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
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
Comparative StudyPartly solid pulmonary nodules: waiting for change or surgery outright?
It has been assumed that if the prognosis and rate of lymph node metastases differ between two groups of patients being followed up for partly solid tumours, those with an increased solid component and those without change, these differences can help to decide on the time of surgery for patients with partly solid tumours. Therefore, this study compared the differences in pathological results and prognosis after surgical resection between patients with no change and and those with change in partly solid tumours during the preoperative period. ⋯ The pathological results and prognosis of lung cancer patients with persistent partly solid tumours who develop changes in their lesions after a certain period of follow-up time were not different from those of patients who did not develop any changes in the lesions. Therefore, surgery can be deferred until those lesions demonstrate changes in size or growth in their solid component when the overall size of ground-glass opacity (GGO) is less than 3 cm and the proportion of GGO is greater than 50%.
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Interact Cardiovasc Thorac Surg · Oct 2014
Case ReportsSingle-port thoracoscopic lobectomy in a nonintubated patient: the least invasive procedure for major lung resection?
General anaesthesia with single-lung ventilation was always considered a condition for thoracoscopic major pulmonary resections. However, nonintubated thoracoscopic lobectomy has been reported recently by using conventional video-assisted thoracoscopic surgery (VATS), epidural anaesthesia and vagus blockade. Here, we present a technique that reduces the surgical access trauma even more: single-incision VATS approach with no need for epidural or vagus blockade in a nonintubated patient. ⋯ Single-port video-assisted thoracoscopic lobectomy in nonintubated patients seems to be feasible and safe, and probably represents the least invasive approach to lobectomy. Further studies are necessary to evaluate the results with a series of patients.
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Interact Cardiovasc Thorac Surg · Oct 2014
Comparative StudyWhat is the extent of the advantage of video-assisted thoracoscopic surgical resection over thoracotomy in terms of delivery of adjuvant chemotherapy following non-small-cell lung cancer resection?
Video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) is a safe and effective alternative to open lobectomy. Adjuvant chemotherapy is part of the treatment recommended for patients with performance status (PS) 0-1 following resection of NSCLC of stages T1-3 N1-2 M0 and T2-3 N0 M0. If VATS reduces morbidity, does it help delivery of postoperative chemotherapy? We studied our data to compare the delivery and toxicity of chemotherapy in patients following VATS or open lung resections. ⋯ Adjuvant chemotherapy was started significantly earlier in patients following VATS lung resections for NSCLC compared with thoracotomy. There was also a trend towards improved tolerance with more complete courses and reduced haematological toxicity.