The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Sep 2006
ReviewPrimary closure of median sternotomy: a survey of all German surgical heart centers and a review of the literature concerning sternal closure technique.
Sternal instability and mediastinitis are rare but serious complications following cardiac surgery with median sternotomy. ⋯ There is no uniform osteosynthetic method for primary sternal closure and there is substantial variation in the perception of risk factors for sternal instability and possible surgical consequences among the surgical heart centers in Germany.
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Thorac Cardiovasc Surg · Sep 2006
The effects of a neutrophil elastase inhibitor on the postoperative respiratory failure of acute aortic dissection.
Postoperative respiratory failure is often encountered in patients suffering from acute aortic dissection (AAD) and is believed to be influenced by release of neutrophil elastase after cardiopulmonary bypass. Sivelestat is a specific neutrophil elastase inhibitor, and this study aims to evaluate the effects of sivelestat on postoperative respiratory failure due to AAD. ⋯ Inhibiting the activity of the neutrophil elastase may attenuate the postoperative respiratory complications of patients with AAD.
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Thorac Cardiovasc Surg · Sep 2006
Case ReportsPosttraumatic pulmonary pseudocyst: a rare complication of blunt chest trauma.
Posttraumatic pulmonary pseudocyst is a rare cavitary lesion lacking an epithelial lining, which develops within the pulmonary parenchyma after blunt chest trauma. Such pseudocysts develop most commonly in children and young adults. The clinical course is usually benign with spontaneous resolution of the radiologic manifestations within 2 to 4 months after trauma. A young male injured in a motor vehicle accident, sustaining a posttraumatic pulmonary pseudocyst, is presented here.
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Thorac Cardiovasc Surg · Aug 2006
Comparative StudyMalignant pleural effusion treatment outcomes: pleurodesis via video-assisted thoracic surgery (VATS) versus tube thoracostomy.
Video-assisted thoracic surgery (VATS) has been widely used in the diagnosis and management of various thoracic diseases. The objective of this retrospective study was to compare the effectiveness of patients undergoing pleurodesis through VATS versus tube thoracostomy for malignant pleural effusion (MPE). Study design was a retrospective review of patients treated in medical centers and hospitals in Taiwan. ⋯ VATS treatment for MPE appears to be superior to tube thoracostomy for diagnostic accuracy and effectiveness in preventing effusion recurrence; however, the role of these treatments for MPE is palliative, and does not significantly prolong survival time.
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Thorac Cardiovasc Surg · Aug 2006
Prediction of and risk factors for surgical wound infection in the saphenous vein harvesting leg in patients undergoing coronary artery bypass.
Surgical wound infection (SWI) of the leg after saphenous vein harvesting is an important complication of coronary artery bypass graft (CABG) procedures. SWIs may restrict mobility in the postoperative period and increase costs of postoperative hospitalisation and antibiotic treatment. ⋯ The choice of suture and suturing technique is important to prevent SWI following saphenous vein harvesting. More precise definitions of wound signs are necessary if they are to be used as predictors of SWI.