Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2013
ReviewShould mediastinal lymphadenectomy be performed during lung metastasectomy of renal cell carcinoma?
A best evidence topic was constructed according to a structured protocol. The question addressed was whether radical mediastinal lymphadenectomy should be performed during lung metastasectomy of renal cell carcinoma (RCC). Of the 13 papers found through a report search, seven represent the best evidence to answer this clinical question. ⋯ Indeed, most patients referred to surgery are younger, fitter, and have fewer metastases. Consequently, the survival gain could be biased, related more to the resectability and the good performance status rather to the resection itself. Consequently, although these preliminary results are interesting, they must be interpreted with caution.
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Interact Cardiovasc Thorac Surg · Apr 2013
Comparative StudyConcomitant surgical atrial fibrillation ablation and event recorder implantation: better monitoring, better outcome?
Concomitant ablation is an established therapy in cardiac surgical patients with atrial fibrillation (AF). Post-discharge care seems to be an essential factor for clinical outcome. We analysed the influence of event recorder (ER) implantation and therapy guidance by the results of continuous rhythm monitoring of consecutive postoperative follow-up by our department of electrophysiology. ⋯ Implantation of an ER with link-up to a cardiology and/or electrophysiology provides optimized anti-arrhythmic drug management and higher rates of consecutive procedures like cardioversion or additional catheter-based ablation. As a result, a trend to higher sinus rhythm conversion rate was observed after 1-year follow-up.
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Interact Cardiovasc Thorac Surg · Apr 2013
Risk factors affecting the survival rate in patients with symptomatic pericardial effusion undergoing surgical intervention.
The optimal management and treatment of pericardial effusion are still controversial. There is limited data related to the risk factors affecting survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion who underwent surgical interventions. ⋯ In the surgical management of pericardial effusion, patients with underlying malignant disease, especially with lung cancer, patients with a detectable invasion of thorax in computed tomography and those with positive echocardiographic findings compatible with tamponade have a poor survival. Therefore, minimally invasive therapies could be considered as a more acceptable alternative for these high-risk patients.
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Interact Cardiovasc Thorac Surg · Apr 2013
Comparative StudyInfluence of donor-recipient gender mismatch on graft function and survival following lung transplantation.
In current practice, donors and recipients are not matched for gender in lung transplantation. However, some data have suggested a possible effect of gender combinations on lung transplant outcomes. We examined whether donor-recipient (D/R) gender mismatch is related to adverse outcomes after lung transplantation in terms of early and long-term graft function and survival. ⋯ Donor-recipient gender mismatch does not have a negative impact on early graft function and mortality following lung transplantation. There is a trend towards a survival benefit for female recipients, irrespective of the donor gender.
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Interact Cardiovasc Thorac Surg · Apr 2013
Case ReportsSuccessful treatment of endoleak Type I with uncovered EX-L stent after thoracic endovascular aneurysm repair.
Treatment of endoleaks after thoracic endovascular repair remains challenging, particularly when the proximal landing zone is small and partly includes the origin of the neck vessels. We report a Type Ia endoleak, occurring after thoracic endovascular aneurysm repair, which was successfully treated with a novel uncovered nitinol stent. With this success, we were able to avoid a conventional surgery to treat the endoleak.