European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Apr 2006
Randomized Controlled Trial Comparative StudyEvaluation of respiratory muscle strength by randomized controlled trial comparing thoracoscopy, transaxillary thoracotomy, and posterolateral thoracotomy for lung biopsy.
The aim of this study was to demonstrate that the postoperative recovery of respiratory muscle strength is better in patients who undergo video-thoracoscopy than in patients who undergo transaxillary thoracotomy or posterolateral thoracotomy. ⋯ Video-thoracoscopy allows better recovery of respiratory muscle function after surgery than posterolateral thoracotomy. However, at 4 and 30 days after surgery, video-thoracoscopy and transaxillary thoracotomy gave similar results of impairment of respiratory muscle strength.
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Eur J Cardiothorac Surg · Apr 2006
Multicenter StudyCurrent percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease. Insights from the SYNTAX run-in phase.
Percutaneous coronary intervention with drug-eluting stents is challenging coronary artery bypass grafting (CABG) as the gold standard for treatment of three-vessel and left main coronary disease. We evaluated the current practice pattern in hospitals throughout Europe and USA. ⋯ In patients with multivessel or left main disease, still coronary artery bypass grafting remains the dominant revascularization strategy. Percutaneous coronary intervention is performed frequently without supporting data from the literature. Percutaneous coronary intervention for this indication is performed more often in Europe than in USA. Only a minority of the patients receives total arterial grafting in case of coronary artery bypass grafting. The SYNTAX trial with randomized and registry cohorts should provide guidance for selecting the preferred form of treatment.
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Eur J Cardiothorac Surg · Apr 2006
Randomized Controlled Trial Comparative StudySuccessful use of a single chest drain postlobectomy instead of two classical drains: a randomized study.
To compare surgical results and complications in the immediate postoperative course between the use of a single drain and two-drain post-anatomical pulmonary resections. ⋯ In our study, we did not find significant differences between the use of one or two drains after lobectomy or bilobectomy in relation to early postoperative outcome. However, the use of only one drain is more economical and is less painful for patients, without any additional adverse consequences.
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Eur J Cardiothorac Surg · Apr 2006
Aortic prosthetic ring annuloplasty: a useful adjunct to a standardized aortic valve-sparing procedure?
Dilation of aortic annulus, sinuses of Valsalva, and sinotubular junction (STJ) diameters are the characteristic lesions of aortic root aneurysm. The remodeling technique reduces STJ diameter and creates three neosinuses of Valsalva. Alternatively, the reimplantation technique reduces both annulus and STJ diameters to the detriment of aortic root dynamics. Although the remodeling technique is recognized as the most physiological valve-sparing procedure, aortic annulus dilation may jeopardize its results. A standardized approach that combines an external subvalvular aortic prosthetic ring annuloplasty with the remodeling technique is suggested. ⋯ The addition of external aortic prosthetic ring annuloplasty improves the remodeling technique's operative reproducibility and short-term results. Therefore, its use as a systematical adjunct to the remodeling procedure is suggested. However, further long-term evaluation comparing this valve-sparing procedure to composite graft replacement should define the best surgical strategy for aortic root aneurysm.
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Eur J Cardiothorac Surg · Apr 2006
Randomized Controlled Trial Comparative StudyEndothelial apoptosis and circulating endothelial cells after bypass grafting with and without cardiopulmonary bypass.
We compared profiles of the numbers of circulating endothelial cells (CEC) and the apoptosis-inducing capacity of serum samples on human endothelial cells (hEC) in on-pump and off-pump coronary artery bypass grafting (CABG) patients. ⋯ The number of circulating endothelial cells and apoptotic endothelial cell death are markers of endothelial activation and damage during CABG. This study provides evidence that CABG with the use of CPB in comparison to OPCAB surgery is associated with a significantly more pronounced endothelial response in the immediate postoperative period.