European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Mar 2009
Review Meta AnalysisUse of N-acetylcysteine to reduce post-cardiothoracic surgery complications: a meta-analysis.
Post-cardiothoracic surgery (CTS) complications (e.g. myocardial injury, renal dysfunction, atrial fibrillation) may occur as a result of enhanced systemic inflammation, perhaps provoked by an oxidative stress response. N-acetylcysteine (NAC) is a free radical scavenger antioxidant agent that may attenuate this physiologic response and reduce post-CTS complications. Thus, a meta-analysis was performed to help characterize the potential beneficial effects of perioperative NAC administration in patients undergoing CTS. ⋯ The exclusion of the study utilizing only oral NAC therapy and the study with lower internal validity did not affect the overall conclusions of our meta-analysis. Currently, the most compelling data for using NAC in CTS patients is in post-CTS AF prevention. However, additional, larger randomized controlled trials evaluating this and other postoperative complication endpoints are needed.
-
Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled TrialNeuropsychological function in children with cyanotic heart disease undergoing corrective cardiac surgery: effect of two different rewarming strategies.
Hypothermia conventionally used in cardiopulmonary bypass necessitates rewarming to normothermic temperatures, which has been shown to be associated with neuropsychological injury. We studied the effects of two different rewarming strategies on postoperative neuropsychological function in cyanotic paediatric patients undergoing elective primary intracardiac repair of tetralogy of Fallot with the aid of cardiopulmonary bypass. ⋯ Weaning off bypass at 33 degrees C is associated with lesser postoperative neuropsychological dysfunction compared to rewarming to 37 degrees C before weaning off bypass. This may be used as a tool to decrease neurologic morbidity following cardiac surgery in children with congenital cyanotic heart disease.
-
Eur J Cardiothorac Surg · Mar 2009
Randomized Controlled Trial Multicenter StudySurgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy.
Endoscopic thoracic sympathetic surgery was effective for palmar hyperhidrosis (PH), but side effects such as compensatory sweating and over dry hands were common. A multiple centers prospective randomized study was designed to compare the efficiency and side effects of T3 and T4 sympathicotomy in the treatment of PH. ⋯ T3 and T4 sympathicotomies are both effective for the treatment of PH. T4 sympathicotomy, decreases the side effects but do not compromise the therapeutic effects, and should be the method of choice.
-
Eur J Cardiothorac Surg · Mar 2009
Multicenter StudyPlasmapheresis before thymectomy in myasthenia gravis: routine versus selective protocols.
The value of thymectomy in management of myasthenia gravis (MG) is well recognized. Plasmapheresis (PMP) before thymectomy appears to improve the postoperative outcome. As PMP has its own complications, selective use of PMP preoperatively for patients at risk of post-thymectomy complications would improve the postoperative outcome, and decreases the PMP-related complications. The aim of this study is to evaluate the effectiveness and safety of routine versus selective use of PMP before thymectomy. ⋯ This study demonstrated that selective use of PMP before thymectomy may reduce the incidence of PMP-related complications without affecting the overall outcome.
-
Eur J Cardiothorac Surg · Mar 2009
Cardiac comorbidity is not a risk factor for mortality and morbidity following surgery for primary non-small cell lung cancer.
We examined the effect of cardiac comorbidity on mortality and postoperative complications following surgery for primary non-small cell lung cancer. ⋯ With careful assessment and patient selection, patients with cardiac comorbidity were not found to be at increased risk of mortality and morbidity following lung resection for primary non-small cell lung cancer in a propensity-matched population.