European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Apr 2014
Multicenter StudyMorbidity and mortality in a large series of surgical patients with pulmonary metastases of colorectal carcinoma: a prospective multicentre Spanish study (GECMP-CCR-SEPAR).
Little information is available on postoperative morbidity and mortality after pulmonary metastasectomy. We describe the postoperative morbidity and mortality in a large multicentre series of patients after a first surgical procedure for pulmonary metastases of colorectal carcinoma (CRC) and identify the pre- and intraoperative variables influencing the clinical outcome. ⋯ The first episode of lung surgery for pulmonary metastases of CRC was associated with very low mortality and reoperation rates (<1%). The postoperative morbidity rate was 16%. Independent risk factors of postoperative morbidity were major lung resection and respiratory and/or cardiovascular co-morbidity. Video-assisted surgery showed a protective effect.
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Eur J Cardiothorac Surg · Apr 2014
Case ReportsManagement of Boerhaave's syndrome with an over-the-scope clip.
Boerhaave's syndrome is a spontaneous barotraumatic disruption of the distal oesophagus secondary to an abrupt increase in intraoesophageal pressure during vomiting. Management ranges from a conservative approach to an oesophagectomy. The over-the-scope-clip (OTSC, Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed clipping method for tissue mechanical compression in the gastrointestinal tract. We report the case of a patient referred with a delayed diagnosis of Boerhaave's syndrome and successfully treated by OTSC application followed by lung decortication.
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Eur J Cardiothorac Surg · Apr 2014
Video-assisted thoracoscopic surgery lobectomy at 20 years: a consensus statement.
Video-assisted thoracoscopic surgery (VATS) lobectomy has been gradually accepted as an alternative surgical approach to open thoracotomy for selected patients with non-small-cell lung cancer (NSCLC) over the past 20 years. The aim of this project was to standardize the perioperative management of VATS lobectomy patients through expert consensus and to provide insightful guidance to clinical practice. ⋯ The present Consensus Statement represents a collective agreement among 50 international experts to establish a standardized practice of VATS lobectomy for the thoracic surgical community after 20 years of clinical experience.
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The use of artificial chordae techniques has increased the number of mitral valve lesions which are amenable to repair. Artificial chordae can be adapted for a wide range of mitral valve pathologies including restricting the motion of overly mobile 'floppy' Barlow disease leaflets, replacing diseased chordae and improving coaptation in degenerative disease. There is continuing concern about the long-term performance of artificial chordae, which become endothelialized over time and may exhibit complications during the early or late follow-up period. ⋯ A number of problems remain in the use of artificial chordae, especially the proper determination of their length. Techniques that solve these issues may enhance patient outcomes further.
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Eur J Cardiothorac Surg · Apr 2014
High-sensitivity troponin T as a biomarker for the development of atrial fibrillation after cardiac surgery.
Atrial fibrillation (AF) occurs in ∼ 30% of patients undergoing coronary artery bypass grafting (CABG) and in 40% of patients after valve surgery. High-sensitivity cardiac troponin T (hsTnT) is a specific and high-sensitivity marker of myocardial injury, while N-terminal proB-type natriuretic peptide (NT-proBNP) is an established biomarker for wall remodelling. We investigated whether hsTnT and NT-proBNP levels could be used as valuable biomarkers for AF occurrence after cardiac surgery. ⋯ High presurgical hsTnT levels were independently predictive of patients developing AF after cardiac surgery. hsTnT levels determined post-surgery suggest that cardiac perioperative myocardial injury is not associated with postoperative AF development. NT-proBNP did not reach statistical significance as a biomarker for AF prediction.