European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2010
Does video-assisted thoracoscopic lobectomy for lung cancer provide improved functional outcomes compared with open lobectomy?
We evaluated video-assisted thoracic surgery (VATS) and open (OPEN) lobectomy for lung cancer and impact upon 6-month postoperative (postop) functional health status and quality of life. ⋯ VATS lobectomy for curative lung cancer resection appears to provide a superior functional health recovery compared with OPEN techniques.
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Eur J Cardiothorac Surg · Feb 2010
The impact of afterload reduction on the early postoperative course after the Norwood operation - a 12-year single-centre experience.
The objective of this study was to analyse the postoperative course and early outcome after the Norwood operation for patients with hypoplastic left heart syndrome. We particularly aimed to assess the impact of surgical and pharmacological modifications introduced. ⋯ Adamant afterload reduction improves systemic blood flow early after the Norwood operation and may have contributed to the reduction in early postoperative mortality achieved over 12 years.
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Eur J Cardiothorac Surg · Feb 2010
Absolute and relative risk prediction in patients candidate to isolated aortic valve replacement: should we change our mind?
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) calculator performance in 30-day outcome prediction after isolated aortic valve replacement (AVR) was evaluated to assess its absolute reliability and usefulness as selection criteria to percutaneous aortic valve implantation (PAVI). ⋯ EuroSCORE appears to be an invalid model in absolute and relative risk prediction for isolated AVR. On this basis, its use in selecting candidates to PAVI should be carefully weighted. Correct stratification and sufficient calibration of absolute risk estimate of high-risk patients are, therefore, mandatory in the aim of assigning those patients who show risk factors really responsible for the worst surgical outcome to new techniques. The goal should be reached by exploring the weight of each independent predictor of death in each single institution involved in PAVI procedures, evaluating local surgical results in terms of absolute risk and analysing those variables significantly affecting relative risk.
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Eur J Cardiothorac Surg · Feb 2010
Hypersensitivity reactions to aprotinin re-exposure in paediatric surgery.
Hypersensitivity to aprotinin is low (1-3%) but more likely with re-exposure. The manufacturer issued a black box warning which lists aprotinin re-exposure within 1 year of prior exposure as a contraindication. We investigated the temporal relationship between re-exposure interval and hypersensitivity in children. ⋯ The incidence and type of hypersensitivity to aprotinin re-exposure in our cohort is consistent with previous reports. Repeat exposure within 1 year did not increase the risk of systemic hypersensitivity.
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Eur J Cardiothorac Surg · Jan 2010
Comparative StudyPostoperative change in pulmonary function of the ipsilateral preserved lung after segmentectomy versus lobectomy.
Anatomical repositioning and expansion of the ipsilateral preserved lung after lung resection may influence postoperative pulmonary function. To study the postoperative changes in pulmonary function of the preserved lung after lobectomy compared with that after segmentectomy, the preoperative and postoperative forced expiratory volume in 1s (FEV(1)) of the ipsilateral non-operated lobe was measured using perfusion single-photon-emission computed tomography and computed tomography (SPECT/CT). ⋯ The FEV(1) of the ipsilateral non-operated lobes increased after surgery on left upper lobe, whereas it decreased after right upper lobectomy. The surgery on lower lobe did not affect the FEV(1) of the ipsilateral non-operated lobes. Our data may facilitate determining the indications for lung cancer surgery, especially in patients with tumours involving the upper lobes.