European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2012
How to achieve an aortic root remodelling by performing an aortic root reimplantation.
The aortic root remodelling procedure, introduced by Yacoub in the early 1980s, is the valve-sparing aortic root replacement procedure that better reproduces the anatomical and functional properties of the native aortic root. Long-term durability of the repair, in terms of freedom from recurrent aortic regurgitation, has been questioned and can probably be improved by appropriate patient selection. Reproducibility of the operation, however, depends on subjective evaluations and surgical skill. We report a simplification of the technique designed to possibly increase the reproducibility of the aortic root remodelling operation while retaining its functional advantages.
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Eur J Cardiothorac Surg · Nov 2012
Clinical TrialAccuracy of transthoracic ultrasound for the detection of pleural adhesions.
In the era of minimally invasive surgery, preoperative detection of pleural adhesions can be very useful for the assessment of surgical approach, because pleural adhesions are the main contraindication to video-assisted thoracoscopy. The aim of this study was to assess the sensitivity and specificity of transthoracic ultrasound in the detection of pleural adhesions prior to thoracic surgery. ⋯ Transthoracic ultrasound is an effective method for predicting pleural adhesions before thoracic surgery in experienced hands. Its safety, feasibility and low cost make it a useful method for the planning of minimally invasive surgical interventions.
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Eur J Cardiothorac Surg · Nov 2012
Case ReportsEndoscopic volume reduction before or after lung transplantation.
Endobronchial valve therapy in patients with severe emphysema achieves similar clinical benefits to lung volume reduction surgery without the potential morbidity. We report successful endobronchial valve treatments in two patients with severe emphysema. ⋯ The potential benefit of this procedure was anticipated by lobar collateral ventilation measurements. Two months later, forced expiratory volume in 1 s, forced vital capacity and dyspneoa improved in both cases.
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Eur J Cardiothorac Surg · Nov 2012
Review Meta AnalysisEfficacy of tranexamic acid in paediatric cardiac surgery: a systematic review and meta-analysis.
The benefit-to-risk ratio of using tranexamic acid (TXA) in paediatric cardiac surgery has not yet been determined. This systematic review evaluated studies that compared TXA to placebo in children undergoing cardiac surgery. A systematic search was conducted in all relevant randomized controlled trials. ⋯ There was marked variability in the dosage and infusion schemes used in different studies. This systematic review showed that in paediatric cardiac surgery, the benefit-to-risk ratio associated with the use of TXA cannot be adequately defined. Evidence supporting the routine use of TXA in paediatric cardiac surgery remains weak.