Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2007
Review Meta AnalysisIs a stentless aortic valve superior to conventional bioprosthetic valves for aortic valve replacement?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether a stentless valve is superior to conventional stented valves when tissue aortic valve replacement is performed. Altogether more than 515 papers were found using the reported search, of which 16 represented the best evidence to answer the clinical question. ⋯ At six months several studies and a meta-analysis have shown superior left ventricular mass regression in the stentless valve groups. However, by 12 months the stented valve groups catch up in terms of mass regression and this significance disappears. So the 'eminent speaker from the floor', was right with his statement, that there have been no definitively proven benefits for stentless valves.
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Interact Cardiovasc Thorac Surg · Oct 2007
Case ReportsAcute thrombosis of an abdominal aortic aneurysm following intra-aortic balloon pumping.
Acute thrombosis of an abdominal aortic aneurysm is a rare but devastating surgical emergency. We present the first case of a patient with sudden thrombosis of an AAA delayed (more than 24 h) after removal of an intra-aortic balloon pump. ⋯ The patient received an aorto-bifemoral graft. The associations between intra-aortic balloon pump counter-pulsation and abdominal aortic thrombosis are discussed.
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Interact Cardiovasc Thorac Surg · Oct 2007
Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma.
The aim of this study was to evaluate our personal experience with video-assisted thoracoscopic lobectomy and compare survival between this procedure and conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma. Between May 1997 and December 2004, 140 patients with clinical stage IA non-small cell lung carcinoma had either VATS lobectomy (VATS group, 84 patients) or standard lobectomy via open thoracotomy (open group, 56 patients) performed in our hospital. We compared overall survival, disease-free survival and recurrence between the two groups. ⋯ Five patients in the open group developed distant recurrence, whereas one patient developed regional recurrence. In the VATS group six patients developed distant recurrence, whereas one patient developed regional recurrence. We consider VATS lobectomy to be one of the therapeutic options in patients with clinical stage IA non-small cell lung carcinoma.
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Interact Cardiovasc Thorac Surg · Oct 2007
Multicenter StudyTransfusion practice in coronary artery bypass surgery in Denmark: a multicenter audit.
Transfusion rates in coronary artery bypass grafting (CABG) continue to vary substantially, although guidelines for allogeneic transfusion have been developed. In order to evaluate ongoing transfusion practices, we performed a multicenter audit in four Danish hospitals regarding the use of allogeneic blood products among patients undergoing first-time CABG. Data on patient characteristics, peri- and postoperative factors were retrieved from 600 patient records (150 records per hospital). ⋯ The relative risk of receiving an allogeneic blood transfusion was 2.1 (95% CI: 1.6-2.7) in the hospital with the highest transfusion rate, after adjustment for patient-, drug-, and procedure-related factors. Interesting differences in transfusion rates exists in Danish hospitals and these differences may reflect true variations in transfusion practices. Audits create a basis for educational efforts among surgeons and anesthesiologists to standardize transfusion practices.