valve replacement or redo aortic valve replacement?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether transcatheter aortic valve-in-valve replacement (viv-TAVR) or redo aortic valve replacement (rAVR) is the best strategy in a patient with a degenerative bioprosthetic aortic valve. Altogether, 162 papers were found using the reported search, of which 12 represented the best evidence to answer the question. ⋯ Transcatheter aortic valve-in-valve procedures are clinically effective, at least in the short term, and could be an acceptable approach in selected high-risk patients with degenerative bioprosthetic valves. Redo AVR achieves acceptable medium and long-term results. Both techniques could be seen as complementary approaches for high-risk patients.