Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2013
Multicenter StudyEarly and late outcomes of total repair of tetralogy of Fallot: risk factors for late right ventricular dilatation.
This study was undertaken to assess the early and long-term results of total repair of tetralogy of Fallot (TOF) and to identify the risk factors associated with late right ventricular (RV) dilatation. ⋯ Total correction of TOF can be performed with a very low mortality rate. However, the postoperative re-operation or re-intervention rates remain relatively high. Late RV dilatation after total repair of TOF was found to be associated with transannular patch enlargement and a longer postoperative ventilator support period.
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Interact Cardiovasc Thorac Surg · Dec 2013
ReviewAre daily routine chest radiographs necessary after pulmonary surgery in adult patients?
A best evidence topic was constructed according to a structured protocol. The question addressed was whether daily routine (DR) chest radiographs (CXRs) are necessary after pulmonary surgery in adult patients. Of the 66 papers found using a report search, seven presented the best evidence to answer the clinical question. ⋯ Moreover, an OD CXRs strategy lowers the cost of care. Nevertheless, an OD CXRs strategy requires close clinical monitoring by experienced surgeons and dedicated intensivists. However, given the published studies' low level of evidence, prospective and randomized trials, specifically after thoracic surgery, are necessary in order to confirm these results.
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Interact Cardiovasc Thorac Surg · Dec 2013
ReviewRadial artery for coronary artery bypass grafting: does proximal anastomosis to the aorta or left internal mammary artery achieve better patency?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'in coronary artery bypass grafting using radial artery grafts, does proximal anastomosis to the aorta or left internal mammary artery achieve better patency'. Altogether >183 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. ⋯ Additionally, different centres and investigators report very different patency results for grafts that have the same site of proximal anastomosis. One centre was able to achieve patency rates for off-LIMA grafts of 88% up to a mean of 7.7 years postoperatively while another centre reported a patency rate of only 78.6% at three years. Given this, and the plethora of other factors influencing graft patency, we conclude that the best evidence suggests that the site of proximal anastomosis has little or no effect on radial artery graft patency following CABG.