Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Apr 2015
ReviewIn minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery?
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: Are there differences in outcomes in uniport compared with multiport video-assisted thoracoscopic surgery? Altogether, 45 papers were found using the reported search, of which 8 papers represent the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type and level of evidence of publication, relevant outcomes and results of these papers are tabulated. ⋯ Four other studies, however, did not find any significant difference in duration of hospital stay. Pain scores are lower in uniportal VATS, most studies however do not demonstrate differences in other outcomes including analgesic use, duration of chest tube drainage, length of hospital stay or other thoracic complications. We conclude that, although uniport access may offer improved pain scores, the current evidence reveals no differences in most postoperative outcomes between uniport and multiport approaches to VATS in either minor or major thoracic procedures.
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Interact Cardiovasc Thorac Surg · Apr 2015
Preoperative renal function and surgical outcomes in patients with acute type A aortic dissection†.
There are few data concerning the impact of preoperative renal function, assessed using estimated glomerular filtration rate, on surgical outcomes following acute type A aortic dissection. We investigated the accuracy of estimated glomerular filtration rate (in ml/min/1.73 m(2)) in predicting in-hospital mortality and postoperative renal replacement therapy in such cases. ⋯ Preoperative estimated glomerular filtration rate can effectively predict the need for renal replacement therapy after surgery for acute type A aortic dissection. However, it is not an effective diagnostic tool to predict in-hospital mortality. The complexity of the characteristics of patients who undergo surgical procedures may make prediction of surgical outcomes difficult. Risk models to predict hospital mortality and morbidities are needed to assist clinicians in determining the optimal treatment.
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Interact Cardiovasc Thorac Surg · Apr 2015
Comparative StudyResults of comparing transthoracic device closure and surgical repair with right infra-axillary thoracotomy for perimembranous ventricular septal defects.
Transthoracic device closure (TTDC) and surgical repair with right infra-axillary thoracotomy (SRRIAT) are two main alternative minimally invasive approaches for restrictive perimembranous ventricular septal defect (VSD); however, few studies have compared them with each other in terms of effectiveness and cost. ⋯ Both TTDC and SRRIAT showed excellent outcomes and cosmetic appearance for suitable VSD candidates. Although its costs were higher, TTDC had the advantages over SRRIAT of a short operation duration and intensive care unit stay and fewer days in the hospital.
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Interact Cardiovasc Thorac Surg · Apr 2015
Hybrid branch pulmonary artery stent placement in adults with congenital heart disease.
Valuable treatment modalities for branch pulmonary artery (BPA) stenoses are surgical patch angioplasty, percutaneous BPA stenting and hybrid stent placement. The purpose of this study was to report our institutional experience with hybrid stent placement to relieve BPA stenoses. ⋯ Hybrid intraoperative BPA stent placement is safe and effective and can be used as an alternative for surgical patch angioplasty or if percutaneous BPA stenting is not feasible. Short- to mid-term results are good.