Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2014
Artificial chordae in the setting of complex mitral valve repair: early outcomes using the folding leaflet technique.
Neochordal repair is particularly limited in case of large prolapse with absence of a reference point on a nearby segment. Our aim was to overcome these limitations by means of a simple technique: the 'Folding Leaflet'. ⋯ MV repair for complex degenerative MR using this technique of neochordal repair results in excellent early and mid-term outcomes. This technique facilitates the extensive use of neochordae in case of large areas of prolapse.
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Interact Cardiovasc Thorac Surg · May 2014
Prospective validation of EuroSCORE II in patients undergoing cardiac surgery in Argentinean centres.
The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is an updated version of the original EuroSCORE that must be extensively validated. The objective was to prospectively evaluate the efficacy of EuroSCORE II in predicting the immediate results of cardiac surgery in Argentinean centres. ⋯ EuroSCORE II reflects a better current surgical performance and offers a new quality standard to evaluate local outcomes. EuroSCORE showed an overall good discriminative capacity and calibration in this local population; nevertheless, the model performed optimally in non-CABG surgery and in highest-risk patients, underestimating in-hospital mortality in lowest-risk cases. The latter finding may be interpreted as an inadequate behaviour of the model, as a poor performance of surgeons or both. Larger prospective studies will elucidate this hypothesis.
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Interact Cardiovasc Thorac Surg · May 2014
Comment Case ReportsIntraoperative management of failed single lung ventilation using a Fogarty balloon catheter through the open bronchus during off-pump left lung transplantation.
The use of balloon catheters as an interventional procedure is well established in various fields of medicine. Failure of single lung ventilation (SLV) can add difficulty to open bronchus procedures, and could result in a life-threatening situation very quickly. Trying to achieve single lung ventilation by alternate methods is fraught with dangers, and use of urgent cardiopulmonary bypass is less desirable because of increased primary graft dysfunction and mortality. We describe a novel approach of using a Fogarty balloon catheter through the open bronchus to achieve SLV during off-pump left lung transplantation when conventional SLV failed.
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Interact Cardiovasc Thorac Surg · May 2014
Safety considerations during transapical aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) is a new method for the treatment of very high-risk patients with aortic valve stenosis. The radiation dose to which the patient and each member of the heart team are exposed during this new fluoroscopically guided intervention is unknown. ⋯ During a TA-TAVI procedure, the patients receive a higher X-ray dose than during coronary angiography with intervention. After 100 TAVI procedures, the members of the heart team sustain a comparable dose of ionizing radiation to the annual dose received by a busy interventional cardiologist. Therefore, maximal safety and optimal X-ray protection for patients and the members of the team are crucial and should be redefined.