Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2009
Randomized Controlled Trial Comparative StudyProspective randomized evaluation of stentless vs. stented aortic biologic prosthetic valves in the elderly at five years.
Randomized trials comparing stentless to stented bioprostheses for aortic valve replacement in elderly are scarce. The aim of this study was early and mid-term evaluation of these bioprostheses, with regards to clinical outcome and hemodynamic performance. ⋯ At five years, stentless valves were not superior to the stented valves, with regards to hemodynamic performance, regression of left ventricular mass and clinical outcome.
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Interact Cardiovasc Thorac Surg · Mar 2009
Review Meta AnalysisRetrograde autologous priming and allogeneic blood transfusions: a meta-analysis.
A literature review and meta-analysis were undertaken to assess the clinical effectiveness of retrograde autologous priming of the cardiopulmonary bypass circuit to reduce allogeneic packed red blood transfusions in adult cardiac surgery. Structured searches of Medline, Embase, Cochrane Collaboration Library, Scopus, Cumulative Index to Nursing and Allied Health Literature and Science Direct were performed to identify randomized trials comparing retrograde autologous priming to a prospective control group. A total of 21,643 studies were identified and eighteen trials were retrieved for full-text review. ⋯ Retrograde autologous priming, however, did not provide a clinical benefit in reducing the number of units transfused of intraoperative packed red blood cells (WMD=-0.29; 95% CI: -0.59, 0.01; P=0.05). The combined patient population studied in the six trials was mainly primary isolated coronary artery bypass surgery. Assessing the safety of retrograde autologous priming was not possible due to limited data.
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Interact Cardiovasc Thorac Surg · Mar 2009
ReviewDoes lobectomy achieve better survival and recurrence rates than limited pulmonary resection for T1N0M0 non-small cell lung cancer patients?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Does lobectomy achieve better survival and recurrence rates than limited pulmonary resection for T1N0M0 non-small cell lung cancer patients?' Altogether 225 papers were found using the reported search, of which nineteen represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. ⋯ Segmental resection is comparable to lobectomy for small peripheral tumors. Sublobar resection is associated with shorter hospital stay. For bronchioalveolar carcinoma sublobar resection is recommended provided intra-operative pathologic consultation confirms pure bronchioalveolar histology without evidence of invasion, and surgical margins are free of disease.
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Interact Cardiovasc Thorac Surg · Mar 2009
Surgical treatment of catamenial pneumothorax: a single centre experience.
We retrospectively reviewed our experience with catamenial pneumothorax (CP) in terms of treatment and follow-up. From 1993 to 2008, ten women presented at our department with CP. CP was right-sided in all patients: seven presented diaphragmatic defects including one endometriosis, five had apical bulla or blebs that in three patients were the only pathological findings. ⋯ At the time of surgery the diaphragm should be carefully inspected for defects and/or endometriosis. Standard pleurodesis may not suffice and we suggest apical resection and apical pleurectomy associated with a diaphragmatic procedure when indicated. Hormonal treatment with GnRH agonist seems to improve the outcome.