The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Apr 2007
Randomized Controlled TrialTranscutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study.
Insufficient relief of postthoracotomy pain is a major cause of increased rates of postoperative complications including inadequate coughing, mucous plugging, hypoxia, compromised ventilation or even bacterial lung infection. We aimed to assess the efficacy of transcutaneous electric nerve stimulation (TENS) in patients with postthoracotomy pain. ⋯ This study demonstrated that TENS provided a better pain relief and comfort compared to PCA from the fourth postoperative day onwards, and this pain-reducing effect continued for at least two months postoperatively.
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Thorac Cardiovasc Surg · Apr 2007
Comparative StudyThe prognostic importance of trauma scoring systems for blunt thoracic trauma.
Early identification and aggressive management of blunt thoracic trauma are essential to reduce the significant rates of morbidity and mortality. The aim of this study was to evaluate the independent predictive value of 5 different trauma scoring systems (Revised Trauma Score [RTS], Trauma and Injury Severity Score [TRISS], Injury Severity Score [ISS], Lung Injury Scale [LIS], and Chest Wall Injury Scale [CWIS]) with respect to prognostic factors such as tube thoracostomy duration, the need for mechanical support and thoracotomy, the length of hospital and ICU stay, morbid conditions, and deaths of patients with blunt thoracic trauma. ⋯ The LIS grade appeared to correlate with the severity of blunt thoracic injury and was found to be the most useful scoring system in predicting the outcomes of these patients.
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Thorac Cardiovasc Surg · Apr 2007
Case ReportsAortic valve leaflet reconstruction after excision of a papillary fibroelastoma using autologous pericardium.
We report on a case of a rare tumor attached to the nodulus arantii of the left coronary cusp in a 56-year-old female patient. She was referred to our institution for a non-ST elevation myocardial infarction after a troponin-positive test. ⋯ Aortic valve cusp coaptation could be completely restored. Histology revealed the diagnosis of a papillary fibroelastoma.
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Thorac Cardiovasc Surg · Apr 2007
Mechanical aortic and mitral valve replacement in infants and children.
The aim of this study was to evaluate early and late outcomes after mechanical systemic heart valve replacement in pediatric patients. ⋯ Mechanical valve prostheses are a valuable option for left-sided heart valve replacement in pediatric patients. Perioperative morbidity was exclusively related to patients with MVR. Oversizing was often possible to avoid early reoperation for outgrowth. The operative mortality and long-term morbidity are acceptable. Anticoagulation self-management is safe and well accepted.