Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2012
ReviewSniffer dogs as part of a bimodal bionic research approach to develop a lung cancer screening.
Lung cancer (LC) continues to represent a heavy burden for health care systems worldwide. Epidemiological studies predict that its role will increase in the near future. ⋯ However, three decades of research did not bring forward a clinically applicable device. Here, we propose a new research approach by involving specially trained sniffer dogs into research strategies by making use of their ability to identify LC in the breath sample of patients.
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsSutureless aortic bioprosthesis in severe aortic root calcification: an innovative approach.
Aortic valve replacement (AVR) in patients with severe aortic root calcification is technically a very difficult procedure which requires a long cardiopulmonary bypass (CPB) time, especially in patients undergoing complex procedures such as multivalve or valve and coronary surgery. We report a case of successful AVR with an innovative approach in a patient with an extensively calcified aortic root and concomitant tricuspid valve regurgitation who underwent mitral valve replacement 20 years ago.
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Interact Cardiovasc Thorac Surg · May 2012
Case ReportsIsolated aortic root dilatation following sinotubular junction reduction using prosthetic rings.
'Comprehensive Aortic Root and Valve Reconstruction' technique, which was first introduced in 2005 involves aortic root reduction using prosthetic rings in order to preserve the native aortic sinuses in patients having aortic regurgitation associated with aortic root dilatation. We report a case of isolated aortic sinus aneurysm in a Marfan syndrome patient following the aortic root preserving surgery in the presence of ascending aorta aneurysm and annuloaortic ectasia. Re-operation consisted of aortic sinus resection and replacement with an artificial graft, and coronary reimplantation using a button technique. Close follow-up is essential for patients who underwent aortic root preserving surgery to appropriately manage this kind of complication.
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Interact Cardiovasc Thorac Surg · May 2012
Surgical treatment for retrograde type A aortic dissection after endovascular stent graft placement for type B dissection.
Retrograde type A aortic dissection (RTAD) is a life-threatening and underestimated complication of endovascular stent graft placement for type B dissection. Here, we retrospectively investigated our experience of surgical treatment for RTAD after endovascular stent graft placement for type B dissection. Between June 2006 and September 2011, nine patients with RTAD were transferred to our department for surgery. ⋯ The mean follow-up was 34.79 ± 19.37 months and eight patients are still alive. One patient was lost to follow-up. Surgical treatment for RTAD is a safe alternative and the results are encouraging.
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Interact Cardiovasc Thorac Surg · May 2012
Comparative StudyAccuracy of two scoring systems for risk stratification in thoracic surgery.
We investigate the suitability of the two existing risk stratification systems available for predicting mortality in a cohort of patients undergoing lung resection under a single surgeon. Data from the 290 consecutive patients who underwent pulmonary resection between January 2008 and January 2011 were extracted from a prospective clinical data base. In-hospital mortality risk scores are calculated for every patient by using Thoracoscore and ESOS.01 and were compared with actual in-hospital mortality. ⋯ ESOS was reasonably accurate at predicting the overall mortality (sensitivity 88% and specificity 67%), whereas Thoracoscore was a weaker predictor of mortality (sensitivity 67% and specificity 53%). The ESOS score had better predictive values in our patient population and might be easier to calculate. Because of their low specificity, the use of these scores should be limited to the assessment of outcomes of surgical cohorts, but they are not designed to predict risks for individual patients.