European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2004
Randomized Controlled Trial Clinical TrialImpact of pleural effusion pH on the efficacy of thoracoscopic mechanical pleurodesis in patients with breast carcinoma.
A prospective randomised study was conducted to compare the efficacy of treating malignant pleural effusions (MPE) in patients with breast carcinoma by thoracoscopic mechanical pleurodesis (TMP) as a new palliative treatment and talc pleurodesis (TP) at various pleural fluid pH levels and to determine whether at low pH values, when the success of TP is reduced, TMP is more successful. ⋯ TMP is a safe palliative treatment for MPE in breast carcinoma, with a minimal number of complications and a short hospital stay; it is more successful than TP in patients with pH of MPE below 7.3.
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Eur J Cardiothorac Surg · Aug 2004
Randomized Controlled Trial Clinical TrialProphylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass.
Perioperative use of tranexamic acid (TA), a synthetic antifibrinolytic drug, decreases perioperative blood loss, and the proportion of patients receiving blood transfusion in cardiac surgery, but the results may vary in different clinical settings. The primary objective of the present study was to determine the efficacy of TA to decrease chest tube drainage and the proportion of patients requiring perioperative allogeneic transfusions following primary, elective, on-pump coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding. ⋯ An antifibrinolytic effect following prophylactic use of TA in elective, primary CABG among patients with a low risk of postoperative bleeding, did not result in any significant decrease in postoperative bleeding compared to a placebo group.
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Thoracic injuries are uncommon in children and few report present on blunt ones. ⋯ Associated injury is the most important mortality factor. Thoracic operations can be performed with minimal morbidity and without mortality in children with blunt thoracic trauma.
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Eur J Cardiothorac Surg · Aug 2004
Changes in coagulation condition, cytokine, adhesion molecule after repair of type A aortic dissection.
Because residual dissection often exists even after the repair of a type A dissection, we evaluated coagulation conditions, cytokine levels, and adhesion molecule levels in mid-term follow up after repair of type A dissections. ⋯ Hypercoagulation conditions continued even after repair. Both TAT and D-dimer would be good indices for following up patients having repaired aortic dissections. Furthermore, cytokine, adhesion molecules, and collagen turnover would return to a stable state unless impairment and expansion of the vessel wall occurred.
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Eur J Cardiothorac Surg · Aug 2004
Effects of the patent false lumen on the long-term outcome of type B acute aortic dissection.
To determine the most effective treatment, we performed a detailed comparative study of the clinical course of patients with type B aortic dissection with a patent or thrombosed false lumen who did not undergo surgery in the acute period. We examined the effect of patency of the false lumen on outcome. ⋯ Patency of the false lumen is a strong independent prognostic factor for type B aortic dissection. Location of the most dilated aortic segment at the distal arch is a significant risk factor in the patients with a patent false lumen.