European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2003
Randomized Controlled Trial Clinical TrialCombined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results.
The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency (RF) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results. ⋯ The combination of mitral valve surgery and irrigated RF Maze procedure was safe and efficient through a port access approach. There were no procedure related complications like esophageal or coronary artery injury. Early and mid-term results were favourable with 93.6% of patients free of AF at 1 year in comparison to the 9.4% of the control group. The data is not sufficient to reach any conclusions in terms of thromboembolic rates, despite favourable results for the RF Maze group. Nevertheless, in terms of feasibilty, sinus rhythm restoration and overall outcome, early results are encouraging and we advocate the use of the combined procedure through a port access approach.
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Eur J Cardiothorac Surg · Aug 2003
Case ReportsSuccessful treatment of Salmonella mycotic aneurysm of the descending thoracic aorta.
Salmonella mycotic aneurysms of the descending thoracic aorta are exceedingly rare. There are few case reports and even fewer reports of long term survival. The case of a 68-year-old female presenting with a mycotic aneurysm of the descending thoracic aorta caused by Salmonella species is described, which involved successful surgical intervention.
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Eur J Cardiothorac Surg · Aug 2003
Intramural hematoma and dissection involving ascending aorta: the clinical features and prognosis.
The clinical features and remedies of acute aortic intramural hemorrhage (IMH) are well discussed. This study prospectively analyzes the features compared with those of Type A aortic dissection, and evaluate the treatment modalities and the prognosis with Type A IMH managed by our original program, Eighty-six consecutive patients consisted of acute type A IMH (n = 36) and dissection (n = 50) were diagnosed between January 1994 and March 2002. Patients with IMH were older (mean 67 and 60, P = 0.0017), more hypertensive (P = 0.0015), not hyperlipidemic (P = 0.0042) than those with dissection. The incidences of preoperative pericardial effusion and aortic regurgitation were significantly lower in patients with intramural hematoma than with dissection, respectively (8:28 versus 22:28, P = 0.0366, 4:32 versus 22:28, P = 0.0011). ⋯ Type A IMH tends to occur in older, more hypertensive and not hyperlipidemic patients, showed lower incidences of preoperative aortic valve regurgitation and pericardial effusion than dissection. Medical treatment alone was not enough to manage all type A IMH patients, and 47.2% (17/36) of the patients needed surgical intervention. Urgent surgical repair was not necessary for all type A IMH patients to achieve favorable surgical outcome with careful follow-up using imaging modality.