European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Mar 2010
Rotation thromboelastometry (ROTEM) stability and reproducibility over time.
Thromboelastometry is a whole blood assay performed to evaluate the viscoelastic properties during blood clot formation and lysis. Rotation thromboelastography (ROTEM), Pentapharm GmbH, Munich, Germany) has overcome some of the limitations of classic thromboelastography. So far, no clinical validation on reproducibility (inter- and intra-assay variability) and sample stability over time has been published. ⋯ ROTEM yields stable results over 120 min with a minimal variability on the same ROTEM device. However, small but significant differences between ROTEM devices were observed. Analysis should be performed on the same ROTEM device if small differences are of importance for treatment.
-
Eur J Cardiothorac Surg · Mar 2010
Controlled Clinical TrialVisceral protection during moderately hypothermic selective antegrade cerebral perfusion through right brachial artery.
This study investigates distal organ protection during moderately hypothermic right brachial artery selective antegrade cerebral perfusion (MHSACP) in patients undergoing aortic arch repair. ⋯ The present data show that with the use of MHSACP, distal organs are relatively well protected during aortic arch repairs.
-
Eur J Cardiothorac Surg · Mar 2010
Comparative StudyTraining, certification and practice of cardiac and thoracic surgeons in Europe: a comparison of the members of the European Association for Cardio-Thoracic Surgery and the European Society of Thoracic Surgeons.
There is little knowledge around the world about training and certification for general thoracic surgeons, and the relationship between thoracic surgery and cardiac surgery. Examination of the membership of European Association for Cardio-Thoracic Surgery (EACTS) and European Society of Thoracic Surgeons (ESTS) can clarify the training, practice and academic activity of European thoracic surgeons, as well as the similarities and differences between these two professional societies. ⋯ Members of EACTS and ESTS are very similar in length of training, board certification and academic practice and activity, although they have expected practice variation, given the different membership focus and demographics. Both societies provide important education and advocacy services for their members. Increased co-operation may further propagate improvements in cardiothoracic education and improve patient access and outcomes through shared specialty advocacy.
-
Eur J Cardiothorac Surg · Mar 2010
Tracheal lacerations after endotracheal intubation: a proposed morphological classification to guide non-surgical treatment.
Postintubation tracheobronchial lacerations (PITLs) are traditionally managed surgically. We sought to evaluate the rationale for non-surgical management of PITL. ⋯ Level I or II PITL should be managed non-surgically. When adequate respiratory status is present, Level IIIA PITL can be managed conservatively in selected institutions only, because these injuries are high-risk injuries. Any PITL associated with injury involving the oesophagus or with mediastinitis (Level IIIB) must be treated as soon as possible by surgery.
-
Eur J Cardiothorac Surg · Mar 2010
Case ReportsTransapical off-pump aortic valve-in-a-valve implantation in two elderly patients with a degenerated porcine bioprosthesis.
Re-operative heart-valve replacement is a high-risk procedure and even more so in elderly patients. Another option in high-risk patients with a degenerated aortic xenograft is the implant of a second aortic bioprosthesis using a transcatheter approach. We report two cases of patients with a severely degenerated porcine aortic bioprosthesis who were successfully treated by a transapical valve-in-a-valve implantation.