European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2012
Surgical outcomes in patients with primary mediastinal non-seminomatous germ cell tumours and elevated post-chemotherapy serum tumour markers.
Platinum-based chemotherapy followed by surgical resection of residual masses has become the standard treatment of patients with primary mediastinal non-seminomatous germ cell tumours (NSGCTs). Persistent serum tumour marker (STM) elevation after chemotherapy usually indicates a poor prognosis. We retrospectively assessed surgical outcomes in patients with high STM levels after chemotherapy for primary mediastinal NSGCT. ⋯ In patients with primary mediastinal NSGCTs and elevated post-chemotherapy STMs, surgery is warranted when complete resection is deemed feasible. In specialized oncology centres, this aggressive approach can provide a cure in some patients.
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Eur J Cardiothorac Surg · Jul 2012
Case ReportsDavid procedure during a reoperation for ongoing chronic Q fever infection of an ascending aortic prosthesis.
Chronic Q fever infections, caused by Coxiella burnetii, are associated with cardiovascular complications, mainly endocarditis and vascular (graft) infections. We report a case of a patient with a C. burnetii infected thoracic aorta graft treated initially in a conservative way. ⋯ In the absence of practical guidelines, treatment is tailored to the individual patient. Furthermore, we want to emphasize the need to include chronic Q fever in the differential diagnosis in patients with culture negative aortitis, especially in the regions with Q fever epidemics in the recent past.
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Eur J Cardiothorac Surg · Jul 2012
Case ReportsSuccessful correction of unroofed coronary sinus with pulmonary vein stenosis.
We present a case of an infant with an unroofed coronary sinus associated with a persistent left superior vena cava draining into the left atrium, right superior pulmonary vein stenosis, an atretic left superior pulmonary vein and a double-outlet right ventricle. For pulmonary vein stenosis and atresia, we used a sutureless technique with an autologous pericardial patch to create a neoatrium.
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Eur J Cardiothorac Surg · Jul 2012
Practice GuidelineThoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI).
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Eur J Cardiothorac Surg · Jul 2012
Surgical treatment to increase the success rate of multidrug-resistant tuberculosis.
Mycobacterium tuberculosis infects more than one-third of the world's population and causes an estimated 2-3 million deaths annually. The medical treatment of multidrug-resistant tuberculosis (MDR-TB) can cure 50-75% of cases. The median prevalence of new MDR-TB cases is 1.1%, while that of previously treated cases is 7%. ⋯ The absolute indications for the surgical treatment of MDR-TB include failure of medical therapy (due to persistent cavitary disease and lung or lobar destruction) and massive haemoptysis. Proper patient selection and the timing of operations are crucial to avoid relapses and to provide a definitive cure. Good cooperation between chest physicians and thoracic surgeons as well as patients' adherence to pre- and post-chemotherapy can increase the success rate of MDR-TB treatment.