European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2013
Low-dose human atrial natriuretic peptide for the prevention of postoperative cardiopulmonary complications in chronic obstructive pulmonary disease patients undergoing lung cancer surgery.
Lung cancer patients with chronic obstructive pulmonary disease are at an increased risk of respiratory and cardiovascular complications after pulmonary resection. The objective of the present study was to evaluate the clinical effects of low-dose human atrial natriuretic peptide (hANP) on postoperative cardiopulmonary complications in untreated chronic obstructive pulmonary disease patients undergoing lung cancer surgery. ⋯ Treatment with hANP during the perioperative period had a prophylactic effect against postoperative cardiopulmonary complications in chronic obstructive pulmonary disease patients undergoing lung cancer surgery.
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Eur J Cardiothorac Surg · Jul 2013
The risk of death due to cardiorespiratory causes increases with time after right pneumonectomy: a propensity score-matched analysis.
The study aimed to compare in-hospital, 30-day and non-cancer-related 6-month death rates in a series of right and left pneumonectomy cases matched according to functional parameters. ⋯ The risk of death after pneumonectomy increases with time and strongly depends on the side of the operation (it is higher after right pneumonectomy) and on the occurrence of any postoperative cardiorespiratory complication. Neither hospital nor 30-day mortality should be reported as a valid outcome after pneumonectomy since they do not represent the real risk of the operation.
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Eur J Cardiothorac Surg · Jul 2013
The maximum standardized uptake value of fluorodeoxyglucose positron emission tomography of the primary tumour is a good predictor of pathological nodal involvement in clinical N0 non-small-cell lung cancer.
Fluorodeoxyglucose positron emission tomography (FDG-PET) plays an important role in the evaluation of resectable non-small-cell lung cancer (NSCLC). However, this modality cannot be used to detect histological nodal involvement, which can result in stage-migration for resectable lung cancer. In this study, we tried to evaluate the possibility of predicting histological nodal involvement in patients with NSCLC using the maximum standardized uptake value (SUVmax) of FDG-PET of the primary tumour instead of that of the lymph nodes. ⋯ Postoperative nodal status was significantly predicted by the SUVmax of FDG-PET of the primary tumour instead of the lymph nodes themselves. The patients with NSCLC in particular who show strong uptake values of SUVmax in the primary tumour could have occult nodal metastases, and may be indicated for a further preoperative modality for an accurate staging.
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Eur J Cardiothorac Surg · Jul 2013
Phenylephrine infusion improves blood flow to the stomach during oesophagectomy in the presence of a thoracic epidural analgesia.
Gastric tube necrosis is a major cause of mortality after oesophagectomy. The construction of the gastric tube used for oesophageal reconstruction involves a division of several arteries leading to a reduction in the blood supply at the fundus, which is used for the oesophageal anastomosis. This study was undertaken to determine the effect of thoracic epidural anaesthesia and intravenous phenylephrine on haemodynamics and blood flow in the tubularized stomach. ⋯ An intravenous phenylephrine infusion can reverse the epidural bolus-induced reduction in blood flow at the anastomotic end of the newly formed gastric tube.
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Eur J Cardiothorac Surg · Jul 2013
A 17-year experience with mitral valve repair with artificial chordae in infants and children.
We sought to examine our long-term results of mitral valve (MV) repair with expanded polytetrafluoroethylene (ePTFE) sutures and to determine the predictors for the outcome of this procedure. ⋯ MV repair with artificial chordae in infants and children is safe and effective and associated with a low reoperation rate. Further investigation into the long-term durability and biological adaptation of ePTFE sutures after patient growth is mandatory.