European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1996
Predictive factors for postoperative cerebral complications in patients with thoracic aortic aneurysm.
Perioperative factors affecting the outcomes of postoperative brain function in patients with thoracic aortic aneurysm were demonstrated. ⋯ Although there was an increased incidence of advanced age and complex lesions in patients with aortic aneurysm, an improvement in surgical results has recently been achieved using advanced diagnostic and surgical techniques.
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Eur J Cardiothorac Surg · Jan 1996
Respiratory muscle strength after lung resection with special reference to age and procedures of thoracotomy.
Changes in respiratory muscle strength after lung resection were examined concerning age and procedures of thoracotomy. Maximum inspiratory (MIP) and expiratory (MEP) mouth pressure were measured before operation and 1, 2, 4, and 12 weeks after operation in 81 patients undergoing lung resection. In 48 patients undergoing pneumonectomy, lobectomy, or segmentectomy, patients older than 70 showed a significantly lower MIP and MEP before operation and throughout the postoperative period compared to younger ones (P < 0.01). ⋯ In 31 patients undergoing lung wedge resection, patients undergoing limited thoracotomy (LT) and video-assisted thoracic surgery (VATS) showed significantly higher percentages of postoperative MIP and MEP than those undergoing posterolateral thoracotomy (PLT) 1 and 2 weeks after operation (P < 0.01 or 0.05). But there was no significant difference in the values between LT and VATS. We concluded that (1) elderly patients suffered respiratory muscle weakness before and after operation and their postoperative recovery of respiratory muscle strength was slower than in younger patients, and (2) VATS and LT resulted in more rapid recovery of respiratory muscle strength than PLT, but the difference between VATS and LT was not significant.
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Since 1990 the Institute of Cardiac Survey has compiled data on open heart surgery. In 1993 247,943 operations were performed. ⋯ This subset was 1.9%, e.g. 4,689, of the total number. The increasing rate of open heart surgery in Europe was 8.3%, whereby the highest increasing rate could be observed in CABG.
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Eur J Cardiothorac Surg · Jan 1996
Clinical Trial Controlled Clinical TrialThe effect of pentoxifylline on the lung during cardiopulmonary bypass.
Cardiopulmonary bypass (CPB) produces an inflammatory response due to the interaction of blood with a foreign body surface. The lungs are most affected by this inflammatory response. Pentoxifylline (PTX), a phosphodiesterase inhibitor and an inhibitor of leukocyte activation, is used to minimize damage in lungs where leukocytes play an important role. ⋯ The alveolar-arterial PO2 gradient increased after the CPB in both groups but a moderate decrease was observed 2 h postoperatively. In lung biopsy specimens taken before and after the CPB, there was marked leukocyte sequestration in the control group, whereas the number of leukocytes was seen to be insignificant in the PTX group (P < 0.005). This dosage regimen of PTX inhibits the postoperative increase in PVR and greatly minimized leukocyte sequestration in the lung due to CPB.
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Eur J Cardiothorac Surg · Jan 1996
Case ReportsInfected left atrial myxoma with concomitant mitral valve endocarditis.
Myxomas are the most common primary cardiac tumors. They may simulate infective endocarditis but are rarely infected. Currently, 17 infected left atrial myxomas have been reported in the literature [1, 7, 8, 10, 11]. We present a patient with infected left atrial myxoma combined with mitral valve endocarditis, treated by excision of the myxoma and mitral valve reconstruction.