European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2012
Comparative StudyDo tumours located in the left lower lobe have worse outcomes in lymph node-positive non-small cell lung cancer than tumours in other lobes?
Although an association between prognosis and lobar location of lung cancer, particularly the left lower lobe (LLL), has been suggested, the certainty of such association remains controversial. The purpose of this study was to evaluate the impact of tumour lobar location on surgical outcomes as an independent prognostic factor for survival in our non-small cell lung cancer (NSCLC) patient series. ⋯ LLL tumours with lymph node metastasis are strongly associated with mortality in NSCLC patients. The location of the primary tumour may contribute in determining the optimal management strategy and accurate prediction of prognosis.
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Eur J Cardiothorac Surg · Sep 2012
Comparative StudyLungs from donation after circulatory death donors: an alternative source to brain-dead donors? Midterm results at a single institution.
Donor organ shortage remains to be the major limitation in lung transplantation, and donation after circulatory death (DCD) might represent one way to alleviate this problem. DCD was introduced to our institution in 2007 and has been a part of our clinical routine since then. Here, we present the mid-term results of lung transplantation from DCD in a single institution and compare the outcomes with the lung recipient cohort receiving lungs from donation after brain death (DBD). ⋯ Medium-term results after lung transplantation with organs procured after circulatory death are comparable with those obtained after standard lung transplantation. Therefore, DCD could be used to significantly increase the donor pool.
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Eur J Cardiothorac Surg · Sep 2012
Comparative StudyLong-term results and mid-term features of left ventricular reconstruction procedures on left ventricular volume, geometry, function and mitral regurgitation.
We retrospectively analysed the long-term results and mid-term features of the surgical procedures on left ventricular (LV) volume, geometry, function and mitral regurgitation (MR) in patients with ischaemic cardiomyopathy (antero-septal dominant) who underwent LV reconstruction (LVR). ⋯ Despite the more spherical LV change, LVR led to a significant volume reduction (45%), still maintaining its physiological shape that confirmed an improved LV function and better long-term results. The Dor procedure could significantly reduce the larger LV volume without losing the end-systolic elliptical shape and mitral valvular competence like other techniques without the Fontan stitch.
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Eur J Cardiothorac Surg · Sep 2012
Bidirectional cavopulmonary shunt with additional pulmonary blood flow: a failed or successful strategy?
In patients with single ventricle physiology, Fontan circulation is considered as the optimal surgical approach, although it entails a growing incidence of late complications. It has been speculated that the association of bidirectional cavopulmonary shunt (BCPS) and additional pulmonary blood flow (APBF) might provide long-lasting palliation. The present study was undertaken to assess the long-term outcome of this strategy. ⋯ BCPS with APBF approach: (i) fails as a strategy for definitive palliation, (ii) provides a high survival rate, (iii) does not preclude a successful Fontan completion and (iv) may delay the long-term deleterious consequences of Fontan circulation. Palliation by BCPS with APBF should be achieved early in life.
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Eur J Cardiothorac Surg · Sep 2012
Comparative StudyImpact of previous cardiac operations on patients undergoing transapical aortic valve implantation: results from the Italian Registry of Transapical Aortic Valve Implantation.
Redo cardiac surgery has an increased risk of morbidity and mortality when compared with the initial operation. The aim of this study was to assess the impact of previous cardiac operations on patients undergoing transapical aortic valve implantation (TA-TAVI). ⋯ According to our data, patients undergoing TAVI with previous cardiac operations have a higher preoperative risk profile but have similar outcomes when compared with patients undergoing a first operation. In these subset of patients, TAVI is a promising therapeutic option.