The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Jun 2014
Comparative StudySurvival after major cardiac surgery: performance and comparison of predictive ability of EuroSCORE II and logistic EuroSCORE in a sample of Mediterranean population.
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II has been recently introduced to improve mortality prediction in cardiac surgery. We compare the predictive ability of the new EuroSCORE II with that of the original logistic EuroSCORE and we made an evaluation of a sample of our population submitted to major cardiac surgery in the context of a Mediterranean country. ⋯ Mortality in our population was higher than the mortality that would have been expected by the new EuroSCORE II analysis. Although EuroSCORE II has good calibration and discrimination capacity, both are worse than those demonstrated by logistic EuroSCORE. Forthcoming evaluations are necessary when the new model will be widely used.
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Thorac Cardiovasc Surg · Apr 2014
Long-term follow-up with Ross procedure at a single institution in China.
Although the Ross operation requires double-valve replacement for aortic valve disease, it has been shown to provide excellent hemodynamic results and is associated with low morbidity and mortality rates. We reviewed our long-term experience after completion of the Ross procedure. ⋯ The Ross procedure can be safely performed in patients with aortic valve disease. To date, mortality, morbidity, and reoperation rates are very low. Reasons for these superior results may include the following: (1) the diameter of the aortic valve annulus matching that of the pulmonary valve and (2) patients were monitored with antihypertensive medications to keep systolic blood pressure under 120 mm Hg to delay pressure lesions to the pulmonary autograft.
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Thorac Cardiovasc Surg · Apr 2014
Case ReportsParasternal mass revealing as a postvaccinal Bacillus Calmette-Guérin (BCG)-elicited sternal osteomyelitis.
Although osteomyelitis is a very rare complication of Bacillus Calmette-Guérin (BCG) vaccination, sternal osteomyelitis as a late complication of BCG vaccination diagnosed by polymerase chain reaction (PCR) in a child is described. We might consider BCG osteomyelitis in the case of osteomyelitis without bacterial isolation within a year after BCG vaccination, the absence of pulmonary foci, and a contact to the patient with tuberculosis.
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Thorac Cardiovasc Surg · Mar 2014
Serial changes in pulmonary function after video-assisted thoracic surgery lobectomy in lung cancer patients.
The aim of this study is to evaluate the serial changes in pulmonary function and the recovery time for the observed postoperative values to reach the predicted postoperative values after video-assisted thoracic surgery (VATS) lobectomy for lung cancer. ⋯ Postoperative pulmonary function and recovery time were different depending on the lobe resected and presence of COPD in VATS lobectomy patients. The information obtained from postoperative serial PFT would help accurately predict postoperative pulmonary function changes and recovery time after VATS lobectomy for lung cancer.
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Thorac Cardiovasc Surg · Mar 2014
Analysis of predictive factors for postoperative survival for non small cell lung carcinoma patients with unexpected mediastinal lymph nodes metastasis.
To discuss the predictive factors of postoperative survival for non small cell lung carcinoma (NSCLC) patients with clinical N0 stage but postoperative pathological N2 stage (cN0-pN2). ⋯ The postoperative survival for NSCLC patients with cN0-pN2 was related to operational method, adjuvant chemotherapy, and the number of metastatic mediastinal lymph node stations. Patients with a single station of metastatic mediastinal lymph node are likely to benefit from VATS, whereas patients with multiple stations of metastatic mediastinal lymph nodes are likely to benefit from adjuvant chemotherapy.