European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2010
Multicenter StudyImpact of prophylactic intra-aortic balloon counter-pulsation on postoperative outcome in high-risk cardiac surgery patients: a multicentre, propensity-score analysis.
The aim of this multicentre study was to determine whether the prophylactic use of intra-aortic balloon pump (IABP) translates into better early and long-term results in high-risk patients undergoing cardiac surgery. ⋯ Prophylactic IABP support, in this multicentre experience, was showed to enhance perioperative management and outcome of high-risk cardiac surgery patients.
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Eur J Cardiothorac Surg · Nov 2010
Comparative StudyRisk prediction and outcomes in patients with liver cirrhosis undergoing open-heart surgery.
There are few data assessing factors, which identify patients with liver cirrhosis (LC) facing high risk for open-heart surgery. We sought to compare the Model for End-Stage Liver Disease (MELD) score, the Child-Turcotte-Pugh (CTP) classification and the European system for cardiac operative risk evaluation (EuroSCORE) for risk prediction in cirrhotic patients. ⋯ The mortality of patients with liver cirrhosis undergoing open-heart surgery progressively increases with the severity of liver dysfunction. Therefore, the MELD score most reliably identifies those cirrhotic patients who are at high risk for open-heart surgery.
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Eur J Cardiothorac Surg · Nov 2010
Should root replacement with aortic valve-sparing be offered to patients with bicuspid valves or severe aortic regurgitation?
To examine the results of root replacement with aortic valve-sparing in patients with bicuspid aortic valve (BAV) or severe aortic regurgitation (AR). ⋯ The outcome in terms of survival is excellent for all patients after aortic valve-sparing operations. There is no significant difference in terms of re-operation between patients, who presented with BAV or TAV. Re-operation rates are higher for patients who presented with severe AR but these rates do not reach statistical significance. Hence, root replacement with aortic valve-sparing should be offered even in the presence of a BAV or severe AR.
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Eur J Cardiothorac Surg · Nov 2010
The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation.
The Ross procedure is the aortic valve-replacement procedure of choice in children. Nonetheless, late autograft re-operation for dilatation and/or valve regurgitation is of concern. We examined whether preoperative haemodynamic manifestation (e.g., stenosis, regurgitation and mixed aortic valve disease) affected late re-operation risk. ⋯ The Ross procedure in children is associated with excellent survival. Late autograft re-operation may be required; however, it is more common in children with preoperative aortic regurgitation, especially those with rheumatic fever. Better patient selection in later era has mitigated the risk of autograft re-operation. Continued improved candidate selection, along with modifications in autograft implantation and root/sinotubular stabilisation techniques, may further decrease late autograft failure.