European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2003
Comparative StudyPrognostic value of visceral pleura invasion in non-small cell lung cancer.
The purpose of this study was to clarify the prognostic significance of visceral pleura invasion in T2 non-small cell lung cancer (NSCLC). ⋯ We were able to demonstrate that visceral pleura invasion was a factor of poor prognosis in T2 NSCLC. It was found to correlate with more extensive mediastinal lymph node involvement and a decreased survival rates. Therefore, the patients with visceral pleura invasion should be closely followed up especially.
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Eur J Cardiothorac Surg · Jun 2003
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized study to evaluate splanchnic hypoxia during beating-heart and conventional coronary revascularization.
Cardiopulmonary bypass (CPB) is associated with gut mucosal hypoxia, which may contribute to gastrointestinal complications. We examined gastric mucosal oxygenation together with whole-body oxygen flux in low-risk patients undergoing coronary artery bypass grafting (CABG) with and without CPB. ⋯ Despite superior global oxygen flux associated with beating-heart revascularization, gastric mucosal hypoxia occurred to similar extents in both groups with worsening trends for the OPCAB patients postoperatively. The splanchnic pathophysiology during beating-heart revascularization should be further explored.
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Eur J Cardiothorac Surg · Jun 2003
Comparative StudyDoes sodium nitroprusside reduce lung injury under cardiopulmonary bypass?
We hypothesized that direct pulmonary arterial infusion of sodium nitroprusside (SNP) would ameliorate lung injury under cardiopulmonary bypass. ⋯ The results represented in our study indicate that pulmonary arterial infusion of sodium nitroprusside during reperfusion can reduce lung injury under cardiopulmonary bypass.
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Eur J Cardiothorac Surg · Jun 2003
Comparative StudyAn evaluation of existing risk stratification models as a tool for comparison of surgical performances for coronary artery bypass grafting between institutions.
Risk stratification systems are used in cardiac surgery to estimate mortality risk for individual patients and to compare surgical performance between institutions or surgeons. This study investigates the suitability of six existing risk stratification systems for these purposes. ⋯ This study suggests that two of the scores may be useful in comparing institutions. None of the risk scores provide accurate risk estimates for individual patients in the two hospitals studied although EuroSCORE may have some utility for certain patients. All six systems perform moderately at ranking the patients and so may be useful for patient management. More results are needed from other institutions to confirm that the EuroSCORE and the simple Bayes model are suitable for institutional risk-adjusted comparisons.
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Eur J Cardiothorac Surg · Jun 2003
Reoperation after fresh homograft replacement: 23 years' experience with 655 patients.
Through a retrospective study on the use of fresh homografts in 655 aortic valve replacement patients over a period of 23 years, we aimed to assess the reasons for eventual reoperation and causes of valve dysfunction. ⋯ The results of the study suggest that reoperation in patients with aortic homografts is a low-risk procedure as compared to alternative therapies. Primary allograft aortic valve replacement can give acceptable results for up to 23 years. The major cause of valve dysfunction and indication for reoperation was degeneration. Cumulative rates for freedom from reoperation for any cause in age groups suggest careful selection and indications in homograft implantation in the younger patients. Young age is a risk factor for an early homograft structural deterioration (degeneration).