European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2013
Randomized Controlled Trial Comparative StudyComparison of non-divided intercostal muscle flap and intercostal nerve cryoanalgesia treatments for post-oesophagectomy neuropathic pain control.
Oesophagectomy is at present considered to be the optimal curative treatment for patients with severe oesophageal disease. Postoperative pain, both acute and chronic, plays a significant role in the quality of life for post-oesophagectomy patients. The present study compared the effects of two methods-application of a non-divided intercostal muscle flap (NIMF) and intercostal nerve cryoanalgesia (INC) treatment-in reducing neuropathic pain in post-oesophagectomy patients. ⋯ Both NIMF and INC treatments were effective and safe for the treatment of acute pain after oesophagectomy. NIMF was the better technique in reducing chronic postoperative pain.
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Eur J Cardiothorac Surg · Mar 2013
Early and late prognostic implications of coronary artery bypass timing after myocardial infarction.
The optimal timing of coronary artery bypass grafting (CABG) after myocardial infarction (MI) is still controversial. With advances in perioperative care and myocardial protection, CABG is not infrequently undertaken sooner. Although CABG soon after MI is associated with high morbidity and mortality, the impact of CABG timing on late survival is not clear. ⋯ Early and late mortality risk for CABG declines with increasing interval from MI for reasons indirectly linked to the timing of surgery. Our findings emphasize the importance of preoperative organ system optimization and consistent left internal mammary artery use, regardless of the proximity of surgery to MI or the exigency of surgery.
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Eur J Cardiothorac Surg · Mar 2013
Is heart transplantation for complex congenital heart disease a good option? A 25-year single centre experience.
Heart transplantation (HTx) in patients with complex congenital heart disease (CHD) is a challenge because of structural anomalies and multiple previous procedures. We analysed our results in adult and paediatric patients to evaluate outcome and assess risk factors affecting mortality. ⋯ We demonstrated that heart transplantation for patients with CHD can be performed with the expectation of excellent results. Previous procedures, including the Fontan operation, do not reduce survival. Mortality is related to preoperative patient condition. We advocate early referral of complex CHD patients for transplant assessment and for inclusion in waiting lists before the detrimental effects of end-stage failure manifest themselves.
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Eur J Cardiothorac Surg · Mar 2013
First clinical results with the new sinus prosthesis used for valve-sparing aortic root replacement.
Sinuses of Valsalva are important in assuring the physiological function of the aortic valve. This study evaluates short-term clinical results of the reimplantation technique for aortic valve-sparing root replacement using a new prosthesis with three separate sinuses of Valsalva (sinus prosthesis). ⋯ The new sinus prosthesis provides near normal root geometry and hemodynamics in valve-sparing aortic root replacement using the reimplantation technique, applicable for tricuspid and also bicuspid aortic valves.