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 2003
Orthotopic heart transplantation for failing single ventricle physiology.
Evaluation of incremental risk factors for early mortality in children undergoing orthotopic heart transplantation (OHT) for failing single ventricle physiology. ⋯ OHT for structural CHD with single ventricle physiology entails substantial early mortality while BDG enables the best transition to heart transplant. OHT should be considered in the decision-making process as an alternative to Fontan completion in high-risk candidates, since rescue-OHT after failing Fontan seems unwarranted.
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Eur J Cardiothorac Surg · Sep 2003
Practice Guideline GuidelineOptimal structure of a congenital heart surgery department in Europe.
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Eur J Cardiothorac Surg · Sep 2003
Is a learning curve for arterial switch operation in small countries still acceptable? Model for cooperation in Europe.
To assess the results of a cooperative arrangement between Slovakia and Slovenia for neonatal cardiac surgery. The aim of the study was to analyze the performance of this approach for complete transposition of the great arteries (D-TGA). ⋯ In the current era a prolonged learning curve for ASO is not acceptable to most European countries and their patients. The risk of surgery can be minimized by concentrating surgical experience as part of the quality control of congenital heart programs. If the number of new patients is small due to the birth rate and size of the population, institutions should merge activity. Such centralization amplifies the experience to the benefit of the patient.
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Eur J Cardiothorac Surg · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialEarly postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study.
Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolateral thoracotomy. ⋯ In conclusion, preoperative epidural analgesia is an appropriate method for post-thoracotomy pain and is more effective in preventing acute postoperative pain.