Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2014
Multicenter Study Comparative StudyImproved clinical outcomes and survival following repair of acute type A aortic dissection in the current era.
The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute type A aortic dissection during 2000-2005 and 2006-2010. ⋯ Surgical era significantly impacts early outcomes and actuarial survival following repair of acute type A aortic dissection.
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Interact Cardiovasc Thorac Surg · Dec 2014
Randomized Controlled Trial Comparative StudyLong-term follow-up of a randomized, controlled clinical trial of three therapeutic strategies for multivessel stable coronary artery disease in women.
Coronary artery disease is the leading cause of death in women. The proposed treatments for women are similar to those for men. However, in women with multivessel stable coronary artery disease and normal left ventricular function, the best treatment is unknown. ⋯ Percutaneous coronary intervention and coronary artery bypass graft surgery compared with medical treatment had better results after 10 years of follow-up.
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Interact Cardiovasc Thorac Surg · Dec 2014
ReviewDoes the placement of an Amplatzer septal occluder device confer benefit in patients with a post-infarction ventricular septal defect?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is the placement of an Amplatzer septal occluder device across a post-infarction ventricular septal defect a suitable alternative for patients not eligible for surgical repair?' Altogether, 31 papers were found using the reported search, of which 17 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. ⋯ Patients presenting in cardiogenic shock experienced an increased risk of death and if the timing of myocardial infarction to VSD closure could be delayed by 3 weeks, there was a statistically significant reduction in operative mortality. Percutaneous closure of a post-infarction VSD may avoid the requirement for surgical closure. However, in some cases, it provides time to allow the VSD to mature and the patient to stabilize and be optimized acting as a bridge to surgery to offer the best possible outcome for the patient.
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Interact Cardiovasc Thorac Surg · Dec 2014
Risk factors for acute kidney injury in aortic arch surgery with selective cerebral perfusion and mild hypothermic lower body circulatory arrest.
Previous studies have reported a high incidence of acute kidney injury (AKI) after thoracic aortic surgery. However, the incidence of AKI in patients undergoing total arch replacement (TAR) with selective cerebral perfusion (SCP) and mild hypothermic lower body circulatory arrest (mild HLBCA) with a tympanic temperature of 25°C remains unknown. We studied AKI incidence and associated risk factors, as defined by the Acute Kidney Injury Network (AKIN). ⋯ Our method of TAR was associated with low mortality and low rate of kidney injury by discharge. However, prolonged mild HLBCA and preoperative CKD might need additional consideration.
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Interact Cardiovasc Thorac Surg · Dec 2014
Observational StudyTriple valve surgery in the modern era: short- and long-term results from a single centre.
Triple valve surgery (TVS) is still a challenge for surgeons because of prolonged cardiopulmonary bypass (CPB) and myocardial ischaemic times. The reported operative mortality rate for TVS ranges between 2.5 and 25%; long-term survival is also diminished, with reported survival rates at 5 and 10 years of 75-82 and 61-75%, respectively. The objective of our study is to define early and late clinical outcomes, reporting the initial experience in the treatment of triple valve disease through a minimally invasive approach. ⋯ TVS offers encouraging short-term and long-term patient survival; these good results after TVS in patients with advanced valvular heart disease justify aggressive surgical therapy in these patients. TVS with a minimally invasive approach is feasible and could be another treatment option.