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 2009
Multicenter StudySubaortic obstruction in univentricular heart: results using the double barrel Damus-Kaye Stansel operation.
We review our experience with relief of subaortic obstruction in univentricular hearts following pulmonary artery banding (PAB) with double barrel Damus-Kaye Stansel procedure (DKS) and subsequent staged palliation to Fontan. The purpose was to determine if PAB alters semilunar valve function after the double barrel DKS procedure and if this staged approach negatively influences the achievement of Fontan palliation. ⋯ PAB (+/-coarctation repair) with interval double barrel DKS is effective palliation for univentricular heart and excessive pulmonary blood flow. PAB does not create significant pulmonary insufficiency and subsequent DKS effectively relieves single ventricle to aortic gradient. Optimal second stage pulmonary blood flow is usually established with a bidirectional Glenn. The need for a Blalock shunt or a Glenn plus a Blalock is associated with increased mortality.
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Eur J Cardiothorac Surg · Jan 2009
Multicenter StudyThe Chinese coronary artery bypass grafting registry study: how well does the EuroSCORE predict operative risk for Chinese population?
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) model is a widely used risk prediction algorithm for cardiac surgery in China due to lack of a local model, although its validation has never been tested. The aim of this study was to assess the performance of the logistic EuroSCORE when applied in the Chinese Coronary Artery Bypass Grafting Registry database, which is representative of adult cardiac surgery in China. ⋯ EuroSCORE model does not accurately predict outcomes in this group of Chinese CABG patients. Therefore, caution should be exercised when using it for risk prediction in China. Creation of a new model, which accurately predicts outcomes in Chinese CABG patients, is warranted.
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Eur J Cardiothorac Surg · Dec 2008
Multicenter Study Comparative StudySAPS 3 at dialysis commencement is predictive of hospital mortality in patients supported by extracorporeal membrane oxygenation and acute dialysis.
This study examined the association between hospital mortality and five illness-severity scoring systems evaluated at different time points in the intensive care unit (ICU) as well as clinical variables as predictors in critically ill patients supported by extracorporeal membrane oxygenation (ECMO) and acute dialysis. ⋯ Among five common ICU scoring systems evaluated at different time points, SAPS 3 at dialysis commencement is the best risk adjustment systems to predict hospital mortality in critically ill patients supported by ECMO and acute dialysis. Furthermore, the SAPS 3 score at dialysis commencement and IABP usage before ECMO are two major independent predictors for hospital mortality in patients supported by ECMO and acute dialysis.
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Eur J Cardiothorac Surg · Nov 2008
Multicenter Study Comparative StudyHydrodynamic comparison of biological prostheses during progressive valve calcification in a simulated exercise situation. An in vitro study.
Despite continuous development of anticalcification treatment for biological valve prostheses, calcification remains one major cause of structural failure. The following study investigates hemodynamics and changes in opening and closing kinematics in progressively calcified porcine and pericardial valves in a simulated exercise situation. ⋯ In the exercise situation pericardial valves demonstrated superior systolic function compared to porcine valves. Therefore pericardial valves have some advantage in active patients due to the lower gradients. Total energy loss remained constant during progressive calcification for both valves. Leaflet opening and closing is faster in porcine valves; clinical impact of these findings is not known. Diastolic performance is also important and should always be tested also in vivo.
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Eur J Cardiothorac Surg · Mar 2008
Multicenter StudyPostoperative exacerbation of chronic obstructive pulmonary disease. Does it exist?
One of the characteristics of chronic obstructive pulmonary disease (COPD) is the tendency to develop acute exacerbation, defined by the presence of different clinical findings as worsening dyspnea, increase in sputum purulence and volume. This study was designed to verify if definition of acute COPD exacerbation is applicable to patients who underwent pulmonary surgery, and if it has any impact on postoperative morbidity and mortality. ⋯ Postoperative exacerbation of COPD is an existing, frequent clinical entity after lung resection and, when present, it increases the risk of pulmonary complications. The existing guidelines for the treatment of acute exacerbation should be adapted for the management of patients after lung resection in order to test the hypothesis that they could reduce respiratory morbidity.