European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2019
Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS).
Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training. ⋯ The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.
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Eur J Cardiothorac Surg · Jul 2019
The role of thoracic endovascular repair in elective, symptomatic and ruptured thoracic aortic diseases.
Thoracic endovascular aortic repair (TEVAR) has emerged as a safe procedure in the treatment of a wide spectrum of descending thoracic aortic pathologies, with satisfactory results both in elective and urgent settings. We investigated the results of our elective, urgent and emergency TEVAR interventions. ⋯ TEVAR is an effective treatment strategy in thoracic aortic disease. Though emergency repair of the ruptured thoracic aorta still shows high rates of perioperative mortality and morbidity, symptomatic non-ruptured and asymptomatic patients have comparable early outcomes.
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Eur J Cardiothorac Surg · Jul 2019
Meta AnalysisWhat is the best graft to supplement the bilateral internal thoracic artery to the left coronary system? A meta-analysis.
This meta-analysis was designed to assess the effect of the use of arterial conduits (ACs) versus great saphenous vein (GSV) grafts as a third conduit for revascularization of the right coronary artery system, in addition to the bilateral internal mammary artery on the left coronary artery. PubMed and OVID's version of MEDLINE were searched from January 2000 to September 2017 for relevant publications. The primary end point was the long-term mortality rate. ⋯ No publication bias was found. This meta-analysis is the first to compare the GSV to the radial artery and the right gastroepiploic artery for right coronary artery grafting in patients receiving a bilateral internal mammary artery to left coronary artery. The choice of a third AC seems to be preferable in order to achieve better long-term survival.
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Eur J Cardiothorac Surg · Jul 2019
One-stage aortic replacement for type A aortic dissection: using a Vasoring and a conventional elephant trunk graft.
We used a vascular ring connector (Vasoring) and a conventional elephant trunk graft for complete repair in open surgery for type A aortic dissection. This report described the immediate and mid-term results of this new technique. ⋯ The combined use of the vascular ring connector and the conventional elephant trunk graft may reduce bleeding and pump time, stop the blood flow in the false lumen and allow the 1-stage total arch replacement to be performed safely. The conventional elephant trunk graft is free from stent graft-induced new entry.