The Thoracic and cardiovascular surgeon
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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.
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Thorac Cardiovasc Surg · Mar 2007
Is lobe-specific lymph node dissection appropriate in lung cancer patients undergoing routine mediastinoscopy?
The extent and the necessity of lymph node dissection has yet to be defined after resectional surgery for lung cancer. We aimed to analyze the lobe-specific extent of lymph node positivity in patients who underwent preoperative mediastinoscopy as a routine strategy. ⋯ In patients who underwent routine mediastinoscopy, lobe-specific lymph node dissection could be recommended. Patients with multilevel N2 involvement did not seem to benefit from resectional surgery.
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Thorac Cardiovasc Surg · Mar 2007
Favorable acute and long-term outcomes after the resection of pulmonary aspergillomas.
This retrospective study was designed to examine the acute and long-term outcomes after surgical treatment of patients with pulmonary aspergillomas. ⋯ Pulmonary resection for aspergilloma showed favorable acute and long-term outcomes when surgical treatment was applied in selected patients.
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Surgical therapy of prosthetic valve endocarditis (PVE) is still associated with a high mortality of up to 80 %. Further risk analysis and characterization of clinical features are important for a further improvement of surgical results. The aim of this retrospective study was a risk analysis of clinical features of the pre-, intra-, and postoperative period. ⋯ Predictors of overall mortality were Staphylococci infection ( P = 0.01), heart failure ( P = 0.02) and abscess formation ( P = 0.02). Surgical therapy of prosthetic valve endocarditis is still associated with quite a high mortality during the early and midterm follow-up. Predictors of outcome particularly include preoperative risk constellations (heart failure, Staphylococci infection).
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Thorac Cardiovasc Surg · Mar 2007
Efficacy and frequency of cerebrospinal fluid drainage in operative management of thoracoabdominal aortic aneurysms.
Paraplegia remains the most dreaded complication following thoracoabdominal aortic repair. We investigated the efficacy of cerebrospinal fluid drainage as a spinal cord-protecting modality. We also evaluated the correlation between the frequency of cerebrospinal fluid drainage and the Crawford classification. ⋯ Cerebrospinal fluid drainage is a valuable neuroprotective interventional tool to lower the risk of spinal cord ischemia. The combination of neurophysiological monitoring and cerebrospinal fluid drainage optimizes the prevention of paraplegia during aortic repair.