Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2014
Mid-term results of aortic root replacement using a self-assembled biological composite graft.
To report the mid-term results of aortic root replacement using a self-assembled biological composite graft, consisting of a vascular tube graft and a stented tissue valve. ⋯ Aortic root replacement using a self-assembled biological composite graft is an interesting option. Haemodynamic results are excellent, with freedom from structured valve failure. Need for reoperation is extremely low, but long-term results are necessary to prove the durability of this concept.
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Interact Cardiovasc Thorac Surg · Oct 2014
Endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymphadenopathy: effect of the learning curve.
This study aimed to evaluate the learning curve and efficacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the examination of mediastinal or hilar lymph nodes suspected of having cancer or of benign disease such as sarcoidosis. A success-adjusted cumulative sum model was used to evaluate the learning curve for diagnostic rates and operation time. A total of 99 patients (77 men and 22 women) who underwent EBUS-TBNA from April 2011 to March 2012 in a single centre were analysed retrospectively. ⋯ The sensitivity, specificity, and positive and negative predictive values and diagnostic accuracy for EBUS-TBNA were 80, 100, 100, 87.1 and 91.5%, respectively. According to the learning curve analysis, the ability to perform EBUS required performing approximately 37 procedures for the trials. In conclusion, more successful results are obtained after a certain learning curve, as is the case for every other invasive procedure.
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Interact Cardiovasc Thorac Surg · Oct 2014
Multicenter Study Comparative Study Observational StudyPolytetrafluoroethylene neochordae is noninferior to leaflet resection in repair of isolated posterior mitral leaflet prolapse: a multicentre study.
Resection techniques are the established method for posterior mitral valve leaflet repair in degenerative mitral valve disease. However, implantation of expanded polytetrafluoroethylene (ePTFE) neochordae is gaining acceptance. The aim of this study was to compare the durability and clinical outcome following mitral valve repair using ePTFE neochordae or leaflet resection. ⋯ ePTFE neochordae is noninferior to resection repair for posterior mitral leaflet prolapse. Both techniques have comparable early and mid-term postoperative outcomes with low mortality, and a low incidence of reoperation and recurrent mitral regurgitation.
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Interact Cardiovasc Thorac Surg · Oct 2014
Randomized Controlled Trial Comparative StudyLow protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.
Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy. ⋯ Regardless of the daily drainage, chest tubes can safely be removed earlier than anticipated in most patients after lobectomy if the protein content of the draining fluid is low.