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 2012
Review Meta AnalysisEstimating the risk of complications related to re-exploration for bleeding after adult cardiac surgery: a systematic review and meta-analysis.
The aim of this study was to evaluate the impact of re-exploration for bleeding after cardiac surgery on the immediate postoperative outcome. ⋯ This study suggests that re-exploration for bleeding after cardiac surgery carries a significantly increased risk of postoperative mortality and morbidity.
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Eur J Cardiothorac Surg · Oct 2011
ReviewA competency framework in cardiothoracic surgery for training and revalidation - an international comparison.
The conventional methods of education, certification and recertification in cardiothoracic surgery face a paradigm shift in line with recent innovations in diagnostics and therapeutics. The attributes of a competent clinician entail proficiency in knowledge, communication, teamwork, management, health advocacy, professionalism and technical skills. This article investigates the skills required for a cardiothoracic surgeon to be competent. ⋯ Validated and competency-based curricula should be designed to develop core competencies to successfully integrate them into practice. Challenges to the implementation of such curricula and potential solutions are explored. Patient safety remains the ultimate aim to ensure excellence of both competency and performance.
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Eur J Cardiothorac Surg · Oct 2011
Review Randomized Controlled TrialIntra-operative paravertebral block for postoperative analgesia in thoracotomy patients: a randomized, double-blind, placebo-controlled study.
Epidural analgesia is the gold standard for post-thoracotomy pain relief but is contraindicated in certain patients. An alternative is paravertebral block. We investigated whether ropivacaine, administered through a paravertebral catheter placed by the surgeon, reduced postoperative pain. ⋯ Paravertebral block using a catheter placed by the thoracic surgeon was ineffective on postoperative pain after thoracotomy and did not confirm the analgesic effect that has been observed after percutaneous catheter placement. A direct comparison of these two placement methods is required.
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Eur J Cardiothorac Surg · Sep 2011
ReviewModified simple sliding aortoplasty for preserving the sinotubular junction without using foreign material for congenital supravalvar aortic stenosis.
The surgical approach for treating supravalvar aortic stenosis (SVAS) has evolved from a plain patch technique to a three-dimensional patch repair, which has some drawbacks. Here, we report on the midterm outcomes after using our modified simple sliding aortoplasty preserving sinotubular junction without foreign material for surgical correction of SVAS. ⋯ Our modified simple sliding aortoplasty showed excellent surgical results, and may be a good option for discrete SVAS.
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Eur J Cardiothorac Surg · Aug 2011
ReviewThe implication of vasa vasorum in surgical diseases of the aorta.
Vasa vasorum (VV) are microscopic vases that perfuse the vessel's wall; arteries and veins. Many recent researches support the opinion that VV have a significant role in aortic pathology. The VV, or 'the vessels of the vessels', form a network of microvessels that lie in the adventitia and penetrate the outer media of the host vessel wall. ⋯ Although the proliferation of VV due to atherogenic stimuli is controversial, experimental and clinical studies strongly suggest the potential of VV in vascular proliferative disorders. It seems that the rupture of VV is implicated in intramural hematoma, which can develop in acute aortic dissection. In this review article, we would like to stress the anatomy and mainly the pathophysiology, and the implication of VV in the acute and chronic aortic pathologies.