Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jan 2018
Acute DeBakey Type I aortic dissection without intimal tear in the arch: is total arch replacement the right choice?
Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. ⋯ TAR was associated with higher 30-day mortality compared with the less extensive hemiarch replacement. In the long term, TAR showed a trend of improved survival and higher reintervention rate.
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Interact Cardiovasc Thorac Surg · Dec 2017
Case ReportsAn aorto-oesophageal fistula treated with endovascular aortic repair: the fate of untreated oesophageal lesion on endoscopic follow-up.
Oesophageal foreign body is an emergency situation. Once oesophageal perforation occurs, damage and subsequent infection involving surrounding tissue or organs may ensue. ⋯ During the early follow-up period, part of the graft stent was discovered in the oesophageal perforation with no haemorrhage. The patient is still in good condition during follow-up.
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Interact Cardiovasc Thorac Surg · Dec 2017
Case ReportsSurgical treatment of a pericardio-oesophageal fistula using a right lower lobe pulmonary tissue patch.
A 58-year-old man presented with fever and chest pain 11 days after atrial fibrillation catheter ablation. The diagnosis of pericardio-oesophageal fistula was made. ⋯ The patient was discharged from hospital approximately 2 months later. The use of a pulmonary patch is a rare but a highly effective technique that can be used in this indication.
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Interact Cardiovasc Thorac Surg · Dec 2017
Optimum position of transthoracic intracardiac line following cardiac surgery.
The transthoracic intracardiac line placed in the right atrium provides a convenient access to the central venous system following cardiac surgery. However, it is associated with risks such as migration and bleeding. We conducted a retrospective study to determine whether position of transthoracic line with respect to site of exit from the chest makes a difference in the rate of complications. ⋯ The upper transthoracic line is associated with significantly lower incidence of catheter migration and offers a more optimum position for central access following cardiac surgery.
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Interact Cardiovasc Thorac Surg · Dec 2017
Review Meta AnalysisThe clinical benefits of perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery: a meta-analysis.
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016. ⋯ Compared with placebo or no antioxidant vitamin therapy, administration of antioxidant vitamin therapy resulted in a reduction in postoperative atrial fibrillation (POAF) (RR 0.55, 95% CI 0.42, 0.73, P < 0.0001), duration of hospital stay (MD -0.68, 95% CI -0.98, -0.39, P < 0.00001), intensive care unit length of stay (MD -0.21, 95% CI -0.30, -0.12, P < 0.00001) and intubation time (MD -2.41, 95% CI -3.83, -0.98, P = 0.001). Our results also showed a trend towards a decrease in postoperative complications (RR 0.72, 95% CI 0.48, 1.08, P = 0.11) and duration of POAF (MD -1.950, 95% CI -3.28, 0.29, P = 0.10). This meta-analysis demonstrated that perioperative antioxidant vitamin therapy in patients undergoing cardiac surgery can reduce the incidence of POAF, duration of hospital stay, intensive care unit length of stay and intubation time.