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 2016
Non-invasive spinal cord oxygenation monitoring: validating collateral network near-infrared spectroscopy for thoracoabdominal aortic aneurysm repair.
Near-infrared spectroscopy of the collateral network (cnNIRS) has recently been trialled to monitor real-time tissue oxygenation of the paraspinous vasculature as a surrogate for spinal cord tissue oxygenation. This large animal study was designed to investigate the correlation between cnNIRS and spinal cord oxygenation by comparing it to laser Doppler flowmetry (LDF), a proven method for direct oxygenation and flow assessment. ⋯ These experiments confirm that the paraspinous vasculature in the presented large animal model is directly linked to spinal cord microcirculation and that the regional paraspinous muscle oxygenation status reflects spinal cord tissue oxygenation. As lumbar cnNIRS reproducibly depicts tissue oxygenation of the paraspinous vasculature, it can be used for non-invasive spinal cord oxygenation monitoring in real-time.
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Eur J Cardiothorac Surg · Oct 2016
Complete myocardial revascularization using only bilateral internal thoracic arteries provides a low-risk and durable 10-year clinical outcome.
Bilateral internal thoracic artery (BITA) bypass provides long-term survival benefits over strategies that use single internal mammary arteries during coronary artery bypass grafting (CABG). However, the rate of adoption of this strategy remains very low. Moreover, optimal BITA configuration and the use of cardiopulmonary bypass still remain a matter of debate. We investigated the long-term results of a coronary revascularization strategy, utilising exclusively BITA-Y composite grafts using off-pump platform and sequential anastomoses. ⋯ Performance of an exclusive composite BITA off-pump revascularization strategy optimal and sustained long-term protection from MACCE.
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Eur J Cardiothorac Surg · Sep 2016
Randomized Controlled Trial Comparative StudyUniportal video-assisted thoracoscopic lobectomy versus other video-assisted thoracoscopic lobectomy techniques: a randomized study.
A prospective, randomized study was carried out on patients undergoing lung cancer surgery, with the aim of determining if uniportal video-assisted lobectomy has more favourable postoperative outcomes than other video-assisted thoracoscopic lobectomy techniques (Duke approach and Copenhagen approach). ⋯ Uniportal video-assisted thoracoscopic lobectomy does not present better postoperative outcomes than other video-assisted thoracoscopic lobectomy techniques.
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Eur J Cardiothorac Surg · Sep 2016
Comparative StudyComparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR.
Thymectomy may be part of the therapeutic strategy in patients with myasthenia gravis (MG) without thymoma. Median sternotomy is still considered as the gold standard, but during the last 15 years, several groups have demonstrated the non-inferiority of cervicotomy with upper sternotomy and minimally invasive techniques. To date, there is no consensus on surgical procedure choice. The aim of our study was to compare the morbidity and mortality of three techniques [cervicotomy with upper sternotomy versus sternotomy versus video-assisted thoracic surgery (VATS)/robotic-assisted thoracic surgery (RATS)] from the national database EPITHOR and to analyse French epidemiology. ⋯ In our study, we were unable to prove the superiority of minimally invasive techniques due to the important differences between the groups. However, this study shows us major changes in French surgical procedures during the last decade with an increase in minimally invasive procedures such as VATS and RATS.