Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2013
Multicenter StudyEarly and long-term results of pulmonary resection for non-small-cell lung cancer in patients over 75 years of age: a multi-institutional study.
Older lung cancer patients with multiple morbidities are increasingly referred to thoracic surgery departments. The aim of this multicenter study was to analyse the prognostic factors for in-hospital morbidity and mortality and to elucidate the predictors of long-term survival and oncological outcomes. ⋯ Nowadays, we can consider surgery a safe and justifiable option for elderly patients. Careful preoperative work-up and selection are mandatory to gain satisfactory results. Good long-term results were achieved in elderly patients with early stage who underwent lobar or sublobar lung resection. The role of surgery or other alternative therapies, in patients with advanced stages, extensive nodal involvement and/or requiring extensive surgical resection for curative intent, is still unclear and further studies are certainly needed.
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Interact Cardiovasc Thorac Surg · Jul 2012
Multicenter StudyConservative treatment of post-lobectomy bronchopleural fistula.
Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is essential for its successful resolution. Most published papers deal with endoscopic and surgical treatment. We report our experience with conservative management. ⋯ Two patients died due to causes unrelated to the treatment. The period of time elapsed for the resolution of this complication varied between 5 and 36 days. We conclude that conservative treatment of post-lobectomy bronchopleural fistula is a safe and simple option that must be taken into account in the management of this problem.
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Interact Cardiovasc Thorac Surg · Apr 2012
Multicenter StudyPlatelet reduction after stentless pericardial aortic valve replacement.
The aim of the study was to investigate the multi-factorial phenomenon of possible postoperative thrombocytopenia after aortic valve replacement (AVR) with the freedom SOLO (FS) bioprosthesis. A total of 254 patients underwent AVR with FS bioprosthesis in two cardiac surgery institutes. Platelet counts were measured preoperatively, immediately postoperatively and daily until the 11th day postoperatively. ⋯ Compared with patients with no preoperative thrombocytopenia, patients with preoperative thrombocytopenia had an 8.69 increased odds of being in the group with postoperative platelet count <150 10(3)/mm(3). No major haemorrhagic or thromboembolic event was reported during hospitalization. This study shows that thrombocytopenia after the FS bioprosthesis replacement is a transient postoperative phenomenon, largely resolved within a few days after surgery, with no clinical consequences and haemodynamic dysfunction.
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Interact Cardiovasc Thorac Surg · Mar 2012
Multicenter Study Comparative StudyPolicies of withholding and withdrawal of life-sustaining treatment in critically ill patients on cardiac intensive care units in Germany: a national survey.
To determine the decision-making process of withholding and/or withdrawal (WH/WD) of life-sustaining treatment in cardiac intensive care units (ICUs) in Germany. ⋯ This survey is a step towards creating standards of end-of-life care in cardiac ICUs, which may contribute to build consensus and avoid conflicts among caregivers, patients and families at each step of the decision-making process.
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Interact Cardiovasc Thorac Surg · Jan 2012
Multicenter Study Comparative StudyOutcome of pulmonary embolectomy for acute pulmonary thromboembolism: analysis of 32 patients from a multicentre registry in Japan.
Massive pulmonary embolism is relatively rare but a potentially life-threatening condition. The purpose of this study was to analyse the outcome of pulmonary embolectomy in registered data from the Japanese Society of Pulmonary Embolism Research (JaSPER). ⋯ Pulmonary embolectomy is an effective therapeutic option for patients with massive or submassive pulmonary embolism. Prompt triage of patients with haemodynamic instability is important.