European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2014
Practice GuidelineRevised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer.
Accurate preoperative staging and restaging of mediastinal lymph nodes in patients with potentially resectable non-small-cell lung cancer (NSCLC) is of paramount importance. In 2007, the European Society of Thoracic Surgeons (ESTS) published an algorithm on preoperative mediastinal staging integrating imaging, endoscopic and surgical techniques. In 2009, the International Association for the Study of Lung Cancer (IASLC) introduced a new lymph node map. ⋯ For restaging, invasive techniques providing histological information are advisable. Both endoscopic techniques and surgical procedures are available, but their negative predictive value is lower compared with the results obtained in baseline staging. An integrated strategy using endoscopic staging techniques to prove mediastinal nodal disease and mediastinoscopy to assess nodal response after induction therapy needs further study.
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Eur J Cardiothorac Surg · May 2014
A papillary-ventricular complex repair technique for functional mitral regurgitation.
The objective of this study was to describe a simple and reproducible papillary-ventricular complex technique for repairing functional mitral regurgitation. To avoid a recurrence of mitral regurgitation subsequent to left ventricular remodelling, we performed papillary muscle plication and papillary muscle and head approximation in combination with relocation of the papillary muscle heads to correct any anterior and or posterior mitral leaflet discrepancy and to preserve the papillary-ventricular complex. Preliminary results in 7 patients showed an encouraging functional improvement following surgery. Future long-term controlled studies in a greater number of patients are required to further assess this novel technique.
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Eur J Cardiothorac Surg · May 2014
The Yasui operation for patients with adequate-sized ventricles and ventricular septal defect associated with obstructions of the aortic arch and left ventricular outflow tract.
To review the surgical outcome of the Yasui operation in patients with adequate-sized ventricles and ventricular septal defect (VSD) associated with obstructions of the aortic arch and left ventricular outflow tract (LVOT). ⋯ The results of the Yasui operation were excellent, showing low mortality and good mid-term left ventricular function without outflow tract stenosis or neoaortic valve insufficiency. Bilateral PAB as initial palliation is a useful option in symptomatic neonates.