European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2013
Acute lung injury after mechanical circulatory support implantation in patients on extracorporeal life support: an unrecognized problem.
We observed early acute lung injury (ALI) after a switch from veno-arterial extracorporeal life support (VA-ECLS) to long-term mechanical circulatory support (MCS). The aim of our study was to analyse the frequency, impact on mortality and characteristics of patients presenting ALI after MCS implantation in the bridge-to-bridge (BTB) strategy. ⋯ Implantation of a long-term MCS device in patients on ECLS can result in severe ALI, which is associated with ominous outcomes. Various preimplant risk factors for ALI have been identified and might allow devising strategies to prevent this complication.
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Eur J Cardiothorac Surg · Sep 2013
Prognostic impact and initial recurrence site of lymphovascular and visceral pleural invasion in surgically resected stage I non-small-cell lung carcinoma.
This study aimed to analyse and validate the prognostic impact and effect of the initial recurrence site of lymphovascular and visceral pleural invasion (VPI) on survival outcomes for Stage I non-small-cell lung carcinoma (NSCLC). ⋯ We propose that LVI and/or VPI may be a candidate marker to determine adjuvant therapy or a more careful follow-up for these patients.
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Eur J Cardiothorac Surg · Sep 2013
Assessing the relationships between health-related quality of life and postoperative length of hospital stay after oesophagectomy for cancer of the oesophagus and the gastro-oesophageal junction.
To evaluate baseline health-related quality of life (HRQL) factors that influence short-term outcome after oesophagectomy for cancer of the oesophagus and gastro-oesophageal junction and the effects of postoperative length of hospital stay on postoperative HRQL, as perceived by the patients themselves. ⋯ A better perception of preoperative physical functioning might have a beneficial effect on LOS. Our data, furthermore, suggest that early discharge correlates with improved postoperative HRQL outcomes. A clear decrease of the HRQL is seen at 3 months after the surgery, particularly in the LOS >10 days group. Generally, return to the level of the reference population scores is achieved at 1 year in the LOS ≤10 days, but not in the LOS >10 days group.
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Eur J Cardiothorac Surg · Sep 2013
Open aortic arch replacement in the era of endovascular techniques.
Despite the progress in protection and surgical techniques, the proponents of endovascular techniques for aortic arch repair still consider conventional arch replacement to be high risk, mostly due to deep hypothermia, which in the past was generally used for cerebral and organ protection. The aim of the study was to evaluate the operative results of open aortic arch replacement using current perfusion and surgical techniques in which deep hypothermia is avoided. ⋯ Conventional arch surgery offers definitive repair and can be safely performed using current perfusion and operative techniques. Open procedures ensure simultaneous aortic valve repair, which is frequently necessary, and can be performed by reconstruction in more than half of the cases. The use of refined surgical and cerebral perfusion techniques allows the avoidance of deep hypothermia with all its negative side effects and leads to excellent outcomes against which the results of alternative approaches should be compared.
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Eur J Cardiothorac Surg · Sep 2013
The European Association for Cardio-Thoracic Surgery (EACTS) database: an introduction.
Continuous monitoring of surgical outcomes through benchmarking and the identification of best practices has become increasingly important. A structured approach to data collection, coupled with validation, analysis and reporting, is a powerful tool in these endeavours. However, inconsistencies in standards and practices have made comparisons within and between European countries cumbersome. The European Association for Cardio-Thoracic Surgery (EACTS) has established a large international database with the goals of (i) working with other organizations towards universal data collection and creating a European-wide repository of information on the practice of cardio-thoracic surgery, and (ii) disseminating that information in scientific, peer-reviewed articles. We report on the process of data collection, as well as on an overview of the data in the database. ⋯ The EACTS database has proven to be an important step forward in providing opportunities for monitoring cardiac surgical care across Europe. As the database continues to expand, it will facilitate research projects, establish benchmarking standards and identify potential areas for quality improvements.