The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 2012
Comparative StudyMidterm results of beating heart coronary bypass surgery for non-left internal thoracic artery anastomosis according to grafting design and implications of intraoperative flow characteristics on graft patency.
The aim of the present study was to investigate the midterm patency of coronary artery bypass grafting (CABG) surgery according to the grafting design and intraoperative flow characteristics. Between March 2007 and July 2008, 218 beating heart CABG patients were prospectively divided into two groups according to the non-left internal thoracic artery (LITA) bypass grafting design; Group I (n = 161, aorta-saphenous vein) and Group II (n = 57, LITA-radial artery composite grafting). Preoperative patient characteristics and the additive EuroSCORE were similar between the two groups (p = 0.82). ⋯ The overall rates of freedom from graft occlusion for the non-LITA to LAD bypasses at 100, 200, and 300 days were 99, 98, and 89%, respectively, in group I, and 95, 88, and 70%, respectively, in group II (P < 0.01). Overall freedom from graft occlusion for LITA to LAD bypasses showed no significant differences between the two groups (98 vs. 93%, p = 0.053). The results suggest superior intraoperative flow characteristics of the direct aorta-saphenous vein bypass grafting design to be attributable for its favorable patency results.
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Thorac Cardiovasc Surg · Oct 2012
Video-assisted thoracoscopic surgery for posttraumatic hemothorax in the very elderly.
Thoracic injury is a life-threatening condition with advanced age being an independent risk factor for both higher morbidity and mortality. Furthermore, elderly patients often have severe comorbidity and in case of chest trauma with rib fractures and hemothorax, their clinical condition is likely to deteriorate fast. Aim of this study is to investigate the feasibility and results of video-assisted thoracoscopy for the treatment of posttraumatic hemothorax in very elderly patients of 80 years or more. ⋯ Video-assisted thoracoscopic surgery for treatment of posttraumatic hemothorax shows excellent results in very elderly patients of 80 years or more. Despite severe comorbidity and often delayed surgery all patients recovered. We therefore conclude that advanced age is no contraindication for surgical management of posttraumatic hemothorax by means of video-assisted thoracoscopy.