Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Nov 2012
Comparative StudyDiagnostic accuracy of 16- versus 64-slice multidetector computed tomography angiography in the evaluation of coronary artery bypass grafts: a comparative study.
Multidetector computed tomography (MDCT) angiography, which is used for native coronary vessels and bypass graft (CABG) imaging is a non-invasive test. Here, we aimed to compare the diagnostic accuracy of 16- and 64-slice MDCT for graft patency and stenosis. ⋯ This study showed that the 16-slice has a diagnostic accuracy comparable with the 64-slice system for graft patency and can still be used for this purpose if newer systems with improved performance are not available on-site. On the other hand, by the virtue of better image quality, the 64-slice MDCT demonstrates significant graft lesions with higher sensitivity.
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Interact Cardiovasc Thorac Surg · Nov 2012
Six-year prospective audit of 'scoop and run' for chest-reopening after cardiac arrest in a cardiac surgical ward setting.
The aim of the study was to identify which cardiac surgical ward patients benefit from 'scoop and run' to the operating room for chest reopening. ⋯ The key determinant of a favourable 'scoop and run' outcome was whether the arrest occurred during daytime or night-time hours (P < 0.05). Despite a median time to chest opening of 22 min, all five survivors were discharged neurologically intact. The median time from surgery in these survivors was 4 days. Because of the risk of hypoxic brain damage, 'scoop and run' should be restricted to patients suffering witnessed arrests. The study has potential implications for resuscitation training and out-of-hours medical staffing in cardiothoracic hospitals.
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Interact Cardiovasc Thorac Surg · Nov 2012
Case ReportsSurgical management of superior vena cava syndrome after failed endovascular stenting.
The superior vena cava syndrome encompasses a constellation of symptoms and signs resulting from obstruction of the superior vena cava. We report a successful surgical management after failed endovascular stenting for superior vena cava syndrome, caused by a postradiation fibrosis after conventional radiotherapy for breast cancer. We emphasize the rarity of this uncommon surgical procedure and the bailout procedure for failed angioplasty and intravascular stenting. Key points of superior vena cava syndrome and its management are discussed.
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Interact Cardiovasc Thorac Surg · Nov 2012
Case ReportsLarge monophasic synovial sarcoma of the mediastinum in a 15-year old boy.
We present the interesting case of a 15-year old boy with a monophasic synovial sarcoma (MSS) of the mediastinum, which was infiltrating the right heart chambers and the inferior vena cava (IVC). A radical excision was performed, with extensive reconstruction of the heart, under deep hypothermic circulatory arrest. Radical surgical excision is considered to be the treatment of choice for these lesions, as chemotherapy and radiotherapy have little effect. Unfortunately, the patient and his parents refused any further consultation with an oncologist and, although there was no recurrence at 12 months following the procedure, at 24 months we were informed of his death due to the tumour appearing on the left cardiac chambers with subsequent multi-organ failure.
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Interact Cardiovasc Thorac Surg · Nov 2012
18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients.
Postoperative follow-up and surveillance after curative resection for non-small-cell lung cancer (NSCLC) patients are generally performed. However, there is no consensus on the best programme at this time. The aim of this study was to evaluate the diagnostic capability of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in postoperative NSCLC patients without clinical and radiological evidence of recurrence, as a follow-up and surveillance programme. ⋯ FDG-PET/CT is a useful tool that has high capability to detect recurrences in asymptomatic NSCLC patients after a potentially curative operation. However, a large-scale multi-institutional randomized control trial may be needed to ascertain the benefit of surveillance with FDG-PET/CT.