European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Dec 2012
Six-year experience with a hybrid stent graft prosthesis for extensive thoracic aortic disease: an interim balance.
To avoid a two-stage surgical approach for complex thoracic aortic disease with its additive mortality and morbidity, a hybrid stent graft prosthesis was introduced 6 years ago for simultaneous treatment of the ascending, arch and descending aortas, relying proximally on a surgical suture line with an integrated distal stent graft for downstream splinting. We report the mid-term single-centre experience. ⋯ The durable hybrid one-stage repair of complex thoracic aortic disease is feasible with acceptable mortality. Distal reintervention is infrequent and associated with low risk; thus, the indication for the optimization of the peripheral flow using the endovascular aortic repair techniques is gradually widened.
-
Eur J Cardiothorac Surg · Dec 2012
Randomized Controlled Trial Multicenter StudyOptimized temporary bi-ventricular pacing improves haemodynamic function after on-pump cardiac surgery in patients with severe left ventricular systolic dysfunction: a two-centre randomized control trial.
Optimized temporary bi-ventricular (BiV) pacing may benefit heart failure patients after on-pump cardiac surgery compared with conventional dual-chamber right ventricular (RV) pacing. An improvement in haemodynamic function with BiV pacing may reduce the duration of 'Level 3' intensive care. ⋯ Postoperative haemodynamic function may be enhanced by temporary BiV pacing of high-risk patients after on-pump cardiac surgery.
-
Eur J Cardiothorac Surg · Dec 2012
Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years.
Cardiac troponin I (cTnI) is a highly sensitive, specific marker for myocardial cell injury. We sought to determine whether cTnI on admission may help to identify patients with increased risk of open surgical embolectomy with acute pulmonary embolism (PE). ⋯ cTnI on admission may improve risk assessment of patients undergoing open surgical embolectomy due to acute PE.
-
Eur J Cardiothorac Surg · Dec 2012
Comparative Study Clinical TrialComparison between homografts and Freestyle® bioprosthesis for right ventricular outflow tract replacement in Ross procedures.
Although data from large series indicate the satisfactory performance of bioprosthetic valves in the right ventricular outflow tract (RVOT), replacement of the pulmonary valve in adult patients undergoing the Ross procedure is usually performed with pulmonary allografts. We evaluated the outcomes of homografts vs. bioprosthetic RVOT replacement after the Ross procedure in adults. ⋯ Patients with bioprostheses in the RVOT position after the Ross procedure showed a significantly higher risk of reintervention or pulmonary valve dysfunction. The main problem, early development of a stricture at the proximal suture line, has to be solved to achieve satisfactory bioprosthetic function in the RVOT.
-
Eur J Cardiothorac Surg · Dec 2012
Randomized Controlled TrialSelective pulmonary pulsatile perfusion with oxygenated blood during cardiopulmonary bypass attenuates lung tissue inflammation but does not affect circulating cytokine levels.
Improved respiratory outcome has been shown after selective pulsatile pulmonary perfusion (sPPP) during cardiopulmonary bypass (CPB). No contemporary study has analysed the impact of sPPP on alveolar and systemic inflammatory response in humans. ⋯ sPPP attenuates alveolar inflammation, as demonstrated by the lower neutrophilic/lymphocytic alveolar infiltration, and the secretion of anti-inflammatory rather than proinflammatory mediators.