Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Feb 2015
Review Meta AnalysisProphylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis.
Coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant that could have beneficial effects in patients undergoing cardiac surgery with cardiopulmonary bypass. There is no clear evidence about its clinical effects or a systematic review published yet. We aimed to conduct a systematic review and meta-analysis of the literature to elucidate the role of coenzyme Q10 in preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ However, CoQ10 treatment was not associated with Cardiac index 24 h after surgery [mean difference (95% CI) 0.06 (-0.30 to 0.43)], hospital stay (days) [mean difference (95% CI) -0.61 (-4.61 to 3.39)] and incidence of atrial fibrillation [OR (95% CI) 1.06 (0.19-6.04)]. Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic treatment for preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. However, better quality randomized, controlled trials are needed to clarify the role of CoQ10 in patients undergoing cardiac surgery with cardiopulmonary bypass.
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Interact Cardiovasc Thorac Surg · Feb 2015
Multicenter Study Observational StudyRed blood cell transfusion is a determinant of neurological complications after cardiac surgery.
The aim of this study was to evaluate the impact of red blood cell (RBC) transfusions on the occurrence of stroke and transient ischaemic attack (TIA) after cardiac surgery. ⋯ Transfusion of more than 2 units of RBCs after cardiac surgery is associated with a significantly increased risk of postoperative stroke and TIA.
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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.