European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1996
Comparative StudyEndoscopic versus transaxillary thoracic sympathectomy for primary axillary and palmar hyperhidrosis and/or facial blushing: 5-year-experience.
Thoracic sympathectomy is effective in the permanent cure of primary axillary and palmar hyperhidrosis and facial blushing, which can be so troublesome for patients that their social and professional relations can be affected. Between October 1988 and April 1994, a total of 50 thoracic sympathectomies (10 surgical and 40 endoscopic) were performed on 5 and 23 patients, respectively. The operations were performed unilaterally, followed by the contralateral intervention after a period of 6-8 weeks. ⋯ None of them considered these side effects to be troublesome. Although there is no difference between transaxillary thoracic sympathectomy and the endoscopic intervention in terms of efficacy, the latter is associated with less postoperative pain, shorter hospital stay and a rapid recovery. The thoracic sympathectomy is the treatment of choice for primary hyperhidrosis and excessive facial blushing.
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Eur J Cardiothorac Surg · Jan 1996
Early and long-term results for correction of total anomalous pulmonary venous drainage (TAPVD) in neonates and infants.
To present our 17-year experience of surgical repair of total anomalous pulmonary venous drainage (TAPVD) in 71 consecutive neonates and infants, with particular emphasis on the role of preoperative pulmonary venous obstruction (PVO), the management of postoperative pulmonary hypertensive crises and the long-term results. ⋯ Early repair of TAPVD with aggressive management of pulmonary hypertensive crises carries low operative mortality nowadays. Preoperative PVO as a risk factor has been neutralized since 1987. Long-term results are gratifying: no late death after 6 months, no reoperation and functional good results. Progressive pulmonary vein fibrosis remains an unpredictable rare cause of death within the 1st year after surgery.
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Gastrointestinal (GI) complications after cardiac surgery with cardiopulmonary bypass (CPB) are uncommon complications with significant morbidity and mortality rates. ⋯ Gastrointestinal complications, although of low incidence, carry a significantly high mortality, and the clinician must be alert to institute early appropriate treatment.
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Eur J Cardiothorac Surg · Jan 1996
Myocardial protection in chronic volume-overload hypertrophy of immature rat hearts.
The benefit of cardioplegic cardiac arrest for protection of the immature myocardium is controversial. We therefore investigated the efficacy of (1) topical hypothermia alone (2) slow cooling by coronary perfusion hypothermia and (3) cardioplegic cardiac arrest plus topical cooling for protection of isolated immature rat hearts (age: 28 days). ⋯ Rapid cooling by topical hypothermia along provides superior protection of hypertrophied- and non-hypertrophied-immature rat hearts to additional slow pre-arrest cooling. Use of St. Thomas' Hospital cardioplegic solution No.2 (STS 2) does not improve protection, and even hinders functional recovery in hypertrophied immature hearts. Endothelial injury caused by cold asanguinous perfusates, including cardioplegia, interferes with the recovery of vascular function, which in turn, may limit mechanical function.
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Eur J Cardiothorac Surg · Jan 1996
Comment Letter Case ReportsExtrapleural haematoma secondary to blunt chest trauma.