Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jan 2012
Multicenter Study Comparative StudyOutcome of pulmonary embolectomy for acute pulmonary thromboembolism: analysis of 32 patients from a multicentre registry in Japan.
Massive pulmonary embolism is relatively rare but a potentially life-threatening condition. The purpose of this study was to analyse the outcome of pulmonary embolectomy in registered data from the Japanese Society of Pulmonary Embolism Research (JaSPER). ⋯ Pulmonary embolectomy is an effective therapeutic option for patients with massive or submassive pulmonary embolism. Prompt triage of patients with haemodynamic instability is important.
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Interact Cardiovasc Thorac Surg · Jan 2012
Comparative StudyMinimally invasive approach to thoracic effusions in patients with ventricular assist devices.
The aim of this study was to compare our experience between open and video-assisted thoracic surgery (VATS) approaches to the management of thoracic effusions in ventricular assist device (VAD) patients. This was a retrospective review of a prospectively collected database of VAD patients at a single institution. Patients who were operated on for pericardial and/or pleural effusions were included. ⋯ There was no operative mortality and no difference in perioperative complications between approaches. The open and VATS approaches had similar rates of pleural (open = 63%; VATS = 41%; P = 0.42) and pericardial (open = 31%; VATS = 17%; P = 1) effusion recurrences. In spite of apparent challenges, the VATS approach may be as safe and effective as open surgery for the management of pleural and pericardial effusions in VAD patients in centres with significant minimally invasive thoracic experience.
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Interact Cardiovasc Thorac Surg · Jan 2012
ReviewThe role of myocardial ischaemic preconditioning during beating heart surgery: biological aspect and clinical outcome.
Short periods of ischaemia consecutive to reperfusion periods before a sustained ischaemic condition, the so-called ischaemic preconditioning (IP), aim to protect myocardial cells against prolonged ischaemia. IP appears as a considerable endogenous cardioprotective mechanism decreasing the infarct size after total occlusion in either experimental models or humans. Angina periods before an acute coronary syndrome limit the myocardial infarction being protective for the myocardium. Our report aims to review the international bibliography of the IP during off-pump coronary artery bypass grafting.
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Interact Cardiovasc Thorac Surg · Jan 2012
Comparative StudyPredicting risk of intensive care unit admission after resection for non-small cell lung cancer: a validation study.
A model for predicting the risk of emergency, unplanned intensive care unit (ICU) admission after lung resection for lung cancer has been reported. However, it has not been validated outside of the derivation cohort, and the aim of our study was to undertake external validation at our institution. We reviewed a series of consecutive patients who underwent major lung resection for non-small cell lung cancer over a 6-year period. ⋯ The mortality rate among these patients was 17%. The area under the ROC curve was 0.66 (95% CI 0.53-0.79). The Brunelli scoring system had moderate discriminating ability to predict the risk of ICU admission after lung resection in our institution.
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Interact Cardiovasc Thorac Surg · Jan 2012
Case ReportsTapia's syndrome--a rare complication following cardiac surgery.
Tapia's syndrome is a rare complication following cardiac surgery. It includes the extracranial involvement of the recurrent laryngeal nerve and the hypoglossal nerve and results in ipsilateral paralysis of the vocal cord and the tongue. It is usually a complication related to anaesthesia and positioning of the head of the patient during surgery. ⋯ A 49-year old man developed Tapia's syndrome after an uneventful coronary artery bypass surgery. He complained of dysphonia, hoarseness of voice and an inability to swallow soon after extubation. The syndrome resolved completely over the following weeks with no neurological deficit.