Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jan 2011
Randomized Controlled TrialCerebroprotective effect of piracetam in patients undergoing open heart surgery.
Reduction of cognitive function is a possible side effect after the use of cardiopulmonary bypass (CPB) during cardiac surgery. Since it has been proven that piracetam is cerebroprotective in patients undergoing coronary bypass surgery, we investigated the effects of piracetam on the cognitive performance of patients undergoing open heart surgery. ⋯ Piracetam had no cerebroprotective effect in patients undergoing open heart surgery. Unlike the patients who underwent coronary surgery, piracetam did not reduce the early postoperative decline of neuropsychological abilities in heart valve patients.
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Ann Thorac Cardiovasc Surg · Jan 2011
ReviewThoracic endovascular aortic repair--indications and evidence.
Since its introduction more than a decade ago, thoracic endovascular aortic repair (TEVAR) has shown promising results for patients with various thoracic aortic diseases. The aim of the current review is to assess the current literature to evaluate the safety and efficacy of TEVAR. ⋯ Despite numerous encouraging results from a large number of publications in recent years, there remains a lack of level 1 evidence to support an improvement of long-term overall survival for patients who underwent TEVAR when compared with traditional treatment modalities. There appears to be an urgent need to conduct well-designed randomized-controlled trials in this rapidly expanding intervention.
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Ann Thorac Cardiovasc Surg · Jan 2011
Randomized Controlled TrialThe effect of sivelestat sodium hydrate on severe respiratory failure after thoracic aortic surgery with deep hypothermia.
Patients who undergo thoracic aortic surgery with deep hypothermia frequently have postoperative respiratory failure as a complication. Severe lung injury in these patients results in a fatal outcome. A specific neutrophil elastase inhibitor, sivelestat sodium hydrate, is an innovative therapeutic drug for acute lung injury. ⋯ The duration of mechanical ventilation, the length of stay in the intensive care unit, and the length of hospital stay were shorter in Group S, but not significantly. Sivelestat sodium hydrate is a specific neutrophil elastase inhibitor that improves pulmonary function in patients with severe postoperative respiratory failure following thoracic aortic surgery with deep hypothermia. The drug may shorten the duration of postoperative ventilation, intensive care unit stay, and hospital stay.
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Ann Thorac Cardiovasc Surg · Jan 2011
Comparative StudyCystatin C in diabetics as a marker of mild renal insufficiency after CABG.
The purpose of this study was to evaluate the accuracy of plasma cystatin C in acute impairment in renal function; plasma cystatin C was compared to plasma creatinine in two hundred patients undergoing elective CABG surgery. ⋯ Cystatin C and cystatin C-based estimation of GFR may be useful and more sensitive than creatinine in detecting mild acute renal insufficiency in diabetic patients.
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Ann Thorac Cardiovasc Surg · Jan 2011
Surgery offers high cure rates in multidrug-resistant tuberculosis.
Drug resistance has become a major problem in the treatment of tuberculosis, and pulmonary resection in combination with chemotherapy appears to be an effective measure for the treatment. The purpose of this study was to investigate the results of resection for multidrug-resistant pulmonary tuberculosis (MDR-TB). ⋯ Even with high morbidity in the early post-operative period, surgery, in addition to medical therapy, offers higher cure rates than only medical therapy; however, meticulous preoperative evaluation of patients is needed.