Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Nov 2015
Case ReportsTransient limb ischaemia during extracorporeal membrane oxygenation: inappropriate venous cannula location.
Percutaneous placement of extracorporeal membrane oxygenation (ECMO) cannulas has many benefits. However, limb ischaemia still remains as an unresolved problem. We experienced an interesting case of limb ischaemia that was caused by external compression of the superficial femoral artery by the venous cannula. ⋯ The venous cannula, which was approaching the common femoral vein from the lateral side, was passing between the bifurcation area of the superficial and deep femoral arteries, directly compressing the superficial femoral artery from beneath. We rapidly removed the inappropriately placed venous cannula, and then re-inserted it at another location of the femoral vein. Although it was an unusual case where arterial occlusion was due to external compression of the venous cannula, successful limb reperfusion could be obtained through rapid identification and correction.
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Interact Cardiovasc Thorac Surg · Oct 2015
Meta Analysis Comparative StudyRobotic thoracic surgery versus video-assisted thoracic surgery for lung cancer: a meta-analysis.
There are two different minimally invasive approaches, robotic thoracic surgery (RTS) and video-assisted thoracic surgery (VATS), which are performed for lung cancer resection. This meta-analysis aimed to compare the perioperative outcomes of RTS with those of VATS for patients with lung cancer. ⋯ This meta-analysis showed that RTS resulted in similar outcomes compared with VATS cases. RTS appears to be an appropriate alternative to VATS, which is associated with improved outcomes compared with open thoracotomy. RTS should be studied further in selected centres and compared with VATS in a randomized fashion to better define its potential advantages and disadvantages.
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Interact Cardiovasc Thorac Surg · Oct 2015
The relevance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging in diagnosing prosthetic graft infections post cardiac and proximal thoracic aortic surgery.
Diagnosis of prosthetic graft infection after cardiac and proximal aortic surgery is a challenge. Besides technical considerations, redo surgery is associated with substantial morbidity and mortality. Therefore, an accurate diagnosis is mandatory. We report on our experience with hybrid 18-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET)/computed tomography (CT) imaging, which is increasingly used to diagnose infections in the detection of graft infection after cardiac surgery. ⋯ PET provides functional data, confirms a CT diagnosis and may even increase diagnostic sensitivity in comparison with CT alone in selected cases. Specificity can be compromised by postoperative changes or chronic inflammatory reactions induced by the graft. CT and/or echocardiography should remain the first diagnostic step in case of a suspected infection because of their broad and fast availability. If confirmation is needed or diagnosis is not achievable using conventional methods, PET might be chosen as the next modality to gain additional information in experienced centres.
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Interact Cardiovasc Thorac Surg · Oct 2015
The effects of preoperative statins on the incidence of postoperative acute kidney injury in patients undergoing cardiac surgeries.
Recent evidence has emphasized multifunctional therapeutic effects of statins on renal protection after cardiac surgeries. We aimed to assess the effects of preoperative administration of statins on lowering the incidence of postoperative acute kidney injury in patients undergoing cardiac surgeries. ⋯ Preoperative statin use may not inhibit acute kidney injury after operation.