European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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This paper was undertaken to determine the long-term outcome of active infective endocarditis treated with antibiotic and radical excision of infected tissues by surgery. ⋯ These data suggest that surgery for active infective endocarditis yield a high probability of eradicating the infection with relatively low operative mortality and good long-term results.
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Eur J Cardiothorac Surg · Jan 1997
Comparative StudyEfficacy and safety of videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease.
The aim of this study was to determine the efficacy and safety of videothoracoscopic lung biopsy (VTLB) in the diagnosis of infiltrative lung disease (ILD) and compare the results of VTLB with the results previously obtained in patients with open lung biopsy at the same institution. ⋯ VTLB is a valid alternative to OLB in most cases. Along with a comparable efficacy, VTLB has several advantages that should make it the method of choice for patients with only minimally impaired respiratory function. In contrast, the role and advantages of VTLB compared to OLB in patients with severe lung disease, require further investigation.
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Eur J Cardiothorac Surg · Jan 1997
Emergency surgery for acute infective aortic valve endocarditis: performance of cryopreserved homografts and mode of failure.
To describe our experience in the surgical treatment of infective, native and prosthetic aortic valve endocarditis, using cryopreserved homograft valves. ⋯ Emergency aortic valve replacement with cryopreserved homografts for acute native or prosthetic aortic valve endocarditis has a low operative mortality. The late incidence of recurrent endocarditis or homograft failure up to 7 years is acceptable. Cryopreserved homografts are non-viable. The presence of T-cell lymphocytes in explanted homografts indicates that rejection may be possible.
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Eur J Cardiothorac Surg · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative hemodynamics depend on cardiopulmonary bypass temperature: the potential role of endothelin-1.
There is a growing body of evidence that perfusion temperature during cardiopulmonary bypass (CPB) influences postoperative systemic vascular resistance (SVR). The reason for this is not clear. Extracorporeal circulation can provoke raised plasma levels of endothelin-1 (ET-1), a very potent vasoconstrictor peptide produced by endothelial cells. We therefore analysed the effect of CPB temperature on postoperative vascular resistance and plasma concentrations of ET-1. ⋯ These results suggests that the hemodynamic differences after normothermic and hypothermic CPB might be mediated, at least in part, by temperature dependent changes in ET-1 plasma levels.
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Eur J Cardiothorac Surg · Jan 1997
Spontaneous cardioversion and mitral valve repair: a role for surgical cardioversion (Cox-maze)?
The objectives of this study are to describe: (1) The incidence of change in pre-operative rhythm (cardioversion) with mitral valve repair early and at 1 year's review after surgery (late). (2) The characteristics of those patients who remain in atrial fibrillation (AF) or sinus rhythm (SR) at late follow up. (3) The characteristics of those patients whose rhythm is seen to change (cardiovert) from SR to AF, or AF to SR and to remain so at 1 year. In this way it is hoped to more clearly define those patients who would benefit from the combination of mitral valve repair and surgical cardioversion (Cox-maze procedure). ⋯ Immediately prior to surgery the presence of AF was associated with a tendency to larger left atrial size, older age and a greater LVESD. Cardioversion was common for both patients in AF (46%) and SR (25%) early following conservative mitral surgery. The prevalence of late cardioversion was of a similar order in both those originally in AF (21%) and SR (17%). The maintenance of, or cardioversion to SR seemed to be characterised only by the LVESD. This analysis captures many of the problems of retrospective review. A multi-centre, prospective study is proposed to achieve the aim of an accurate formula predicting long standing cardioversion with mitral valve surgery.