Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Nov 2014
Recursive and non-linear logistic regression: moving on from the original EuroSCORE and EuroSCORE II methodologies.
EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. Recursive, non-linear and mixed recursive and non-linear regression analysis were assessed with regard to sensitivity, specificity and predictability of the original EuroSCORE and EuroSCORE II systems. ⋯ The original EuroSCORE and the EuroSCORE II risk models do not have adequate ROC and Hosmer-Lemeshow statistics to allow accurate assessment of cardiac surgeons in the modern era. A mixed recursive and non-linear regression model utilizing the EuroSCORE II risk model improves both the ROC and Hosmer-Lemeshow statistics.
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Interact Cardiovasc Thorac Surg · Nov 2014
Multicenter Study Comparative StudyUrgent lung transplant programme in Italy: analysis of the first 14 months.
Lung transplantation (LTx) is the only effective treatment for end-stage lung disease. In rapidly deteriorating patients awaiting transplant, supportive strategies for lung function allow only a short period of support and lung transplantation remains the definitive therapy. An urgent transplant programme may reduce the waiting time, allowing lung transplantation in these patients. ⋯ The urgent lung transplant programme allowed transplantation in a significant percentage of prioritized patients with acceptable 30-day and 1-year mortality rates. An accurate selection of recipients may further improve the clinical impact of this programme, reducing the ethical concerns about transplantation in high-risk patients.
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Interact Cardiovasc Thorac Surg · Nov 2014
Comparative StudyDoes body mass index impact the early outcome of surgical revascularization? A comparison between off-pump and on-pump coronary artery bypass grafting.
To investigate the effects of body mass index (BMI) on early outcomes after revascularization using either on-pump or off-pump surgery. ⋯ Our study did not detect significant differences between BMI classes with regard to mortality and morbidity. However, a slight trend towards a steadily increasing short-term mortality was detectable for patients with higher BMI values. When comparing ONCAB versus OPCAB, patients with higher BMI values appeared to have a weak tendency towards a reduced short-term morbidity and mortality in favour of OPCAB.
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Interact Cardiovasc Thorac Surg · Nov 2014
Case ReportsCombined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.
Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. ⋯ Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.