Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2013
Simplified model for end-stage liver disease score predicts mortality for tricuspid valve surgery.
The model for end-stage liver disease score (MELD = 3.8*LN[total bilirubin] + 9.6*LN[creatinine] + 11.2*[PT-INR] + 6.4) predicts mortality for tricuspid valve surgery. However, the MELD is problematic in patients undergoing warfarin therapy, as warfarin affects the international normalized ratio (INR). This study aimed to determine whether a simplified MELD score that does not require the INR for calculation could predict mortality for patients undergoing tricuspid valve surgery. Simplified MELD score = 3.8*LN[total bilirubin] + 9.6*LN[creatinine] + 6.4. ⋯ The simplified MELD score predicts mortality in patients undergoing tricuspid valve surgery. This model requires only total bilirubin and creatinine and is therefore applicable in patients undergoing warfarin therapy.
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Interact Cardiovasc Thorac Surg · May 2013
Wound complications after median sternotomy: a single-centre study.
Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre. ⋯ Wound complications following median sternotomy remain a challenge to cardiac surgery. Redo and emergency operations are the most important risk factors in this contemporary series. More efforts seem mandatory to decrease this arduous morbidity and the costs of prolonged treatment.
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Interact Cardiovasc Thorac Surg · May 2013
Case ReportsTwo-patch repair of a bicuspid aortic valve with vegetation on its raphe.
We report the successful repair of a bicuspid aortic valve with vegetation on its thickened raphe by using two pericardial patches. After excising the vegetation and thickened raphe, the first patch was sewn between the remaining leaflets. Another patch was then sewn at the base of the cusp to create sufficient geometrical height for good coaptation. Our two-patch technique may facilitate intraoperative accommodation of the 3-D shape of the new cusp.
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Interact Cardiovasc Thorac Surg · Apr 2013
Are we running out of thoracic or cardiac surgeons? Demography of thoracic and cardiac surgeons in France in 2012.
The aim of the study was to accurately evaluate the inflow and outflow of thoracic and cardiac surgeons in France. ⋯ France will not run out of cardiothoracic surgeons. The inflow compensates for the outflow of surgeons liable to stop their activity in the next 10 years.
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Interact Cardiovasc Thorac Surg · Apr 2013
ReviewShould mediastinal lymphadenectomy be performed during lung metastasectomy of renal cell carcinoma?
A best evidence topic was constructed according to a structured protocol. The question addressed was whether radical mediastinal lymphadenectomy should be performed during lung metastasectomy of renal cell carcinoma (RCC). Of the 13 papers found through a report search, seven represent the best evidence to answer this clinical question. ⋯ Indeed, most patients referred to surgery are younger, fitter, and have fewer metastases. Consequently, the survival gain could be biased, related more to the resectability and the good performance status rather to the resection itself. Consequently, although these preliminary results are interesting, they must be interpreted with caution.