Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Sep 2014
ReviewDo patients with haematological malignancy who need cardiopulmonary bypass have a short-term higher mortality or a higher chance of disease progression?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether patients with haematological malignancy (HM) who need cardiopulmonary bypass (CPB) have a higher short-term mortality or a higher chance of disease progression secondary to CPB. Altogether, 107 papers were found using the reported search terms, but ultimately only eight were relevant to our subject. ⋯ No paper reported an acute change in blood disorders. Long-term mortality rates were not mentioned in some papers, but when it was stated, the HM patients' long-term mortality seemed not increased by using CPB surgery, with more than 80% survival at 3 years and 20-25% progression of the disease at 3 years. Although these study limitations are linked to the low-evidence levels in some of the papers used, haematological malignancies should not be considered a contraindication for cardiac CPB surgery.
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Interact Cardiovasc Thorac Surg · Sep 2014
Randomized Controlled Trial Comparative StudyComparative evaluation of high-flow nasal cannula and conventional oxygen therapy in paediatric cardiac surgical patients: a randomized controlled trial.
The aim of this study was to compare high-flow nasal cannula (HFNC) and conventional O2 therapy (OT) in paediatric cardiac surgical patients; the primary objective of the study was to evaluate whether HFNC was able to improve PaCO2 elimination in the first 48 h after extubation postoperatively. ⋯ HFNC had no impact on PaCO2 values. The use of HFNC appeared to be safe and improved PaO2 in paediatric cardiac surgical patients.
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Interact Cardiovasc Thorac Surg · Sep 2014
ReviewWho might benefit from early aspirin after coronary artery surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 represented the best evidence to answer the clinical question. ⋯ It is essential to define/quantify the postoperative blood loss that precludes administration of early aspirin. This will enhance prompt administration in some cases and guide judgement, especially in patients with high-risk factors for vein graft thrombosis. Administration at 6 h is the optimal time to give aspirin as long as bleeding has settled.
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Interact Cardiovasc Thorac Surg · Sep 2014
Randomized Controlled TrialUsefulness of vessel-sealing devices for ≤7 mm diameter vessels: a randomized controlled trial for human thoracoscopic lobectomy in primary lung cancer.
Vessel-sealing devices (VSDs) are widely used for various surgical procedures, including thoracoscopic surgery, but very few reports have compared their safety and usefulness with human thoracoscopic lobectomy procedures not employing VSDs. ⋯ VSD is simple and safe to use in thoracoscopic lobectomy involving mediastinal lymph node dissection for primary lung cancer. Furthermore, none of the VSDs used in this study presented any observable differences in quality that could lead to clinical problems.
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Interact Cardiovasc Thorac Surg · Sep 2014
Tirone David procedure for bicuspid aortic valve disease: impact of root geometry and valve type on mid-term outcomes.
A 180/180° configuration has been reported to increase repair durability after valve-sparing aortic root replacement (V-SARR) for bicuspid aortic valve (BAV) disease. We studied the impact of commissural angular configuration (CAC) and of BAV type on valve performance after V-SARR. ⋯ BAV type, including number of raphes, sinuses and commissures (SØ superior to S1) but not commissure geometry within the neoroot alone, appears to be linked to functional outcomes after V-SARR for BAV.