European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Aug 2009
Randomized Controlled TrialA newly designed thorax support vest prevents sternum instability after median sternotomy.
Sternum infection remains one of the primary causes of postoperative morbidity and mortality after median sternotomy. We report the clinical efficacy for primary reinforcement of the sternum with a new design of thorax support vest. ⋯ The use of the Posthorax sternum vest shows a favourable outcome to prevent sternum instability after cardiac surgery. There was one reoperation in patients treated with this sternum vest compared to 16 in the control groups.
-
Eur J Cardiothorac Surg · Aug 2009
Fast-track rehabilitation for lung cancer lobectomy: a five-year experience.
Fast-track rehabilitation is a group of simple measures that reduces morbidity, postoperative complication and accelerates postoperative rehabilitation reducing hospital stay. It can be applied to lung cancer lobectomy. Fast-track rehabilitation cornerstones are: minimally invasive surgical techniques using video-assisted and muscle sparring incisions, normovolemia, normothermia, good oxygenation, euglicemia, no unnecessary antibiotics, epidural patient-controlled analgesia, systemic opiods-free analgesia, early ambulation and oral feeding. Our objective is to describe a five-year experience with fast-track rehabilitation for lung cancer lobectomy. ⋯ Fast-track rehabilitation for lung cancer lobectomies can be safely performed in a selected group of patients if a motivated multidisciplinary group of professionals is available and seems to reduce postoperative complication and hospital stay.
-
Eur J Cardiothorac Surg · Aug 2009
Case ReportsThe use of a bone substitute composite in the management of a post-pneumonectomy bronchopleural fistula.
Post-pneumonectomy bronchopleural fistulas (BPFs) still represent a formidable therapeutic challenge. Several procedures have been proposed of which the least invasive are gaining distinct recognition and favour. We report the case of small-sized BPF treated by plastering the bronchial stump with a combination of bone substitute composite sprayed on a scaffold made of a Vycril mesh and placed on the mediastinal pleura overlying the right hilum.
-
Eur J Cardiothorac Surg · Aug 2009
Randomized Controlled Trial Comparative StudyTranexamic acid and aprotinin in low- and intermediate-risk cardiac surgery: a non-sponsored, double-blind, randomised, placebo-controlled trial.
Tranexamic acid has been suggested to be as effective as aprotinin in reducing blood loss and transfusion requirements after cardiac surgery. Previous studies directly comparing both antifibrinolytics focus on high-risk cardiac surgery patients only or suffer from methodological problems. We wanted to compare the effectiveness of tranexamic acid versus aprotinin in reducing postoperative blood loss and transfusion requirements in the patient group representing the majority of cardiac surgery patients: low- and intermediate-risk patients. ⋯ Aprotinin has clinically significant advantages over tranexamic acid in patients with normal renal function scheduled for low- or intermediate-risk cardiac surgery.