Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Aug 2009
Efficacy of emergent percutaneous cardiopulmonary support in cardiac or respiratory failure: fight or flight?
We retrospectively evaluated early outcome and conducted this study to determine the predictive factors for percutaneous cardiopulmonary support (PCPS) weaning and hospital discharge. From January 2004 to December 2006, 92 patients diagnosed as cardiac or respiratory failure underwent PCPS using the Capiox emergent bypass system (Terumo, Tokyo, Japan). The mean+/-S. ⋯ PCPS provides an acceptable survival rate and outcome in patients with cardiac or respiratory failure. Prompt application and selection of patients with a specific disease (myocarditis) provides good results. It is also effective in elderly patients, providing hospital survival similar to that for younger patients.
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Interact Cardiovasc Thorac Surg · Aug 2009
Extracorporeal membrane oxygenation for treatment of cardiac failure in adult patients.
This report reviews our experience in venoarterial extracorporeal membrane oxygenation (ECMO) support treatment in adult patients with cardiac failure, as well as analysis of the risk factors of early mortality. From February 2005 to June 2008, 45 patients undergoing cardiogenic shock required temporary ECMO support. They were divided into three groups: post-cardiotomy (n=31) and post-transplantation (n=5) heart failure, decompensated heart failure (n=9). ⋯ The dominant mode of death was multisystem organ failure (9/19). ECMO offers effective cardiopulmonary support in adults. The better outcome requires a multidisciplinary approach to prevent complications unique to itself and limit organ injury before and during this support.
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Interact Cardiovasc Thorac Surg · Aug 2009
Surgical treatment for non-small cell lung cancer in octogenarians--the usefulness of video-assisted thoracic surgery.
The purpose of this study was to investigate whether surgical treatment for non-small cell lung cancer (NSCLC) confers a survival benefit in octogenarians, and whether video-assisted thoracic surgery (VATS) is effective in terms of postoperative morbidity, mortality, and quality of life (QOL). Among 1684 patients with primary NSCLC who underwent pathologically complete resection, 95 were octogenarians. Operation was performed by the VATS approach (VATS group, n=58) or the standard thoracotomy (ST group, n=37). ⋯ There was no significant difference in overall 5-year survival rates between the ST group and the VATS group (P=0.144). The VATS approach for pulmonary resection is recommended for octogenarians with NSCLC. Surgical resection is the optimal treatment for stage IA NSCLC, and therefore, advanced age is not a contraindication for curative resection.
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Interact Cardiovasc Thorac Surg · Aug 2009
Cardiopulmonary bypass line sternal wrapping for protection and haemostasis.
Sternal marrow haemostasis is often obtained with the application of bone wax, with potential side effects pertaining to sternal wound healing. We illustrate an alternative technique which also offers some protection to sternal edges. ⋯ After sternotomy they are placed across each sternal edge and kept in position by two stitches and the spreader blades. They are removed just before sternal closure.