Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Mar 2018
Case ReportsCannulation strategy for centrifugal-flow ventricular assist device implantation late after arterial switch operation.
The field of paediatric ventricular assist device (VAD) support is growing rapidly. Among paediatric patients, those with complex congenital heart disease represent a challenging population for VAD support. ⋯ Because of the unique anatomy and the complicated vascular situation, implantation of the centrifugal-flow VAD and subsequent explantation for cardiac transplantation required modifications to the standard surgical approach. The details of surgical pitfalls encountered are described.
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Interact Cardiovasc Thorac Surg · Mar 2018
Multicenter StudySafety and efficacy of minimalist approach in transfemoral transcatheter aortic valve replacement: insights from the Optimized transCathEter vAlvular interventioN-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry.
Favourable results have been reported for monitored anaesthesia care that includes local anaesthesia and conscious sedation [minimalist approach (MA)] for transfemoral transcatheter aortic valve replacement (TAVR). However, the efficacy of MA is still controversial in Japan. We describe our experience from a Japanese multicentre registry. ⋯ MA-TAVR has similar results to NMA-TAVR in terms of mortality and stroke in this Japanese multicentre registry. Shorter procedure time and hospital stays were seen in the MA-TAVR group. MA-TAVR is as safe and effective as NMA-TAVR.
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Interact Cardiovasc Thorac Surg · Mar 2018
Multicenter StudyPrognostic significance of immune-nutritional parameters for surgically resected elderly lung cancer patients: a multicentre retrospective study.
The world's population is rapidly ageing, and the age of patients with lung cancer will increase as well. The prognostic nutritional index, controlling nutritional status and the geriatric nutritional risk index (GNRI) are useful parameters for evaluating immune-nutritional status. We aimed to perform a multicentre retrospective study to investigate the correlations of these immune-nutritional parameters with postoperative comorbidities or surgical outcomes of elderly patients with non-small-cell lung cancer (NSCLC). ⋯ Preoperative GNRI is a novel preoperative predictor of postoperative comorbidities and a prognostic factor that may identify high-risk elderly patients with NSCLC.
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Interact Cardiovasc Thorac Surg · Mar 2018
Surgical strategy for aortic arch reconstruction after the Norwood procedure based on numerical flow analysis.
Inefficient aortic flow after the Norwood procedure is known to lead to the deterioration of ventricular function due to an increased cardiac workload. To prevent the progression of aortic arch obstruction, arch reconstruction concomitant with second-stage surgery is recommended. The aim of this study was to determine the indications for reconstruction based on numerical simulation and to reveal the morphology that affects the haemodynamic parameters. ⋯ Determining the surgical strategy for arch reconstruction based on numerical flow analysis may effectively reduce the ventricular load even if no stenosis or pressure gradients are observed on catheter examination or echocardiography.
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Interact Cardiovasc Thorac Surg · Mar 2018
EuroSCORE II and the STS score are more accurate in transapical than in transfemoral transcatheter aortic valve implantation.
The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons (STS) score are currently used to estimate periprocedural risk of death in patients undergoing transcatheter aortic valve implantation (TAVI). However, data regarding the predictive ability and usefulness of these scores for TAVI are controversial, especially for different access sites. ⋯ The EuroSCORE II and the STS score were independent predictors of 30-day and cumulative mortality rates in patients undergoing TAVI. The EuroSCORE II and the STS score were associated with 30-day mortality and mortality during follow-up period only in TA TAVI.