Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyFull sternotomy versus right anterior minithoracotomy for isolated aortic valve replacement in octogenarians: a propensity-matched study †.
Surgical aortic valve replacement (AVR) is increasingly performed in elderly patients with good perioperative outcomes and long-term survival, resulting in significant health-related quality-of-life benefits. This study aimed to evaluate the outcome of patients aged ≥ 80 years undergoing isolated AVR through a right anterior minithoracotomy (RAMT) and compare it with a full sternotomy (FS). ⋯ Minimally invasive AVR through right anterior minithoracotomy can be safely performed in patients aged ≥80 years with acceptable morbidity and mortality rates. It is an expeditious and effective alternative to full sternotomy AVR and might be associated with lower postoperative stroke incidence, earlier extubation and shorter hospital stay.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative StudyPrognosis of non-small-cell lung cancer patients with positive pleural lavage cytology.
Positive pleural lavage cytology (PLC) is considered as a precursor condition of pleural dissemination (PD) or malignant pleural effusion (PE), and one of the poor prognostic factors in surgically resected non-small-cell lung cancer (NSCLC) patients. Although PD and PE are classified as M1a, PLC does not contribute to the tumour, node and metastasis (TNM) classification of the Union Internationale Contre le Cancer. This study aimed to evaluate the prognostic effect of positive PLC status in surgically resected NSCLC patients compared with PD and/or PE. We also aimed to consider the contribution of positive PLC status to the TNM classification. ⋯ Positive pre-PLC had the significant prognostic effect in surgically resected NSCLC patients. However, it is not a contraindication for surgical resection, unlike PD and/or PE. Our data suggest that positive pre-PLC should be classified as pT3 in next TNM classification.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative StudyImpact of age on outcomes following continuous-flow left ventricular assist device implantation.
The goal of our study was to analyse the impact of age on outcomes in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) placement at our institution. ⋯ This study demonstrates that LVAD therapy can be used in the older patients with acceptable mortality and morbidity, and age alone should not be used as the sole criterion for exclusion from LVAD implantation.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyUniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery?
Although the standard video-assisted thoracoscopic surgery (VATS) approach is generally performed through two to four incisions, uniportal VATS pulmonary resection has recently been reported to be a promising, less invasive alternative. To evaluate the adequacy of uniportal VATS lobectomy as an alternative to conventional VATS lobectomy in lung cancer, we analysed and compared the outcomes of uniportal and conventional VATS lobectomies. ⋯ The similar perioperative results of uniportal VATS lobectomy compared with conventional VATS lobectomy suggest that uniportal VATS is a viable alternative approach to the conventional VATS approach in selected patients, especially in patients with early peripheral lung cancer with good anatomy and in good general condition.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative StudyOutcome with peripheral versus central cannulation in acute Type A dissection †.
Acute aortic dissection type A (AADA) is still an emergency operation with high morbidity and mortality. In this acute situation quick cannulation to the heart-lung machine and systemic cooling is often life-saving. However, the often easy access to the femoral vessels for cannulation leads to an arterial backflow in the descending aorta with the likelihood of plaque rupture and cerebral embolism. We analysed the outcome after initial femoral versus central cannulation for AADA. ⋯ This single-centre study with 177 patients could show that an acute aortic dissection type A can be operated on with central and peripheral cannulation with similar results. Risk for early mortality was driven by the preoperative clinical and haemodynamic status before operation rather than the cannulation technique.