Interactive cardiovascular and thoracic surgery
-
Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyUniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery?
Although the standard video-assisted thoracoscopic surgery (VATS) approach is generally performed through two to four incisions, uniportal VATS pulmonary resection has recently been reported to be a promising, less invasive alternative. To evaluate the adequacy of uniportal VATS lobectomy as an alternative to conventional VATS lobectomy in lung cancer, we analysed and compared the outcomes of uniportal and conventional VATS lobectomies. ⋯ The similar perioperative results of uniportal VATS lobectomy compared with conventional VATS lobectomy suggest that uniportal VATS is a viable alternative approach to the conventional VATS approach in selected patients, especially in patients with early peripheral lung cancer with good anatomy and in good general condition.
-
Interact Cardiovasc Thorac Surg · Jun 2015
Comparative StudyOutcome with peripheral versus central cannulation in acute Type A dissection †.
Acute aortic dissection type A (AADA) is still an emergency operation with high morbidity and mortality. In this acute situation quick cannulation to the heart-lung machine and systemic cooling is often life-saving. However, the often easy access to the femoral vessels for cannulation leads to an arterial backflow in the descending aorta with the likelihood of plaque rupture and cerebral embolism. We analysed the outcome after initial femoral versus central cannulation for AADA. ⋯ This single-centre study with 177 patients could show that an acute aortic dissection type A can be operated on with central and peripheral cannulation with similar results. Risk for early mortality was driven by the preoperative clinical and haemodynamic status before operation rather than the cannulation technique.
-
Interact Cardiovasc Thorac Surg · Jun 2015
Multicenter StudyClinicopathological characteristics and lymph node metastasis pathway of non-small-cell lung cancer located in the left lingular division.
The purpose of this study is to assess the clinicopathological characteristics of non-small-cell lung cancer (NSCLC) occurring in the left lingular division (LLD) in association with a proposal of the LLD-specific regional lymph node stations. ⋯ An intraoperative pathological examination using our proposed LLD-specific regional lymph node stations may accurately diagnose the status of node metastasis, and appropriately lead to selective or complete MLND in LLD-NSCLC patients with c-T2N1M0 or lower stage disease.
-
Interact Cardiovasc Thorac Surg · Jun 2015
Veno-veno-arterial extracorporeal membrane oxygenation for respiratory failure with severe haemodynamic impairment: technique and early outcomes.
Patients with respiratory failure may benefit from veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO) support. We report on our initial experience of veno-veno-arterial (v-v-a) ECMO in patients with respiratory failure. ⋯ Veno-veno-arterial ECMO is a technically feasible rescue strategy in treating patients presenting with combined respiratory and haemodynamic failure.
-
Interact Cardiovasc Thorac Surg · Jun 2015
Is minimally invasive mitral valve repair with artificial chords reproducible and applicable in routine surgery?
Traditional resectional techniques and chordal transfer are difficult to apply in video-assisted mitral valve repair. Using artificial chords appears easier in this setting. The purpose of this study was to review the effectiveness and reproducibility of neochordal repair as a routine approach to minimally invasive mitral repair, and to assess the stability of neochord implantation using the figure-of-eight suture without pledgets in this setting. ⋯ Minimally invasive mitral valve repair using neochords provided a high rate of repair, reproducible results in a routine cardiac surgery setting and stable repair during follow-up. This has become our preferred technique for mitral valve surgery.