European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Oct 2013
Multicenter StudyOff-pump surgery in preventing perioperative stroke after coronary artery bypass grafting: a retrospective multicentre study.
To determine the effect of the off-pump technique in preventing stroke development during the early perioperative period after coronary artery bypass graft surgery (CABG). ⋯ Off-pump surgery has a lower perioperative stroke incidence than on-pump only in cases associated with cardiovascular stroke-risk factors, in particular, with chronic renal failure and preoperative cardiac failure, but also with peripheral arteriopathy, prior stroke and non-elective surgery. The perioperative stroke rate remains high in cases with two or more preoperative stroke risk factors, even when using the off-pump technique, particularly when chronic renal failure is present.
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Eur J Cardiothorac Surg · Oct 2013
Propensity-matched analysis of bilateral internal mammary artery vs single internal mammary artery in 7702 cases of isolated coronary artery bypass grafting.
To evaluate early outcomes of bilateral internal mammary artery (BIMA) compared with single IMA (SIMA) in patients who underwent isolated coronary artery bypass grafting (CABG). ⋯ The use of BIMA did not affect either short-term survival as postoperative mortality was low in both groups, or overall morbidity despite higher incidence of deep sternal infection.
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Eur J Cardiothorac Surg · Oct 2013
A population-based study of hospital length of stay and emergency readmission following surgery for non-small-cell lung cancer.
We conducted a population-based analysis of time trends in length of stay (LOS), predictors of prolonged LOS and emergency readmission following resection for non-small-cell lung cancer (NSCLC). ⋯ Half of the patients had a LOS in excess of 13 days, which was longer than any other country with published data. Patient and health-service factors were associated with prolonged LOS, while patient and tumour characteristics were associated with risk of emergency readmission. Deprivation was a conspicuous determinant of both LOS and readmission.
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Eur J Cardiothorac Surg · Sep 2013
Review Meta AnalysisIs video-assisted thoracic surgery lobectomy better than thoracotomy for early-stage non-small-cell lung cancer? A systematic review and meta-analysis.
The study aimed to compare the reported oncological outcomes based on satisfactory lymph node dissection (LND) or lymph node sampling (LNS), systemic and loco-regional recurrence rate and long-term survival rate of patients with early-stage non-small-cell lung cancer (NSCLC) who underwent video-assisted thoracic surgery (VATS) lobectomy or thoracotomy lobectomy. A systematic review was conducted using PubMed, EMBASE and OVID-EBMR databases ranging from 1990 to 2011. The studies compared VATS and thoracotomy for patients with NSCLC, with results including LND or LNS where recurrence as well as survival rates were identified. ⋯ Systemic (RR: 0.61; 95% CI: 0.48 to 0.78; P < 0.01) and loco-regional (RR: 0.66; 95% CI: 0.46 to 0.95; P = 0.03) recurrence rates were significantly lower in the VATS group. Moreover, a significantly higher survival rate (RR: 1.09; 95% CI: 1.03 to 1.15; P < 0.01) was also demonstrated by a Forest plot in the VATS group. These results suggest that VATS lobectomy might be an eligible alternative in place of thoracotomy in patients with early-stage NSCLC by reducing recurrence and improving survival rates.
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Eur J Cardiothorac Surg · Sep 2013
Acute lung injury after mechanical circulatory support implantation in patients on extracorporeal life support: an unrecognized problem.
We observed early acute lung injury (ALI) after a switch from veno-arterial extracorporeal life support (VA-ECLS) to long-term mechanical circulatory support (MCS). The aim of our study was to analyse the frequency, impact on mortality and characteristics of patients presenting ALI after MCS implantation in the bridge-to-bridge (BTB) strategy. ⋯ Implantation of a long-term MCS device in patients on ECLS can result in severe ALI, which is associated with ominous outcomes. Various preimplant risk factors for ALI have been identified and might allow devising strategies to prevent this complication.