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 2014
Randomized Controlled TrialCoronary artery bypass grafting-related bleeding complications in real-life acute coronary syndrome patients treated with clopidogrel or ticagrelor.
Ticagrelor reduces thrombotic events compared with clopidogrel in patients with acute coronary syndrome, but may also increase bleeding complications. Coronary artery bypass grafting (CABG)-related bleeding complications have not previously been compared in clopidogrel and ticagrelor-treated patients outside the controlled environment of clinical trials. ⋯ There was no difference in major bleeding complications overall or when ticagrelor or clopidogrel was used in accordance with guidelines. In patients on dual antiplatelet medication up to 1 day before surgery, there tended to be more bleeding complications in ticagrelor-treated patients.
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Eur J Cardiothorac Surg · Oct 2014
Mechanical cardiac support in children with congenital heart disease with intention to bridge to heart transplantation†.
A significant number of children affected by congenital heart disease (CHD) develop heart failure early or late after surgery, and heart transplantation (OHTx) remains the last treatment option. Due to shortage of donor organs in paediatric group, mechanical circulatory support (MCS) is now routinely applied as bridging strategy to increase survival on the waiting list for OTHx. We sought to assess the impact of MCS as intention to bridge to OHTx in patients with CHD less than 16 years of age. ⋯ Children with CHD can be successfully bridged with MCS to heart transplantation. Single-ventricle circulation compared with biventricular physiology does not increase the risk of death before transplant or before hospital discharge.
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Eur J Cardiothorac Surg · Oct 2014
Surgical management of pulmonary adenocarcinoma presenting as a pure ground-glass nodule.
With recent advances in radiology, the detection of ground-glass nodules (GGNs) has become increasingly common. However, there still is no consensus on management, especially on the need for systemic lymph node (LN) dissection. The purpose of this study was to evaluate the surgical outcomes on the basis of the extent of resection of the primary lesion and mediastinal LN dissection and to carefully suggest appropriate treatment strategies in the patients with pulmonary adenocarcinoma presenting as pure ground-glass opacities. ⋯ For pure GGNs, limited resection can be performed when complete resection is obtained, as it was sufficient for cure and especially because there is high probability of multiple lesions. We were unable to demonstrate any additional therapeutic benefit with mediastinal LN dissection in patients with pure GGNs.
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Eur J Cardiothorac Surg · Oct 2014
The comparison of complication, pain, quality of life and performance after lung resections with thoracoscopy and axillary thoracotomy.
The aim of this prospective study was to compare the effects of axillary thoracotomy (AT) and video-assisted thoracoscopic surgery (VATS) on acute-phase responses, pain, performance status and quality of life in patients undergoing pulmonary resection. ⋯ AT is a technique equivalent to VATS in terms of early complications, pain, performance status and quality of life; VATS provided a shorter postoperative stay.
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Eur J Cardiothorac Surg · Oct 2014
Non-intubated thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation.
Thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation without endotracheal intubation is a promising technique for selected patients, but little is known about its feasibility and safety. ⋯ Non-intubated thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation is technically feasible and safe in surgical treatment of lung, mediastinal and pleural tumours in selected patients.