Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2007
Predictive value of paediatric risk of mortality score and risk adjustment for congenital heart surgery score after paediatric open-heart surgery.
This study compared the performance of risk adjustment for congenital heart surgery (RACHS-1) score with paediatric risk of mortality (PRISM) score in operative risk prediction after open-heart surgery in children. This was a retrospective analysis of a non-selected patient population from the paediatric intensive care unit of Helsinki University Hospital. All consecutive congenital open-heart surgery patients operated in Finland between the years 2000 and 2004, who were under 18 years of age, were included in this retrospective analysis. ⋯ With only a moderate discriminating AUC, RACHS-1 failed to adequately predict death after paediatric open-heart surgery. The predictive power of PRISM in this patient group was poor. Both scores overestimated the actual mortality rate.
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Interact Cardiovasc Thorac Surg · Oct 2007
Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma.
The aim of this study was to evaluate our personal experience with video-assisted thoracoscopic lobectomy and compare survival between this procedure and conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma. Between May 1997 and December 2004, 140 patients with clinical stage IA non-small cell lung carcinoma had either VATS lobectomy (VATS group, 84 patients) or standard lobectomy via open thoracotomy (open group, 56 patients) performed in our hospital. We compared overall survival, disease-free survival and recurrence between the two groups. ⋯ Five patients in the open group developed distant recurrence, whereas one patient developed regional recurrence. In the VATS group six patients developed distant recurrence, whereas one patient developed regional recurrence. We consider VATS lobectomy to be one of the therapeutic options in patients with clinical stage IA non-small cell lung carcinoma.
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Interact Cardiovasc Thorac Surg · Aug 2007
The way the intra-aortic balloon catheter moves within the aorta as a possible mechanism of balloon associated morbidity.
This study set off to investigate which mode of weaning of an intra-aortic balloon pump (IABP) produces more aortic trauma. With the use of a perfusion pump, an intact porcine aorta with an IABP in situ, was studied. Angioscopic images of the interior of the aorta were obtained. ⋯ The aortic impact score at 0.5, 6 and 12 h during the experiments was: (1) When weaning by mode: a) 1:1 3.3+/-0.6, 4.0+/-1.0 and 4.3+/-0.6; b) 1:2 4.7+/-0.6, 6.7+/-0.6 and 7.0+/-0.0; c) 1:3 8.7+/-0.6, 11+/-1.0 and 11.7+/-0.6. (2) Weaning by augmentation: a) 75% 2.3+/-0.6, 2.7+/-0.6 and 3.0+/-0.0; b) 50% 1.3+/-0.6, 1.3+/-0.6 and 1.7+/-0.6. An increasing score was observed while weaning by mode (P<0.05). The 1:3 mode produces marked intimal disruption that worsens with time.
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Interact Cardiovasc Thorac Surg · Aug 2007
ReviewSpinal cord stimulation for lower limb ischemic pain treatment.
Spinal cord stimulation (SCS) was proposed many years ago for pain treatment but healing of ischemic ulcers opened a new treatment indication. The aim of this review was to assess the efficacy of SCS. ⋯ the endovascular approach reduced the number of patients unsuitable for revascularization, however, some patients cannot be treated by angioplasty or open surgery; moreover, some are unfit for surgery, and others have persistent distal ischemia and pain with a functioning revascularization. In these cases SCS (alone or associated with prostanoids) can be indicated on the basis of the more recent evidences. A trial period with external stimulator, associated with a microcirculatory evaluation, is currently utilized to select patients that can derive benefit from this treatment, reducing costs.