Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Dec 2014
Review Meta AnalysisMeta-analysis of three randomized controlled trials comparing coronary artery bypass grafting with percutaneous coronary intervention using drug-eluting stenting in patients with diabetes.
Coronary artery bypass grafting (CABG) was found to be the preferred strategy of revascularization in patients with diabetes in the bare-metal stent (BMS) era. The introduction of drug-eluting stents (DESs) led to a significant reduction in the rates of repeat revascularization (RRV) when compared with BMSs. We did a collaborative analysis of data from randomized controlled trials in the contemporary era to compare CABG versus percutaneous coronary intervention using DESs in diabetic patients. ⋯ In patients with diabetes, PCI was associated with no difference in death and MI at 1 year. However, at 5 years, PCI was associated with a higher incidence of death and MI. PCI was associated with a higher incidence of RRV but a lower incidence of stroke.
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Interact Cardiovasc Thorac Surg · Dec 2014
Randomized Controlled Trial Comparative Study Observational StudyInterposed abdominal compression-cardiopulmonary resuscitation after cardiac surgery.
The management of cardiac arrest after cardiac surgery differs from the management of cardiac arrest under other circumstances. In other studies, interposed abdominal compression-cardiopulmonary resuscitation (IAC-CPR) resulted in a better outcome compared with conventional CPR. The aim of the present study was to determine the feasibility, safety and efficacy of IAC-CPR compared with conventional CPR in patients with cardiac arrest after cardiac surgery. ⋯ IAC-CPR is feasible and safe and may be advantageous in cases of cardiac arrest after cardiac surgery.
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Interact Cardiovasc Thorac Surg · Dec 2014
Multicenter Study Comparative StudyImproved clinical outcomes and survival following repair of acute type A aortic dissection in the current era.
The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute type A aortic dissection during 2000-2005 and 2006-2010. ⋯ Surgical era significantly impacts early outcomes and actuarial survival following repair of acute type A aortic dissection.
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Interact Cardiovasc Thorac Surg · Dec 2014
ReviewEfficacy and safety of negative pressure wound therapy for Szilagyi grade III peripheral vascular graft infection.
A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether it is safe and effective to use negative pressure wound therapy (NPWT) for Szilagyi grade III (i.e. the arterial implant proper involved in the infection) peripheral vascular graft infection. Altogether, 69 papers were found using the reported search. ⋯ The major complication of NPWT was bleeding and the incidence rate was reported to be <10%. We conclude that the amount of evidence for recommending NPWT alone as the first-line treatment for Szilagyi grade III peripheral vascular graft infection is small with only one small-sized randomized controlled trial demonstrating that NPWT alone is superior to alginate dressing change in shortening the time to complete wound healing by 2 months. Limited evidence (case series with >1 year of follow-up) showed that NPWT with a continuous negative pressure of 125 mmHg, or combined NPWT and sartorius myoplasty, may shorten the time to complete wound healing by 2 months, have a >70% success rate, and have a <10% NPWT-related complication rate.
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Interact Cardiovasc Thorac Surg · Dec 2014
Randomized Controlled Trial Comparative StudyLong-term follow-up of a randomized, controlled clinical trial of three therapeutic strategies for multivessel stable coronary artery disease in women.
Coronary artery disease is the leading cause of death in women. The proposed treatments for women are similar to those for men. However, in women with multivessel stable coronary artery disease and normal left ventricular function, the best treatment is unknown. ⋯ Percutaneous coronary intervention and coronary artery bypass graft surgery compared with medical treatment had better results after 10 years of follow-up.