European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2004
Comparative StudyAcute aortic dissection versus aortic root aneurysm: comparison of indications for valve sparing aortic root reconstruction.
To prove whether different indications for valve sparing aortic root reconstruction may have an impact on the outcome and longevity of the repair. ⋯ Regardless of the underlying indication, the aortic valve preserving reimplantation technique can be performed with favourable functional results.
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Eur J Cardiothorac Surg · May 2004
Reoperations and late adverse outcome in Marfan patients following cardiovascular surgery.
Anulo-aortic ectasia represents the most common cardiovascular manifestation requiring surgery in Marfan patients. Aim of this report was to analyze the type of presentation and the incidence of cardiovascular lesions and the clinical follow-up after initial surgery, mainly aortic root repair or replacement. ⋯ The incidence of reoperations is significantly higher in patients who presented initially with acute type A aortic dissection than in those with dilatation only. In addition, this survey demonstrates that unexpected fatal outcome may appear in the remaining native aorta following uncomplicated elective aortic root surgery, even if the aorta is normal-sized. A close follow-up of all Marfan patients is necessary to detect asymptomatic changes requiring surgery because complex elective redo-operations can be performed with a very low perioperative risk.
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Eur J Cardiothorac Surg · May 2004
Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs.
To assess the influence of adjuncts, cerebrospinal fluid drainage (CSFD) and evoked potentials, on morbidity and mortality after thoracoabdominal aortic aneurysm (TAAA) repair and to update our experience. ⋯ The use of different adjuncts introduced over the years clearly influenced our results in a positive way.
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Eur J Cardiothorac Surg · May 2004
Non-steroidal anti-inflammatory drugs decrease the quality of pleurodesis after mechanical pleural abrasion.
Non-steroidal anti-inflammatory drugs (NSAIDs) are often applied for pain management after thoracic surgery. Since these drugs diminish collagen deposition through inhibition of the prostaglandin synthesis, we investigated their effects on adhesion formation after endoscopic mechanical pleural abrasion, which is often applied in the therapy of pneumothorax. ⋯ Our results demonstrate that perioperative use of NSAIDs highly affects the quality of pleural adhesions obtained after mechanical abrasion in this pig model, which further suggests that these drugs should be avoided for pain management when a pleurodesis is performed.
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Eur J Cardiothorac Surg · May 2004
Randomized Controlled Trial Clinical TrialChronic stable ischaemia protects against myocyte damage during beating heart coronary surgery.
Many patients with coronary artery disease demonstrate chronic resting ischaemic myocardial dysfunction. We have investigated whether this ischaemia influences the myocardial damage caused by the period of coronary occlusion involved in beating heart surgery. ⋯ In patients with chronic coronary artery disease, stable preoperative ischaemia may thus represent a naturally occurring form of myocardial protection, whose presence reduces Troponin T release after beating heart surgery. This protection is different in nature from classical ischaemic preconditioning.