European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2017
ReviewTechniques and standards in intraoperative graft verification by transit time flow measurement after coronary artery bypass graft surgery: a critical review.
Transit time flow measurement (TTFM) is a quality control tool for intraoperative graft evaluation in coronary artery bypass graft (CABG) surgery. A critical review of the literature available using TTFM in CABG surgery is the focus of this article. The main objectives will be to detail precise parameters for flow evaluation, to show limitations of TTFM and to prove its predictive impact on postoperative graft failure rate. ⋯ Influence of quantity (vessel territory distribution) and quality (myocardial scar) of the graft perfusion area, on TTFM and FU outcome, was not included by anyone and should be part of future research. TTFM is probably not the tool of choice to detect progressive late graft failure of SVG. Peroperative TTFM values should be correlated with one type of conduit, differentiating between early and late graft failure (by applying a uniform, appropriated definition), to precise and confirm threshold values.
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Eur J Cardiothorac Surg · Jan 2017
Comparative StudyThe differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies.
Video-assisted thoracoscopic surgery (VATS) lobectomy is quickly becoming the standard of care for many patients with early-stage non-small-cell lung cancer (NSCLC) and benign lung conditions. There is a lack of published data defining the differential impact of preoperative patient comorbidity on outcomes following VATS and OPEN lobectomies, which would be beneficial for procedure selection and clinical decision-making. ⋯ The expected postoperative length of stay for a patient treated by OPEN lobectomy is approximately equal to that of a VATS lobectomy patient with an additional 2-3 comorbidities. The VATS approach remains advantageous with respect to PO-LOS, regardless of the number of comorbidities.