Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2013
Surgical technique of lung segmental resection with two intersegmental planes.
Lung segmental resection is of two types: a simple type with resection of only one intersegmental plane, such as lingual or superior segmentectomy; and a complicated type with resection of two or more intersegmental planes, such as anterior segmentectomy. We present a method of identifying the intersegmental plane by physiological function. First, we cut the segmental pulmonary artery and vein. ⋯ In 117 patients who underwent segmentectomy, mean blood loss was 122 ± 193 ml and mean duration of drainage was 3.5 ± 4.8 days. Postoperative complications related to operative procedures occurred in 14 cases (12.0%). Our method of detecting intersegmental planes is convenient and useful for subsegmental resection, particularly for complicated-type cases.
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Interact Cardiovasc Thorac Surg · Apr 2013
ReviewIs there any role for resuscitative emergency department thoracotomy in blunt trauma?
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether there is any role for resuscitative emergency department thoracotomy in severe blunt trauma. Emergency thoracotomy is an accepted intervention for patients with penetrating cardiothoracic trauma. ⋯ Furthermore, the neurological sequelae in the few survivors are frequent and severe. Interestingly, some author groups recommend that emergency department thoracotomy should be contraindicated in cases of blunt trauma with no signs of life at the scene of trauma or on arrival at the emergency department. Larger, well-designed series will be required to reach a consensus on valid prognostic factors and specific subgroups of blunt trauma patients with substantial chances of survival.
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Interact Cardiovasc Thorac Surg · Apr 2013
Multicenter StudyPreoperative atrial fibrillation is an independent risk factor for mid-term mortality after concomitant aortic valve replacement and coronary artery bypass graft surgery.
Preoperative atrial fibrillation (PAF) has been associated with poorer early and mid-term outcomes after isolated valvular or coronary artery bypass graft surgery. Few studies, however, have evaluated the impact of PAF on early and mid-term outcomes after concomitant aortic valve replacement and coronary aortic bypass graft (AVR-CABG) surgery. ⋯ PAF is associated with reduced mid-term survival after concomitant AVR-CABG surgery. Patients with PAF undergoing AVR-CABG should be considered for a concomitant surgical ablation procedure.
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Interact Cardiovasc Thorac Surg · Apr 2013
Early experiences and in-hospital results with a novel off-pump apico-aortic conduit.
To offer surgical treatment in patients with aortic valve stenosis and contraindications for aortic valve replacement (e.g. ostial encroachment and previous mitral valve replacement). The aim of this study was to prove the feasibility and efficacy of this novel innovative off-pump apico-aortic conduit technique. ⋯ With this novel conduit, we observed excellent haemodynamic results. We feel that this additional surgical approach to aortic stenosis in elderly, high-risk patients can augment conventional on-pump and interventional treatments of aortic stenosis.