Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Feb 2015
Comparative StudyThe validity of the original EuroSCORE and EuroSCORE II in patients over the age of seventy.
EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. We investigated the sensitivity, specificity and predictability of original EuroSCORE and EuroSCORE II system in elderly patients. ⋯ The original EuroSCORE and the EuroSCORE II risk models should be used with caution in patients aged 70 or older undergoing cardiac surgery in the modern era. Below the age of 70, both models are sensitive, specific and have good predictive power. Our work needs validation by other large groups.
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Interact Cardiovasc Thorac Surg · Feb 2015
Comparative StudyPatients with multiple nodules and a dominant lung adenocarcinoma have similar outcomes and survival compared with patients who have a solitary adenocarcinoma.
Lepidic growth pattern lung adenocarcinoma commonly presents as a dominant lesion (DL) with associated pulmonary nodules either in the ipsilateral or contralateral lung fields, posing a challenge in clinical decision-making. These tumours may be clinically upstaged compared with those who present with solitary lesions and, as a result, may be offered different therapies. The purpose of this study is to compare recurrence rates, the development of new lesions and survival in patients with adenocarcinoma with a lepidic component presenting with a DL with or without additional nodules. ⋯ We observed that patients with lepidic growth pattern adenocarcinoma presenting with a DL with associated secondary nodules appear to behave similarly to patients with a solitary lesion. Multiple nodules including those that are malignant in this specific subset of non-small-cell lung cancer should not be upstaged as advanced disease and patients should be treated with the same curative intent as those presenting with uninodular disease.
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Interact Cardiovasc Thorac Surg · Feb 2015
Venous cannula performance assessment in a realistic caval tree model.
A new caval tree system was designed for realistic in vitro simulation. The objective of our study was to assess cannula performance for virtually wall-less versus standard percutaneous thin-walled venous cannulas in a setting of venous collapse in case of negative pressure. ⋯ Our in vitro water test was able to mimic a negative pressure situation, where the wall-less cannula design performs better compared with the traditional thin-wall cannula.
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Interact Cardiovasc Thorac Surg · Feb 2015
Surgical embolectomy for intermediate-risk acute pulmonary embolism.
Recent series reported excellent results of surgical embolectomy in patients with acute pulmonary embolism with mortality rates of about 5-9% (range 0-13%). However, very low mortality of patients receiving medical treatment for intermediate-risk pulmonary embolism (1.5 and 2.8% at 7 and 30 days, respectively) was recently reported. Thus, we would like to challenge the indication for surgical embolectomy in the subset of intermediate-risk patients.