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 2010
Randomized Controlled TrialA prospective, single-blind randomised study on the effect of intercostal nerve protection on early post-thoracotomy pain relief.
Intracostal suture or intercostal muscle flap can reduce post-thoracotomy pain through the preservation of intercostal nerves below or above the incision. This study aims to test whether combining intracostal suture with intercostal muscle flap might achieve better pain relief than intracostal suture alone. ⋯ The combination of intracostal suture with intercostal muscle flap may not necessarily achieve better post-thoracotomy pain control than using intracostal suture alone.
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Eur J Cardiothorac Surg · Apr 2010
Multicenter Study Comparative StudyResults of staged total cavopulmonary connection for functionally univentricular hearts; comparison of intra-atrial lateral tunnel and extracardiac conduit.
This study aims to compare the outcome of the two co-existing modifications of staged total cavopulmonary connection (TCPC) - the intra-atrial lateral tunnel (ILT) and the extracardiac conduit (ECC). ⋯ Outcome after staged ILT- and ECC-type Fontan operations is good, with comparable freedom from late re-operations and freedom from Fontan failure at 6-year follow-up. The incidence of arrhythmias was significantly lower in the ECC group. Right ventricular morphology was identified as a risk factor for arrhythmias.
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Eur J Cardiothorac Surg · Apr 2010
Randomized Controlled TrialOff-pump coronary artery bypass surgery versus standard linear or pulsatile cardiopulmonary bypass: endothelial activation and inflammatory response.
Poor outcomes after coronary artery bypass grafting (CABG) have been linked to perioperative endothelial activation and systemic inflammatory responses. The use of pulsatile cardiopulmonary bypass (PCPB) or off-pump CABG (OPCABG) may minimise these phenomena. We compared biochemical and clinical outcomes among patients who underwent CABG with PCPB, CABG with linear CPB (LCPB) or OPCABG. ⋯ LCPB appears to promote endothelial activation and cytokine secretion, which may delay recovery. OPCABG was associated with slight endothelial activation and cytokine response. PCPB significantly attenuates endothelial/cytokine leakage, resulting in hospital outcomes comparable with those after OPCABG.
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Eur J Cardiothorac Surg · Apr 2010
Comparative StudyDiscordant findings in patients with non-small-cell lung cancer: absolutely normal bone scans versus disseminated bone metastases on positron-emission tomography/computed tomography.
At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. The objective of our study was to compare the sensibility of the 2-deoxy-2-[18F] fluoro-d-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) for the detection of bone metastasis in patients with non-small-cell lung cancer (NSCLC) whose technetium 99m methylenediphosphonate (Tc-99m MDP) bone scans were absolutely normal. ⋯ Discordant findings of skeletal metastasis between Tc-99m MDP bone scans and F-18 FDG PET/CT imaging may be seen in 20% of the patients with NSCLC. F-18 FDG PET/CT could detect metastatic bone involvement more accurately than bone scintigraphy. Bone scans are insensitive to early bone marrow neoplastic infiltration. Assessment of glucose metabolism with FDG PET/CT can represent a more powerful tool to detect early bone metastases in lung cancer than with traditional bone scans.
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Eur J Cardiothorac Surg · Apr 2010
The modified Ross operation using a Dacron prosthetic vascular jacket does prevent pulmonary autograft dilatation at 4.5-year follow-up.
Following the Ross operation, pulmonary autografts tend to dilate over time. This study researches the fate of the pulmonary autograft - at 4.5 years following the modified Ross operation - with special reference to the impact of the modification on (a) pulmonary autograft dilatation, (b) the neo-aortic root geometry, (c) neo-aortic valve function and (d) the coronary artery reserve. ⋯ Provision of external support to the entire pulmonary autograft with a DVPJ prevents its dilatation following free-standing pulmonary autograft Ross operation when evaluated at the 4.5-year follow-up. The function and the geometry of the neo-aortic root are not affected negatively by this modification and the patients demonstrated normal exercise capacity.