Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2014
Frailty is a predictor of short- and mid-term mortality after elective cardiac surgery independently of age.
Assessment of perioperative risk of elderly patients in cardiac surgery is difficult, and most of the common risk scores show over- or underestimation. Two frailty scores, the comprehensive assessment of frailty (CAF) score and the Frailty predicts death One yeaR after CArdiac Surgery Test (FORECAST), were developed as additional tools to estimate the preoperative mortality risk, taking into consideration the frailty status of elderly patients. ⋯ CAF and FORECAST are additional tools to evaluate elderly patients adequately before elective cardiac surgery, and showed an association with short- and mid-term mortality independently of age.
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Interact Cardiovasc Thorac Surg · May 2014
Positive intraoperative pleural lavage cytology is a predictive marker of disease recurrence in stage I lung adenocarcinoma.
This study aimed at analysing the relationship between the pleural lavage cytology (PLC) status and clinicopathological characteristics, including the outcome of examined patients and tumour recurrence sites in surgically resected stage I non-small-cell lung carcinoma. ⋯ Our current study showed the clinicopathological characteristics associated with PLC status and demonstrated that PLC status was an independent predictor of increased recurrence in stage I lung adenocarcinoma.
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Interact Cardiovasc Thorac Surg · May 2014
Safety considerations during transapical aortic valve implantation.
Transcatheter aortic valve implantation (TAVI) is a new method for the treatment of very high-risk patients with aortic valve stenosis. The radiation dose to which the patient and each member of the heart team are exposed during this new fluoroscopically guided intervention is unknown. ⋯ During a TA-TAVI procedure, the patients receive a higher X-ray dose than during coronary angiography with intervention. After 100 TAVI procedures, the members of the heart team sustain a comparable dose of ionizing radiation to the annual dose received by a busy interventional cardiologist. Therefore, maximal safety and optimal X-ray protection for patients and the members of the team are crucial and should be redefined.
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Interact Cardiovasc Thorac Surg · Apr 2014
Review Meta AnalysisA meta-analysis of large randomized trials for mid-term major cardio- and cerebrovascular events following off-pump versus on-pump coronary artery bypass grafting.
To determine whether off-pump coronary artery bypass grafting (CABG) increases mid-term major adverse cardiovascular (and cerebrovascular) events MACCE over on-pump CABG, we performed a meta-analysis of exclusive large randomized controlled trials (RCTs). Databases including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched through October 2013 using Web-based search engines (PubMed and OVID). Eligible studies were RCTs of off-pump vs on-pump CABG enrolling >100 patients in each procedure and reporting MACCE at the time of >1 year follow-up. ⋯ There was no evidence of significant publication bias. Meta-regression coefficients were not statistically significant for mean age, proportion of men and that of diabetes. In conclusion, off-pump CABG appears not to increase mid-term MACCE over on-pump CABG.