European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialIntermittent antegrade warm myocardial protection compared to intermittent cold blood cardioplegia in elective coronary surgery--do we have to change?
Intermittent antegrade warm blood cardioplegia (IAWBC) is a simple and cost-effective method of myocardial preservation. However, there are only few prospective trials comparing this type of cardioplegia to established cardioplegic strategies in elective on-pump coronary surgery with respect to myocardial protection and outcome. ⋯ IAWBC is a safe and simple method in elective on-pump coronary artery bypass surgery. Significantly lower ischemic markers suggest an improved myocardial protection compared to cold blood cardioplegia in these patients.
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Eur J Cardiothorac Surg · Mar 2003
Early and medium-term results after modified Fontan operation in adults.
Single ventricle palliation is rarely performed in adults and the results are less optimal than in children. In this article we analyze our experience with the modified Fontan operation in this age group. ⋯ The modified Fontan operation can be performed in adults with acceptable early and midterm mortality and morbidity and leads to either complete or marked relief of cyanosis and enhanced exercise tolerance in all survivors. Postoperative arrhythmias are one of the main drawbacks but the incidence of arrhythmias after ECFO seems to be lower. The long-term follow-up has yet to be established.
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Eur J Cardiothorac Surg · Mar 2003
Comparative StudyThe impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy.
Whether video-assisted thoracic surgery (VATS) is associated with less shoulder dysfunction when compared with posterolateral thoracotomy (PLT) remains unclear. We therefore conducted this prospective study to assess the shoulder function in patients following major lung resection using either the VATS or PLT approach. ⋯ VATS major lung resection is associated with significantly less shoulder dysfunction and pain medication requirement in the early postoperative period when compared to the PLT approach.
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Neurocognitive deficit is an important complication in patients undergoing open heart surgery. The aim of this prospective, contemporary study was to objectively measure neurocognitive brain function following mechanical mitral valve replacement and mitral valve repair. ⋯ As shown by P300 auditory evoked potentials and Trailmaking Test A, there is marked neurocognitive damage related to mechanical valve replacement, whereas mitral valve repair does not affect neurocognitive function. This finding supports the beneficial effect of mitral valve repair over mechanical valve replacement in the decision-making tree of borderline cases, which are suitable for both types of procedure.
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Eur J Cardiothorac Surg · Mar 2003
Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma.
Despite advantages regarding pain and muscle function, video-assisted thoracic surgery (VATS) lobectomy is infrequently performed and is particularly controversial in bronchogenic carcinoma. We have, therefore, reviewed our experience with VATS lobectomy for non-small cell lung cancer (NSCLC) in an attempt to define the long-term results of VATS lobectomy in this setting. ⋯ VATS lobectomy is a safe procedure which is associated with a low probability for conversion to open thoracotomy. The patterns of cancer recurrence do not suggest inadequate local clearance while the long-term survival data for Stage I NSLC cases is encouraging. We believe that this technique should become the operation of choice for early stage NSCLC.