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
Outcome of cardiac surgery in low birth weight and premature infants.
Low birth weight or premature infants may require early surgical treatment of congenital cardiac lesions because of their poor clinical status. Even thought early repair or palliation is carried out with incremental risk factor for morbidity and mortality, it has been demonstrated to be preferable to medical management and delayed surgery. This retrospective study was undertaken to evaluate early and mid-term results in infants, weighing less than 2500 g, who underwent surgery other than patent ductus arteriosus closure. ⋯ Surgery for congenital heart disease can be performed in low weight critically ill infants with reduced, but still acceptable early and mid-term survival.
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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 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
Role of troponin I, myoglobin, and creatine kinase for the detection of early graft failure following coronary artery bypass grafting.
The detection of early graft failure following coronary artery bypass grafting (CABG) enables immediate reintervention and may significantly limit myocardial damage, thus potentially improving outcome. To date, non-invasive indicators of early graft failure following coronary surgery are still of uncertain diagnostic value. ⋯ cTnI, but not Myo and CK served as a reliable marker for the identification of patients with early graft failure following CABG.
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Eur J Cardiothorac Surg · Jul 2004
Case ReportsEndovascular repair for multiple Salmonella mycotic aneurysms of the thoracic aorta presenting with Cardiovocal syndrome.
Salmonella mycotic thoracic aortic aneurysm is a rare but life-threatening condition. We report a 59-year-old man with two Salmonella mycotic thoracic aortic aneurysms, presented with fever and chills associated with hoarseness due to left vocal cord palsy (Cardiovocal syndrome). ⋯ Subsequent computed tomography at 12 months after the operation confirmed exclusion of the two pseudoaneurysms with no endoleak. With potent antibiotics and careful surveillance program, endovascular repair is a possible alternative to conventional open surgery in the management of mycotic thoracic aortic aneurysms, especially in high-risk patients.