European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2016
Discrepancy of epidermal growth factor receptor mutation in lung adenocarcinoma presenting as multiple ground-glass opacities.
To identify epidermal growth factor receptor (EGFR) mutation status between different lesions in lung adenocarcinoma presenting as multiple ground-glass opacity (GGO) lesions and analyse its association with clinical characteristics. ⋯ The study showed different EGFR mutational profiles in multiple GGO lesions, suggesting that lesions seem to arise as independent events. It would offer useful information for determining the appropriate treatment strategy for lung adenocarcinoma presenting as multiple GGO lesions.
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Eur J Cardiothorac Surg · Nov 2016
Outcome after surgical treatment of chronic thromboembolic pulmonary hypertension: dealing with different patient subsets. A single-centre experience.
Pulmonary endarterectomy (PEA) is the only curative treatment for patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH). In patients with a pulmonary vascular resistance (PVR) higher than 1000 dynes s cm-5, this procedure is linked with an increased perioperative risk. We compare the outcomes of patients with moderate to severe versus extremely elevated PVR. ⋯ Despite the increased perioperative risk and mortality, PEA should not be denied to patients with extremely elevated PVR but clear indication for surgery. Keeping increased perioperative risk and mortality in mind, significant pressure reduction and improved functional outcome can be achieved in the majority of these patients.
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Eur J Cardiothorac Surg · Nov 2016
Observational StudyCoronary artery bypass grafting-related bleeding complications in patients treated with dual antiplatelet treatment.
To evaluate the relationship between the timing of either ticagrelor or clopidogrel discontinuation and bleeding-related complications in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). ⋯ Ticagrelor discontinuation >72 h and clopidogrel discontinuation >120 h prior to surgery were not associated with an increased risk of bleeding-related complications. Based on these findings, a period of ticagrelor discontinuation shorter than advised by current international guidelines might be justifiable.
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Eur J Cardiothorac Surg · Nov 2016
Observational StudyNuss procedure for pectus excavatum in adults: long-term results in a prospective observational study.
Since the end of the 1990s, the management of pectus excavatum has undergone major changes. The Nuss procedure (pectus bar) has been the method of choice for patients with pectus excavatum at Bern University Hospital for over a decade. The current study will describe our experiences, with a particular focus on long-term results in adults. ⋯ Our results demonstrate that the Nuss procedure is safe and can be performed with excellent results in adults, both in the short term and in the long term. The improved quality of life and patients' satisfaction with cosmetic results remained high in the long-term follow-up, 10 years after the surgical procedure.
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Eur J Cardiothorac Surg · Nov 2016
Multicenter StudyLong-term support of patients receiving a left ventricular assist device for advanced heart failure: a follow-up analysis of the Registry to Evaluate the HeartWare Left Ventricular Assist System.
The Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE) is an investigator-initiated multicentre, prospective, single-arm database established to collect post-Conformité Européenne Mark clinical information on patients receiving the HeartWare® Ventricular Assist System (HVAD®). The number of patients requiring longer periods of mechanical circulatory support is ever increasing and so further investigation into long-term outcomes in bridge-to-transplant populations is necessary. ⋯ Owing to the low rate of heart transplants, a significant number of patients receiving a left ventricular assist device as a bridge to transplant remain on support for prolonged periods, often exceeding 2, 3 and even 4 years. Real-world use of the HVAD system continues to show excellent outcomes for patients on the device, including those on support beyond 2 years.