The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Randomized Controlled Trial Comparative StudyTissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents.
The study objective was to assess the impact of dedicated instruction and deliberate practice on fourth-year medical students' proficiency in performing a coronary anastomosis using a porcine heart model, compared with nonsimulator-trained senior general surgery residents. ⋯ Dedicated instruction of fourth-year medical students with deliberate and distributed practice of microvascular techniques using a porcine end-to-side coronary artery anastomosis simulation model results in performance comparable to that of senior general surgery residents. These results suggest that focused tissue simulator training can compress the learning curve to acquire technical proficiency in comparison with real-time training.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Extracorporeal life support in patients with severe trauma: an advanced treatment strategy for refractory clinical settings.
Major trauma is a leading cause of death, particularly among young patients. New strategies in management are needed to improve poor outcomes in cases of severe trauma. Extracorporeal life support (ECLS) has proven to be effective in acute cardiopulmonary failure of different causes, even when conventional therapies fail. We report our initial experience with ECLS as a rescue therapy in severely polytraumatized patients in a refractory clinical setting. This study identifies the pre-ECLS characteristics of patients to predict the appropriateness of ECLS treatment. ⋯ From our data, ECLS seems to be a valuable option to resuscitate patients with severe trauma when conventional therapies are insufficient. ECLS is safe, feasible, and effective in providing hemodynamic support and blood gas exchange.
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J. Thorac. Cardiovasc. Surg. · Jun 2013
Editorial ReviewSystematic review of outcomes of combined proximal stent grafting with distal bare stenting for management of aortic dissection.
Available data on outcomes of combined proximal stent grafting with distal bare stenting for management of aortic dissection are limited. This is a systematic review of outcomes of this approach. ⋯ Combined proximal stent grafting with distal bare stenting for management of aortic dissection appears to be a reasonable approach for type B aortic dissection, clearly improved true-lumen perfusion and diameter although failing to suppress false-lumen patency completely. Contemporary information on this approach is mainly provided by small series with a wide range of results.