European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2009
Open-heart surgery in premature and low-birth-weight infants--a single-centre experience.
Because of their poor clinical status, infants may require surgery for congenital heart disease regardless of weight or prematurity. This retrospective review describes a single-centre experience with open-heart surgery in low-weight infants. ⋯ In our patient population, early mortality was higher for infants weighing less than 2.5 kg. However, within the low-weight group, lower weight at surgery or history of prematurity was not associated with a higher mortality or bad neurological outcome.
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Eur J Cardiothorac Surg · Dec 2009
Randomized Controlled TrialThe myocardial protective effect of adenosine as an adjunct to intermittent blood cardioplegia during open heart surgery.
Although adenosine (ADO) has been shown to have beneficial effects against tissue injury after myocardial ischaemia, the controversy still remains regarding the optimal timing, dose, temperature, method of ADO administration and duration of exposure to the drug. This study investigates the cardioprotective effect of exogenous ADO pretreatment as an adjunct to 1 mmol l(-1) ADO cold (12 degrees C) blood cardioplegia during heart valve replacement surgery. ⋯ Compared with simple cold blood cardioplegia in heart valve replacement patients, ADO pretreatment as an adjunct to 1 mmol l(-1) ADO cold blood cardioplegia may reduce cTnI, IL-6 and IL-8 release, resulting in reduced myocardial injury in ultrastructure after surgery.
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Eur J Cardiothorac Surg · Dec 2009
Recommended changes for T and N descriptors proposed by the International Association for the Study of Lung Cancer - Lung Cancer Staging Project: a validation study from a single-centre experience.
The International Association for the Study of Lung Cancer (IASLC) recently recommended changes for T and N descriptors for the next TNM (Tumour, Node, Metastasis) edition. We re-classify our operated patients to evaluate the effectiveness of the IASLC suggestions. ⋯ Our experience confirms the IASLC recommendations to subdivide patients by tumour size at 2, 3 and 7 cm, to re-assign PM1 tumours to T3 and to group patients according to the number of involved lymph nodal zones are valid and provide excellent survival stratification.
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Eur J Cardiothorac Surg · Dec 2009
Comparative StudyHypothermic extracorporeal circulation in immature swine: a comparison of continuous cardiopulmonary bypass, selective antegrade cerebral perfusion and circulatory arrest.
Selective antegrade cerebral perfusion (SCP) has been widely used during complex congenital heart surgery and theoretically affords some degree of neuroprotection. There are limited data to support this claim, however. This study was designed to compare, at profound hypothermia, continuous cardiopulmonary bypass, SCP and circulatory arrest in a survival model of extracorporeal circulation in immature swine. ⋯ In this survival model of hypothermic extracorporeal circulatory support in immature swine, histologic brain injury was similar in piglets subjected to FF, SCP or HCA. Although the HCA group tended to have worse early neurologic outcome, any difference clearly disappeared by POD 5. These data raise the possibility that profound hypothermia alone during extracorporeal support may produce this observed brain injury. Additional study is required to define the precise aetiology of the brain injury observed in this animal model.
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Eur J Cardiothorac Surg · Dec 2009
Clinical TrialPreoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery.
To determine if preoperative statin treatment is associated with a reduction in systemic inflammatory response (SIR) and myocardial damage markers following cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Preoperative treatment with statins is associated with a lower biochemical parameters of SIR and myocardial damage following cardiac surgery with CPB, regardless of it being coronary bypass grafting (CABG) or valvular surgery.