European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Sep 2011
Beneficial effect of exogenous surfactant in infants suffering acute respiratory distress syndrome after cardiac surgery.
The efficiency of exogenous pulmonary surfactant for pediatric patients suffering acute respiratory distress syndrome after cardiac surgery remains indeterminate. This study explored (1) whether use of exogenous surfactant improved recovery for patients suffering postoperative acute respiratory distress syndrome and (2) whether kinetic analysis of pulmonary functional change was helpful to indicate an appropriate dosing scheme. ⋯ Exogenous pulmonary surfactant is an efficient medication for infants suffering acute respiratory distress syndrome after cardiac surgery. Kinetics analysis of functional change after initial surfactant use may be referred for early determination of an optimal dosing scheme.
-
Eur J Cardiothorac Surg · Sep 2011
Bicuspid aortic valve leaflet morphology in relation to aortic root morphology: a study of 300 patients undergoing open-heart surgery.
There is an ongoing discussion regarding the mechanism of aortic dilatation in bicuspid aortic valve (BAV) disease, that is, is this a hemodynamic effect or related to an inborn weakness of the aortic wall? This study evaluated the possibility of BAV morphology being related to ascending aorta morphology as such a correlation would strengthen the idea that hemodynamic alterations cause the dilatation of the aorta. ⋯ In our study population, >50% of the patients admitted for surgery had a bicuspid valve. Aortic aneurysm was more common in BAV than in TAV patients. Aortic stenosis and aortic regurgitation were equally common in TAV and BAV with normal aortic dimensions, while aortic regurgitation was predominant in TAV with dilated aortas and aortic stenosis in BAV with dilated aortas. Dilatation of the aorta was similarly distributed regardless of BAV leaflet morphology. These findings support the idea of an intrinsic mechanisms underlying dilatation of the aorta in BAV patients.
-
Eur J Cardiothorac Surg · Sep 2011
En bloc resection of non-small-cell lung cancer invading the spine.
To describe our surgical en bloc approach and to assess the outcome and survival of non-small-cell lung cancer (NSCLC) invading the spine. ⋯ Multimodality treatment including en bloc lung resections with hemivertebrectomy or total vertebrectomy offer promising long-term survival in highly selected patients with NSCLC invading the spine. These extended resections can be performed with acceptable morbidity and mortality in specialized centers. Patients aged ≥ 70 years should be selected very carefully for radical resection. Sublobar resections should be avoided.
-
Eur J Cardiothorac Surg · Sep 2011
Minimally invasive repair after inefficient open surgery for pectus excavatum.
Pectus excavatum is the most common chest wall deformity, and both open surgery and minimally invasive repair have been proposed for primary correction. The aim of this study was to show the feasibility of minimally invasive repair of recurrent pectus excavatum in patients with inefficient previous open surgery. ⋯ Minimally invasive repair is a safe and easy operation for the correction of pectus excavatum. Previous open surgical repair is not a contraindication for the redo minimally invasive surgery, and it can be performed with acceptable morbidity and length of hospital stay.
-
Eur J Cardiothorac Surg · Sep 2011
Randomized Controlled Trial Multicenter StudyWarm-blood cardioplegia with low or high magnesium for coronary bypass surgery: a randomised controlled trial.
Magnesium (Mg²⁺) is cardioprotective and has been routinely used to supplement cardioplegic solutions during coronary artery bypass graft (CABG) surgery. However, there is no consensus about the Mg²⁺ concentration that should be used. The aim of this study was to compare the effects of intermittent antegrade warm-blood cardioplegia supplemented with either low- or high-concentration Mg²⁺. ⋯ Warm-blood cardioplegia supplemented with 16 mmol l⁻¹ Mg²⁺, compared with 5 mmol l⁻¹ Mg²⁺, does not reduce the frequency of postoperative atrial fibrillation in patients undergoing CABG but may reduce cardiac injury. (This trial was registered as ISRCTN95530505.).