European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2006
ReviewOutcomes in patients with interrupted aortic arch and associated anomalies: a 20-year experience.
The surgical results for the repair of interrupted aortic arch (IAA) have evolved in recent years. We report our results for staged repair of this complex congenital malformation. ⋯ Staged repair of IAA using a left carotid artery turn down can be safely applied in IAA patients with and without other intracardiac anomalies with good results. Use of the left carotid artery for arch reconstruction did not result in any detectable neurological events or growth disturbances later in life. Associated anomalies played an important role in outcomes. The long-term probability for reoperation and/or reintervention remains high regardless of operative technique.
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Eur J Cardiothorac Surg · May 2006
Randomized Controlled TrialIntrapleural intercostal nerve block associated with mini-thoracotomy improves pain control after major lung resection.
To prospectively assess the impact of intrapleural intercostal nerve block (IINB) associated with mini-thoracotomy on postoperative pain and surgical outcome after major lung resections. ⋯ IINB associated with mini-thoracotomy reduces postoperative pain and contributes to improve postoperative outcome after major pulmonary resections.
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Eur J Cardiothorac Surg · May 2006
Diagnosis and prognosis of traumatic pulmonary psuedocysts: a review of 12 cases.
Traumatic pulmonary pseudocysts or post-traumatic pneumatocoeles are a relatively rare-encountered condition occurring after trauma and an even rarer talked about subject. Most resolve within a few weeks, but if complicated by hematoma, may persist for months. This study intends to evaluate the resolution times of traumatic pulmonary pseudocysts and their clinical significance. ⋯ Comparisons between completely blood-filled pseudocysts and uncomplicated pseudocysts have shown statistically significant differences in resolution times. Statistical significance has also been found between pseudocysts of sizes less than 2 cm and those greater than or equal to 2 cm. Conservative treatment is generally the rule; close follow-up and symptomatic treatment are necessary.
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The aim of this study was to develop a graphical method of risk-stratified outcome analysis in paediatric cardiac surgery to provide a means of continuous, prospective performance monitoring and allow real-time detection of change in outcomes. ⋯ VLAD charts provide an effective, easily visualised display of surgical performance and can be applied to paediatric cardiac surgery. Early detection of change, whether improvement or deterioration, is important for ongoing quality assurance within a cardiac surgery programme.
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Eur J Cardiothorac Surg · May 2006
Developing a VATS lobectomy programme--can VATS lobectomy be taught?
Although VATS lobectomy has been demonstrated to be safe and effective, the technique is not widely practiced. This may, in part, reflect difficulty in acquiring appropriate skills. We have evaluated the effect of experience and training on surgical outcomes during the development and establishment of a VATS lobectomy programme. ⋯ VATS lobectomy can be safely taught to trainee thoracic surgeons. However, in view of the limited number of centres undertaking VATS lobectomy, training should be coordinated at a national level to concentrate experience and improve uptake of this technique.