The Annals of thoracic surgery
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Comparative Study
Comparison Between Esophagectomy and Definitive Chemoradiotherapy in Patients With Esophageal Cancer.
This study compared survival between definitive chemoradiotherapy (CRT) and esophagectomy alone among patients with locoregional esophageal squamous cell carcinoma (SCC). ⋯ Esophagectomy alone could provide better survival than definitive CRT for patients with clinical stage I/II esophageal SCC. However, definitive CRT and esophagectomy yield similar overall survival rates in clinical stage III patients.
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Case Reports
Minimally Invasive Awake Mitral Valve Surgery and Cardiopulmonary Bypass Without General Anesthesia.
Herein, we report the case of a 49-year-old man with a potentially fatal allergy to propofol and remifentanil who underwent awake minimally invasive mitral valve surgery with cardiopulmonary bypass using thoracic epidural anesthesia, without the need for endotracheal general anesthesia. The aim was the management of spontaneous respiration during cardiopulmonary bypass surgery in an awake patient.
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Randomized Controlled Trial Comparative Study
Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery.
Patients undergoing aortic arch replacement are at high risk for neurologic injury. This study compared two different established neuroprotective strategies in patients undergoing elective transverse hemiarch replacement. ⋯ Although there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
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Randomized Controlled Trial Multicenter Study Comparative Study
Impact of Heparin- or Nonheparin-Coated Circuits on Platelet Function in Pediatric Cardiac Surgery.
Extracorporeal circuit coating has been shown to improve coagulation derangements during pediatric cardiopulmonary bypass (CPB). This study compared platelet function and hemostasis activation in pediatric cardiac surgery conducted with nonheparin coating (Balance; Medtronic, Minneapolis, MN) versus heparin-based coating (Carmeda; Medtronic) circuits. ⋯ The two circuits showed similar biological effects on platelet function and coagulation. This observation may be useful in optimizing the conduct of CPB and in rationalizing its cost for the treatment of congenital heart disease.
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Meta Analysis Comparative Study
Prothrombin Complex Concentrate in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Prothrombin complex concentrate (PCC) has recently emerged as an effective alternative to fresh frozen plasma (FFP) in treating excessive perioperative bleeding. This systematic review and meta-analysis evaluated the safety and efficacy of PCC administration as first-line treatment for coagulopathy after adult cardiac surgery. ⋯ In patients with significant bleeding after cardiac surgery, PCC administration seems to be more effective than FFP in reducing perioperative blood transfusions. No additional risks of thromboembolic events or other adverse reactions were observed. Randomized controlled trials are needed to establish the safety of PCC in cardiac surgery definitively.