European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2004
Case ReportsTreatment of acute heart failure in an infant after cardiac surgery using levosimendan.
An infant, 2 months old, underwent cardiac surgery because of congenital heart defects and pulmonary hypertension. Surgery was performed in hypothermia and cardiac standstill. On the second day after surgery the infant had to be resuscitated due to a combination of acute left-ventricular failure, pulmonary vascular hypertension and a slight right-to-left-shunt. A breakthrough in the treatment was achieved by using levosimendan to improve left-ventricular function and to decrease vascular resistance.
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Eur J Cardiothorac Surg · Jul 2004
Repair of atrioventricular valve regurgitation in the modified Fontan operation.
To evaluate the prevalence, impact and outcome of repair of atrioventricular valve regurgitation (AVVR) in Fontan patients. ⋯ Trivial to mild AVVR remains stable and their repair during the Fontan operation provides no additional benefits. Valve repair in patients with moderate to severe AVVR improved the regurgitation with comparable operative mortality and long-term outcome; however, similar benefits could be achieved without repair of the atrioventricular valve. We should not deny patients with similar AVVR the Fontan operation.
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Eur J Cardiothorac Surg · Jul 2004
Randomized Controlled Trial Multicenter Study Clinical TrialChemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial.
The non-small cell lung cancer (NSCLC) meta-analysis suggested a survival benefit for cisplatin-based chemotherapy when given in addition to surgery, radical radiotherapy or 'best supportive care'. However, it included many small trials and trials with differing eligibility criteria and chemotherapy regimens. The aim of the Big Lung Trial was therefore to run a large pragmatic trial to confirm the survival benefits seen in the meta-analysis. ⋯ This trial has failed to observe a survival benefit with adjuvant chemotherapy following complete resection of stage I-III NSCLC. However, the hazard ratio and 95% confidence intervals are consistent with the previously reported meta-analysis and two large recently reported trials, which suggest a small survival benefit with cisplatin-based chemotherapy.
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Eur J Cardiothorac Surg · Jul 2004
Case ReportsEndovascular stent-graft for thoracic aorta aneurysm caused by Salmonella.
We describe the placement of an endovascular stent-graft in a patient with mycotic aneurysm of the descending thoracic aorta caused by Salmonella. Endovascular grafting combined with antibiotic therapy in thoracic mycotic aneurysms might represent an alternative to conventional surgery in patients with high operative risk.
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Eur J Cardiothorac Surg · Jul 2004
Factors affecting patency of internal thoracic artery graft: clinical and angiographic study in 1434 symptomatic patients operated between 1982 and 2002.
The purpose is to define factors influencing long-term patency of the internal thoracic artery (ITA) to optimize the operative strategy. ⋯ Even in a patient cohort that had adverse symptoms, excellent LITA and RITA patency was achieved which almost remained constant through all time intervals studied.