The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Comparative StudyDouble-bar application decreases postoperative pain after the Nuss procedure.
This biomechanical study aims to elucidate whether additional bar application increases postoperative pain after the Nuss procedure for pectus excavatum. ⋯ Performing double-bar placement decreases postoperative pain. Therefore, surgeons should not hesitate to perform double-bar correction in patients in whom the deformity extends to multiple intercostal spaces, requiring correction of the thorax shape at multiple sites.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Randomized Controlled Trial Comparative StudyA prospective, randomized trial comparing BioGlue and Vivostat for the control of alveolar air leak.
BioGlue (CryoLife, Europa Ltd, Surrey, UK) is effective in reducing alveolar air leak after pulmonary resection. However, concerns exist regarding the use of bovine-derived products. Vivostat (Vivostat A/S, Alleroed, Denmark) is an autologous fibrin sealant that confers certain advantages. It shows superior elastic properties, a faster absorption time, and the absence of risk of transmission of blood-borne diseases. ⋯ There were no significant differences in the 3 clinical outcome measures of duration of air leak, time to intercostal drain removal, and length of hospital stay in those patients receiving BioGlue or Vivostat. Given the inherent advantages of our institutional preference is to use Vivostat in the control of postoperative air leaks after pulmonary resection.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Comparative StudyNonelective cardiac surgery in the elderly: is it justified?
Elderly patients might be denied nonelective cardiac surgery because of the perception of poor outcomes and an unacceptable quality of life. In this study we evaluate long-term survival and quality of life in these patients. ⋯ Long-term survival and quality of life after nonelective cardiac surgery can equal that of the general elderly population. Age alone should not disqualify a patient for urgent or emergent cardiac surgery.
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J. Thorac. Cardiovasc. Surg. · Jul 2010
Genetic factors are important determinants of impaired growth after infant cardiac surgery.
We sought to estimate the prevalence and identify the predictors of impaired growth after infant cardiac surgery. ⋯ Impaired growth for both weight and head circumference is common (both >30%) in this cohort of children after infant cardiac surgery. Both the apolipoprotein E epsilon2 allele and the presence of a definite or suspected genetic syndrome were associated with impaired weight growth velocity. The apolipoprotein E epsilon2 allele was also associated with impaired growth velocity for head circumference. Persistent poor growth might have long-term implications for the health and development of children with congenital heart defects.