European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2014
Modified valve-sparing reimplantation technique for para-commissural coronary ostia.
In some patients undergoing a valve-sparing reimplantation technique, a coronary ostium may be very close to one of the commissures. This condition jeopardizes the coronary ostium patency and valve reimplantation. The authors describe a simple and safe modification of the reimplantation technique, leaving the misplaced coronary ostium attached to the commissure.
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The use of artificial chordae techniques has increased the number of mitral valve lesions which are amenable to repair. Artificial chordae can be adapted for a wide range of mitral valve pathologies including restricting the motion of overly mobile 'floppy' Barlow disease leaflets, replacing diseased chordae and improving coaptation in degenerative disease. There is continuing concern about the long-term performance of artificial chordae, which become endothelialized over time and may exhibit complications during the early or late follow-up period. ⋯ A number of problems remain in the use of artificial chordae, especially the proper determination of their length. Techniques that solve these issues may enhance patient outcomes further.
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Eur J Cardiothorac Surg · Apr 2014
Cerebral lesions on magnetic resonance imaging correlate with preoperative neurological status in neonates undergoing cardiopulmonary bypass surgery.
To determine the prevalence, spectrum and course of cerebral lesions in neonates with congenital heart disease (CHD) undergoing full flow cardiopulmonary bypass (CPB) surgery using magnetic resonance imaging (MRI) and to examine the correlation between cerebral lesions and clinical neurological abnormalities. ⋯ In neonates with severe CHD, WMI was the predominant preoperative finding, while cerebral strokes were less frequent. New postoperative lesions were rare. Preoperative neurological abnormalities correlated with the presence of cerebral lesions on MRI.
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Eur J Cardiothorac Surg · Apr 2014
Predicted postoperative lung function is associated with all-cause long-term mortality after major lung resection for cancer.
Preoperative lung function is an independent predictor of long-term survival after lung resection for non-small-cell lung cancer (NSCLC). The extent of resection has an impact on operative mortality, determines postoperative lung function and may influence both overall- and cancer-specific survival. We sought to determine the impact of predicted postoperative (ppo) lung function on long-term survival after lung cancer resection. ⋯ Ppo lung function is strongly associated with long-term survival after major lung resection and is more strongly related to survival than preoperative lung function. Surgeons struggle with challenging decisions about the appropriate extent of resection for early-stage cancer, balancing factors such as operative morbidity/mortality, local recurrence and postoperative quality of life. Ppo lung function and its relation to survival also should be taken into consideration during such deliberations.