European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Dec 2013
Experience with the conventional and frozen elephant trunk techniques: a single-centre study.
The treatment of patients with extensive thoracic aortic disease involving the arch and descending/thoracoabdominal aorta is often performed using an elephant trunk procedure. We retrospectively analysed our results comparing two different techniques: the conventional elephant trunk (cET) and the frozen elephant trunk (FET) operation. ⋯ The FET procedure for extensive thoracic aortic disease is associated with an acceptable mortality rate, but with a higher incidence of perioperative spinal cord injury than cET. Arch replacement with a cET technique should be strongly considered in patients with expected prolonged circulatory arrest times, particularly if operated on under mild or moderate hypothermia. Axillary cannulation is associated with superior neurological outcomes and Type A acute aortic dissection is a risk factor for mortality and poor neurological outcomes in this patient population.
-
Eur J Cardiothorac Surg · Dec 2013
Novel surgical ablation through a septal-superior approach for valvular atrial fibrillation: 7-year single-centre experience.
We previously reported favourable short-term results of our 'trans-septal maze procedure', a novel technique for creating biatrial lesions through a septal-superior approach during mitral valve surgery. Here, we reviewed the mid-term results of this procedure and determined the impact of restored left atrial (LA) contraction on late outcomes. ⋯ Our trans-septal maze procedure may be an effective alternative surgical treatment for eliminating AF during mitral valve surgery. In patients with valvular AF, early surgery is warranted to restore sinus rhythm with LA mechanical contraction, before severe LA dilatation occurs. The impact of LA contraction recovery conferred by AF ablation on postoperative haemodynamic improvements and thromboembolic events remains to be determined.
-
Eur J Cardiothorac Surg · Dec 2013
Case ReportsSynergy between stents and extracorporeal membrane oxygenation in multitrauma patients with inferior vena cava injury.
Despite the lack of evidence in the literature, we report the case of a 25-year-old man involved in a road traffic accident, who had an inferior vena cava (IVC) injury and severe lung contusion with parenchymal bleeding requiring an extracorporeal membrane oxygenation (ECMO). An emergency procedure to implant a stent graft was successful in repairing the IVC injury. Moreover, we think that ECMO, in addition to providing oxygenation, reduced bleeding by creating a negative pressure along the injured IVC. The patient was decannulated on the eighth day and discharged 31 days after the accident.
-
Eur J Cardiothorac Surg · Dec 2013
Preoperative anaemia is a risk factor for mortality and morbidity following aortic valve surgery.
The impact of anaemia on patients undergoing aortic valve surgery has not been well studied. We sought to evaluate the effect of anaemia on early outcomes following aortic valve replacement (AVR). ⋯ Preoperative anaemia is a common finding in patients undergoing aortic valve surgery and is an important and potentially modifiable risk factor for postoperative morbidity and mortality.
-
Eur J Cardiothorac Surg · Dec 2013
Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty: an improved operative technique.
We summarize our experiences of video-assisted thoracoscopic surgery (VATS) sleeve lobectomy with bronchoplasty for non-small-cell lung cancer and discuss the indications and technical details of the operation. ⋯ VATS sleeve lobectomy with bronchoplasty is safe and effective. The utility incision placed at the fourth intercostal space, anterior axillary line, is convenient for the anastomosis, and the suturing technique is expeditious and secure. Preserving the azygos vein does not compromise exposure for the anastomosis. This technique is very suitable for centrally located lung cancers <3 cm in diameter, particularly when the cancers are located within the brachial lumen.