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
The RACHS-1 risk categories reflect mortality and length of hospital stay in a large German pediatric cardiac surgery population.
The Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) was published in January 2002, based on 4370 operations registered by the Pediatric Cardiac Care Consortium. It is designed for being easily applicable also for retrospective analysis of hospital discharge data sets; the classification was not developed for patients with heart transplantations, ventricular assist devices or patients above 18 years. We apply this classification to our 2368 correspondent procedures that were performed consecutively on 2223 patients between June 1996 and October 2002 in Bad Oeynhausen and analyze its relation to mortality and length of hospital stay. ⋯ The RACHS-1 classification is applicable to European pediatric populations, too. Category Distribution, outcome class distinction capacity, distribution and mortality are similar. RACHS-1 is able to classify patients into significantly different groups concerning total and postoperative hospital stay duration, although there remains a large variability within the groups.
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Eur J Cardiothorac Surg · Jul 2004
Results of video-assisted thoracic surgery for stage I/II non-small cell lung cancer.
The best indicators for VATS are not well known. Therefore, we review here a series of patients who underwent VATS lobectomy and segmentectomy at our hospital, and we attempt to identify the factors that influence the survival of VATS patients and the backgrounds of such patients. ⋯ Stringent selection of candidates for VATS in NSCLC at pathological stages I and II could be an acceptable and valuable approach.
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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
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.