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
Multicenter StudyRoss and Ross-Konno procedure in children and adolescents: mid-term results.
The aim of the study was to analyze mid-term results of aortic root replacement with pulmonary autograft in children and adolescents in two centers. ⋯ Our 7 years experience with the Ross and Ross-Konno operation has shown excellent mid-term results, with mortality rate approaching zero in both simple and complex left heart lesions, even in the neonates and infants. It is a procedure of choice in children with severe anomaly of the aortic valve and/or left ventricular outflow tract obstruction. The main concern is dilatation of the neo-aortic root leading to progression of AR, especially in the settings of geometric mismatch of aortic and pulmonary roots and bicuspid, regurgitant aortic valve. The risk of autograft failure in these specific subsets of patients remains to be determined.
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Eur J Cardiothorac Surg · May 2004
A prospective analysis of occult pneumothorax, delayed pneumothorax and delayed hemothorax after minor blunt thoracic trauma.
A prospective analysis was conducted to define the incidence of occult pneumothorax (OPX), delayed pneumothorax (DPX) and delayed hemothorax (DHX) and to propose an algorithm for surveillance. ⋯ A safe algorithm is recommended: eCXR for every patient who suffered blunt thoracic injury with at least one rib fracture detected and is treated as an outpatient or in case his/her compliance with the reevaluation schedule will be suboptimal. Close follow-up is also suggested since these entities do exist, cannot be ignored and their treatment is early evacuation of the pleura cavity.
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Eur J Cardiothorac Surg · May 2004
Evaluation of brain injury after coronary artery bypass grafting. A prospective study using neuropsychological assessment and diffusion-weighted magnetic resonance imaging.
Neurocognitive dysfunction is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). Studies using magnetic resonance imaging (MRI) have demonstrated that new focal brain lesions can occur after coronary artery bypass grafting (CABG), even in patients without apparent neurological deficits. Diffusion-weighted MRI is superior to conventional MRI and allows for sensitive and early detection of ischemic brain lesions. We prospectively investigated cerebral injury early and 3 months after CABG using diffusion-weighted MRI and related the findings to clinical data and neurocognitive functions. ⋯ Although neurocognitive decline after CABG is mostly transient, memory impairment can persist for months. New ischemic brain lesions on postoperative diffusion-weighted MRI do not appear to account for the persistent neurocognitive decline.
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Eur J Cardiothorac Surg · May 2004
Comparative StudyRepair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction.
This study was undertaken to compare the outcomes of the Lecompte procedure and Rastelli repair in the transposition of the great arteries (TGA) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) and to determine the risk factors associated with unfavorable events. ⋯ The Lecompte procedure and Rastelli repair provide satisfactory early and late results. However, substantial late morbidity is more associated with conduit obstruction, and LVOTO in Rastelli repair rather than Lecompte procedure.
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Eur J Cardiothorac Surg · May 2004
Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung.
A chest tube is usually placed in the pleural cavity after wedge resection of the lung, even after thoracoscopic procedures. The aim of this study was to determine the validity and safety of postoperative management without chest tube placement for patients undergoing thoracoscopic wedge resection of the lung. ⋯ Avoiding the chest tube placement did not increase postoperative morbidity if carefully selected criteria are met.