Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Aug 2010
Comparative StudyManagement of primary and secondary pneumothorax using a small-bore thoracic catheter.
This study aimed to investigate the efficacies and complications associated with the 7F catheter inserted in patients with pneumothorax in the emergency room and to compare the results for primary and secondary pneumothorax. From June 2006 to May 2008, 200 patients with primary or secondary pneumothorax treated with a 7F catheter were enrolled. The primary endpoint was the immediate success rate. ⋯ The failure group included 26 patients (16.9%) with primary, 20 patients (52.6%) with secondary, and two patients (25%) with iatrogenic pneumothorax. The failure rate of patients with secondary pneumothorax was significantly higher than that of patients with primary pneumothorax (P<0.05). We can confirm that the 7F catheter is an effective approach to the treatment of primary pneumothorax, including first, recurrent, and postoperative pneumothorax.
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Interact Cardiovasc Thorac Surg · Aug 2010
ReviewIs video-assisted thoracoscopic surgical decortication superior to open surgery in the management of adults with primary empyema?
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether video-assisted thoracoscopic surgical decortication (VATSD) might be superior to open decortication (OD) (or chest tube drainage) for the management of adults with primary empyema? Altogether 68 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. ⋯ In agreement with mixed stage empyema, hospital stay was reduced both postoperatively (8.3 vs. 12.8 days; P<0.05) and in total (14+/-1 vs. 17+/-1 days; P<0.05), and when compared with OD (one study), pain (P<0.0001), postoperative air-leak (P=0.004), hospital stay (P=0.020) and time to return to work (P<0.0001) were all reduced with VATS. Additionally, re-operation (4.8% vs. 1%; P=0.09) and mortality (4/123% vs. 0%) were lower in VATS vs. OD.
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Interact Cardiovasc Thorac Surg · Aug 2010
Effectiveness and prognosis of initial pericardiocentesis in the primary management of malignant pericardial effusion.
We retrospectively reviewed the records of 100 patients with malignant disease and symptomatic pericardial effusion initially treated with pericardiocentesis at the National Cancer Institute of Mexico between 1985 and 2009. We analyzed predictive factors for recurrence of pericardial effusion by bi- and multivariate analyses. The group comprised 74 women and 26 men. ⋯ For OS, multivariate analysis yielded that female gender and presence of pericardial effusion at time of primary malignancy diagnosis were associated with higher life expectancy. Initial pericardiocentesis can provide successful management of patients with a control rate of 67%. In spite of the high effectiveness of the primary management of pericardial effusion with pericardiocentesis in oncologic patients, it might be considered for initial treatment, especially those with poor prognosis, leaving pericardial window as a secondary strategy for recurrence.
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Interact Cardiovasc Thorac Surg · Aug 2010
Case ReportsSuccessful aortic reimplantation in a three-year-old child with Marfan syndrome.
Aortic root dilatation is rare in children, and is often secondary to Marfan syndrome (MFS). We experienced a case of a three-year-old boy (92 cm, 12 kg) with MFS presenting with progressive dilatation of aortic root. ⋯ Although the patient required a mitral valve repair due to infective endocarditis postoperatively, the recovery from the second surgery was uneventful. This case is one of the youngest children of valve-sparing aortic root replacement in the literature.
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Interact Cardiovasc Thorac Surg · Aug 2010
Case ReportsSuperior vena cava syndrome secondary to chronic dissecting aortic aneurysm after aortic valve replacement.
Ascending aortic aneurysm is a rare cause of superior vena cava syndrome. Herein, we describe a case of superior vena cava syndrome caused by a chronic dissecting aortic aneurysm after aortic valve replacement. A successful replacement of the aortic root and ascending aorta led to an improvement of edema of the face and bilateral upper limbs caused by superior vena cava syndrome.