European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Oct 2010
Randomized Controlled TrialSlower progression of atherosclerosis in vein grafts harvested with 'no touch' technique compared with conventional harvesting technique in coronary artery bypass grafting: an angiographic and intravascular ultrasound study.
In a long-term randomised coronary artery bypass grafting (CABG) study, the patency rate using a new 'no touch' (NT) vein-graft preparation technique was superior to the conventional (C) technique. This cineangiographic and intravascular ultrasound (IVUS) substudy examined possible mechanisms. ⋯ The superior long-term patency rate using the NT vein-graft technique at CABG could be explained by a significantly slower progression of atherosclerosis.
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Eur J Cardiothorac Surg · Oct 2010
The impact of extracardiac conduit-total cavopulmonary connection on apicocaval juxtaposition.
Modifications of the Fontan procedure are applied to a wide range of complex congenital heart defects with single ventricle physiology. We examined the pathway and the clinical results of extracardiac conduit-total cavopulmonary connection (EC-TCPC) for a malpositioned heart with apicocaval juxtaposition. ⋯ EC-TCPC can be performed in children with apicocaval juxtaposition with excellent mid-term outcomes compared with other Fontan candidates. Based on individual cardiac anatomy, the pathway of the EC behind the ventricle or crossing the vertebra can be used without conduit stenosis or pulmonary venous obstruction.
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The records of 250 patients presenting with flail-chest injury in a level I trauma centre were reviewed and analysed in order to determine prognostic factors. ⋯ (1) ISS is the strongest predictor of outcome associated with increased mortality; and (2) mechanical support was not considered a necessity for the treatment of flail chest.
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Eur J Cardiothorac Surg · Oct 2010
Outcome of patients with nonspecific pleuritis/fibrosis on thoracoscopic pleural biopsies.
Medical thoracoscopy is recommended in the investigation of patients with exudative pleural effusions, especially when pleural fluid analysis is uninformative. The histological finding of 'nonspecific pleuritis/fibrosis' is common in thoracoscopic biopsies and presents a great uncertainty for clinicians and patients as the long-term outcome of these patients is unclear, and anxieties about undiagnosed malignancy persist. ⋯ Thoracoscopic pleural biopsy is valuable in the diagnosis of pleural malignancies. Patients with 'nonspecific pleuritis/fibrosis' require follow-up as a malignant diagnosis (especially mesothelioma) may eventually be established in approximately 12% of cases.