European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2005
Randomized Controlled Trial Comparative Study Clinical TrialManubriotomy versus median sternotomy in thymectomy for myasthenia gravis. Evaluation of the pulmonary status.
In a prospective study, the effect of thymectomy on the pulmonary status of 50 consecutive patients with myasthenia gravis was evaluated over a time range of 4 years in the Chest and Chest surgery departments in the Cairo University Clinics and Thoracic Surgery Department of the Evangelisches Krankenhaus Duisburg-Nord. ⋯ Thymectomy through a manubriotomy, which allows extensive removal of ectopic thymic tissue in addition to the thymus through a less invasive approach than a full median sternotomy, is associated with a significantly smoother postoperative course and less pulmonary complications, when compared with thymectomy through a full median sternotomy.
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Eur J Cardiothorac Surg · Mar 2005
Randomized Controlled Trial Clinical TrialHigh-vacuum drains rival conventional underwater-seal drains after pediatric heart surgery.
The collection of fluid in the mediastinum after cardiac surgery is traditionally prevented using underwater seal drains that may be connected to low-pressure suction. High-vacuum drains (redivac drains) are a potential alternative to this arrangement and have previously been utilized in areas of general surgery, as well as in the treatment of post-sternotomy mediastinitis. There has been no study to date addressing the safety and efficacy of these drains following pediatric cardiac surgery. ⋯ Redivac drains are as safe and effective as conventional drains in the pediatric setting, and resulted in a lower incidence of residual pleural effusions requiring drainage. Together with their ease of care, earlier mobilisation of patients and greater cost-effectiveness, the routine use of high-vacuum drains can be recommended following pediatric heart surgery.
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Eur J Cardiothorac Surg · Mar 2005
Randomized Controlled Trial Clinical TrialA prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection.
Practice varies as to whether or not suction is applied to under-water seal drains following lung surgery. We tested the null hypothesis that there is no difference with respect to air leak duration. ⋯ Applying suction to the underwater seal drains following lung surgery makes no difference in terms of air leak duration. In the light of this finding we have adopted a uniform policy of no suction being applied to the underwater seal, from the time of surgery, unless a specific clinical judgment is made to use it. The anticipated gains are that this will reduce work and cost and aid mobilization.
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Eur J Cardiothorac Surg · Mar 2005
Comparative StudyImproved outcome with composite graft versus homograft root replacement for children with aortic root aneurysms.
Review of surgical repair of aortic root aneurysms using composite graft or homograft in children. ⋯ In children with aortic root aneurysms, reoperation is more common after homograft root replacement than composite graft replacement. Composite graft root replacement provides more stable repair of the aortic root.
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Eur J Cardiothorac Surg · Mar 2005
Risk factors for hemorrhage-related reexploration and blood transfusion after conventional versus coronary revascularization without cardiopulmonary bypass.
The premise of coronary revascularization without cardiopulmonary bypass (off-pump CABG) proposes that patient morbidity and, potentially, mortality can be reduced without compromising the excellent results of conventional revascularization techniques (on-pump CABG). It is unknown, however, whether coronary artery bypass without cardiopulmonary bypass (off-pump CABG) is associated with similar hemorrhage related reexploration rates and blood transfusion requirements compared to the on-pump approach. ⋯ Off-pump CABG eliminates the risks of cardiopulmonary bypass and the systemic inflammatory response it elicits. A substantially lower need for postoperative blood transfusions and a comparable hemorrhage-related reexploration rate suggests that off-pump CABG may avoid the morbidity and mortality associated with excessive postoperative blood loss.