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 2014
Randomized Controlled TrialPerioperative gabapentin for the prevention of persistent pain after thoracotomy: a randomized controlled trial.
To evaluate the effect of perioperative gabapentin treatment for the prevention of persistent post-thoracotomy pain and to establish whether gabapentin has a significant therapeutic impact on acute postoperative pain. ⋯ We found no evidence for the superiority of gabapentin over placebo for the treatment of acute pain following thoracotomy or for the prevention of persistent post-thoracotomy pain.
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Eur J Cardiothorac Surg · Jul 2014
Hybrid approach for hypoplastic left heart syndrome and its variants: the fate of the pulmonary arteries.
To analyse the results of hybrid palliation of hypoplastic left heart syndrome (HLHS) patients and its variants with an emphasis on the long-term fate of the pulmonary arteries. ⋯ Hybrid approach can be pursued with a low mortality. However, the high frequency of catheter and/or surgical interventions, and the sluggish growth of the branch PA pre-Fontan need innovative solutions. A comparison of the neurodevelopmental outcome for the hybrid vs the Norwood cohort would define the role of the hybrid strategy in the treatment of HLHS and its variants.
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Eur J Cardiothorac Surg · Jul 2014
Time to refine N2 staging? cN2α and cN2β based on local regional involvement provide a more accurate prognosis in surgically treated IIIA non-small-cell lung cancer than N2 alone or the number of node stations involved.
The number of stations of N2 nodes involved has been considered to be one of the most important prognostic factors for lung cancer. However, most reports have dealt with the pathological nodal status rather than with the clinical nodal status. We investigated the relationship between the prognosis and the location of the primary tumour and nodes involved. ⋯ Clinical mediastinal lymph node status based on the location of the primary tumour and the node involved was an important preoperative prognostic factor. Thus, this factor should be considered when planning and evaluating clinical trials. Another important finding was that clinical single-station N2 is not always pathological single-station N2 disease.
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Eur J Cardiothorac Surg · Jul 2014
Safety and feasibility of concomitant surgical ablation of atrial fibrillation in patients with severely reduced left ventricular ejection fraction.
Concomitant surgical ablation of atrial fibrillation (AF) is a safe and feasible procedure. However, many surgeons are reluctant to perform it in patients with heart failure. We investigated the safety and efficacy of AF ablation in patients with a severely reduced left ventricular ejection fraction (LVEF <35%). ⋯ Surgical AF ablation was safe and feasible in patients with severely reduced LVEF. The restoration of SR led to a significantly higher improvement in LVEF and alleviation of clinical heart failure symptoms, not observed if AF persisted postoperatively.
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Eur J Cardiothorac Surg · Jul 2014
Comparative StudyThe impact of clopidogrel therapy on postoperative bleeding after robotic-assisted coronary artery bypass surgery.
The purpose of this study was to determine whether patients undergoing robotic-assisted coronary artery bypass graft surgery (CABG) on clopidogrel had an increased risk of bleeding complications compared with those not on clopidogrel. ⋯ Patients undergoing robotic-assisted CABG on clopidogrel had more postoperative bleeding and a higher incidence of blood transfusion. Therefore, despite a less invasive approach, surgery should be delayed in these patients when possible.