European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2011
Randomized Controlled TrialOn-pump coronary surgery with and without cardioplegic arrest: comparison of inflammation, myocardial, cerebral and renal injury and early and late health outcome in a single-centre randomised controlled trial.
To assess the safety and efficacy of on-pump beating heart coronary surgery on organ function, and early and late health outcome as compared with conventional technique. ⋯ On-pump without CA coronary surgery does not provide any obvious advantage when compared with the conventional technique of on-pump with CA in elective patients. Both techniques provide a comparable degree of inflammatory activation, myocardial, cerebral and renal injury with similar 5-year event-free survival.
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Eur J Cardiothorac Surg · May 2011
Randomized Controlled TrialThe myocardial protective effects of adenosine pretreatment in children undergoing cardiac surgery: a randomized controlled clinical trial.
Adenosine pretreatment reduces injury caused by ischemia-reperfusion. To investigate the hypothesis that adenosine pretreatment would modulate injury induced by cardiopulmonary bypass (CPB) and myocardial ischemia/reperfusion, we conducted a randomized controlled trial on the effects of adenosine pretreatment in children undergoing surgery to repair congenital heart defects. ⋯ This study demonstrates that adenosine pretreatment is protective of the myocardium during open-heart surgery in pediatric patients.
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Eur J Cardiothorac Surg · May 2011
Predictors of postoperative decline in quality of life after major lung resections.
Severe impairment in quality of life (QoL) is one of the major patients' fears about lung surgery. Its prediction can be valuable information for both patients and physicians. The objective of this study was to identify predictors of clinically relevant decline of the physical and emotional components of QoL after lung resection. ⋯ A consistent proportion of patients undergoing lung resection exhibit an important postoperative worsening in their QoL. We were able to identify reliable risk factors and predictive equations estimating this decline. These findings may be used as selection criteria for efficacy trials on perioperative physical rehabilitation or psychological treatments, during preoperative counseling, in the surgical decision-making process and for selecting those patients who would benefit from physical and emotional supportive programs.
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Eur J Cardiothorac Surg · May 2011
Outcomes of ventricular assist device support in young patients with small body surface area.
Although the ventricular assist device (VAD) has been a well-established therapy for larger adolescents and adult patients with advanced heart failure, current experience with the use of VAD for mechanical circulatory support in infants and young children with small body surface area is still limited. ⋯ Berlin Heart EXCOR pediatric VAD could provide satisfactory and safe circulatory support for small children with end-stage heart disease.
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Eur J Cardiothorac Surg · May 2011
The impact of preoperative body mass index on respiratory complications after pneumonectomy for non-small-cell lung cancer. Results from a series of 154 consecutive standard pneumonectomies.
Although it may seem intuitive that obesity is an additional risk factor for surgical patients, few studies have correlated this condition with lung cancer resection. The only data currently available suggest that obesity does not increase the rate of complications after anatomic resection for non-small-cell lung cancer (NSCLC). ⋯ The risk of respiratory complications in patients with BMI higher than 25 kg m⁻² undergoing pneumonectomy for lung cancer is 5.3 times higher than that of patients with BMI < 25 kg m⁻². Thoracic surgeons and anaesthesiologists should be aware of this information before planning elective pneumonectomy in overweight and especially in obese patients.