European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2004
Fulminant myocarditis in adults and children: bi-ventricular assist device for recovery.
Fulminant myocarditis (FM) is uncommon and may be followed by a rapidly intractable cardiogenic shock. We report five consecutive patients with FM successfully bridged to recovery with a mechanical paracorporel biventricular assist device (BiVAD). ⋯ In FM with intractable cardiogenic shock, the use of a BiVAD as a bridge to recovery is a life saving approach and should be considered before multi-end organ failure.
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Eur J Cardiothorac Surg · Dec 2004
Logistic versus additive EuroSCORE. A comparative assessment of the two models in an independent population sample.
Validation of EuroSCORE outside the boundaries of the original database has been limited to the additive model and has occasionally shown inconsistencies. Therefore we sought to validate the logistic model and assess its predictive performance compared to the additive approach. ⋯ Logistic EuroSCORE reliably predicted outcomes in our series despite the higher risk profile compared to the reference EuroSCORE sample and the observed variation in clinical performance during the study period. The additive model was less precise, exhibiting a predictive distortion which should be accounted for, particularly when employing it at the individual patient level.
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Eur J Cardiothorac Surg · Dec 2004
Resection of chest wall invasion in patients with non-small cell lung cancer.
The treatment of patients with non-small cell lung cancer invading the parietal pleura or chest wall is still debated. It is unsolved whether the depth of chest wall involvement or the type of resection (extrapleural or en bloc) affects long-term survival. ⋯ Survival of patients with lung cancer invading the chest wall or parietal pleura after resection is highly dependent on the completeness of resection and the extent of nodal involvement, but not so much on the depth of chest wall invasion or type of resection.
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Eur J Cardiothorac Surg · Dec 2004
Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery.
In order to reduce remote cardiac events associated with graft occlusions, arterial conduits are being increasingly utilized in coronary artery bypass grafting (CABG). While the internal thoracic artery (ITA) is the graft of choice for CABG, it is sometimes difficult or impossible to obtain a complete arterial revascularization only with ITAs in three-vessel diseases. We present our experience with total arterial myocardial revascularization with bilateral internal thoracic artery (BITA) and right gastroepiploic artery (rGEA). ⋯ This study indicates that the myocardial revascularization in young patients with three-vessel disease using exclusively pedicle BITA and rGEA provides excellent 9-year patient survival and improvement in terms of freedom from return of angina pectoris and freedom from any cardiac-related event. These results encourage the more extensive use of BITA and rGEA in selected patients with three-vessel coronary disease.
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Eur J Cardiothorac Surg · Dec 2004
Surgical results for active endocarditis with prosthetic valve replacement: impact of culture-negative endocarditis on early and late outcomes.
Surgical treatment of active infective endocarditis requires not only hemodynamic repair, but also special emphasis on the eradication of the infectious focus to prevent recurrence. This goal can be achieved by the combination of aggressive debridement of infective tissue and appropriate and adequate antibiotic treatment. We reviewed our experience with active endocarditis and identified factors determining early and late outcomes, particularly focusing on the factor of culture-negative endocarditis. ⋯ In our analysis, no independent adverse predictor was detected for hospital death; however, culture-negative endocarditis was identified as an independent predictor for both late survival and events after surgery. Event-free survivals were similar between staphylococcus infection and culture-negative endocarditis, and all events occurred within 2 years after operation, suggesting the necessity of close follow-up during that period.