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 2011
Comparative StudyTotal arch repair versus hemiarch repair in the management of acute DeBakey type I aortic dissection.
In acute DeBakey type I aortic dissection, it is still controversial whether to perform extended aortic replacement to improve long-term outcome or to use a conservative strategy with ascending aortic and hemiarch replacement to palliate a life-threatening condition. ⋯ Total arch repair was associated with greater morbidity and mortality compared with hemiarch repair in acute DeBakey type I aortic dissection. Rates of aortic re-operation or aortic dilatation were not significantly different between the two surgical strategies. These findings support a conservative surgical approach to circumvent this life-threatening situation.
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Eur J Cardiothorac Surg · Oct 2011
Comparative StudySurgical results of active infective native mitral valve endocarditis: repair versus replacement.
The current study compared clinical outcomes after mitral valve repair or replacement in patients with active infective endocarditis involving only the native mitral valve. ⋯ The present study showed that postoperative long-term survival and event-free survival in patients with active infective endocarditis of the native mitral valve were not statistically significantly different regardless of whether patients underwent MVP or MVR.
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Eur J Cardiothorac Surg · Oct 2011
Case ReportsCongenital left circumflex artery fistula drainage into left ventricle.
Congenital communication between left coronary artery to left ventricle is a rare anomaly. A 52-year-old male patient visited our institution complaining of paroxysmal palpitation and echocardiography revealed a large fistula draining into the left ventricle. Coronary angiography and computed tomography (CT) scanning confirmed the fistula located between the left circumflex coronary artery (LCX) and left ventricle (LV). A simple fistula ligation was performed, and postoperative three-dimensional coronary CT scanning confirmed the patient got a complete cure.
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Eur J Cardiothorac Surg · Oct 2011
Should we always plan a Fontan completion after a Kawashima procedure?
To determine the late incidence of pulmonary arteriovenous malformations after bidirectional Glenn in patients with azygos continuation of the inferior vena cava (Kawashima operation). ⋯ Unless some hepatic blood flow is directed to both lungs, most, if not all patients with a Kawashima procedure will ultimately develop pulmonary arteriovenous malformations. Elective non-fenestrated Fontan completion in the years following Kawashima procedure should be recommended.
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Eur J Cardiothorac Surg · Oct 2011
Is flexible bronchoscopy necessary to confirm the position of double-lumen tubes before thoracic surgery?
Flexible bronchoscopy is recommended to confirm correct placement of double-lumen tubes used for thoracic anesthesia. However, there is still controversy over routine bronchoscopic confirmation of their position. This study aimed to verify the usefulness of flexible bronchoscopy for confirming the position of double-lumen tubes after blind intubation. ⋯ After blind intubation, 37% of double-lumen tubes required repositioning by means of flexible bronchoscopy, despite positive evaluation made by the anesthesiologist. Our data suggests that initial bronchoscopic assessment should be made with the patient still in the supine position, and confirms that flexible bronchoscopy is useful in verifying the correct position of double-lumen tubes or adjusting possible misplacements, before starting thoracic surgery.