European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. ⋯ The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance.
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Eur J Cardiothorac Surg · Jun 2011
Multicenter StudyAn Australian risk prediction model for determining early mortality following aortic valve replacement.
To develop a multivariable logistic risk model for predicting early mortality following aortic valve replacement (AVR) in adults, and to compare its performance against existing AVR-dedicated models. ⋯ Existing AVR-dedicated risk models were deemed inappropriate for risk prediction in the Australian population. A preoperative risk model was developed using prospective data from a contemporary AVR cohort.
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Eur J Cardiothorac Surg · Jun 2011
Elective pectus bar removal following Nuss procedure for pectus excavatum: a single-institution experience.
Very few data are available on complications following elective bar removal after the Nuss procedure for pectus excavatum. The objective of this study was to investigate the data from 343 consecutive patients. ⋯ Bar removal following the Nuss procedure is a quick and safe operation with very few complications. Occurrence of complications is not dependent on the experience of the surgeon.
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Eur J Cardiothorac Surg · Jun 2011
Microalbuminuria is associated with high adverse event rate following cardiac surgery.
To examine if preoperative microalbuminuria is associated with an increased risk of long-term adverse outcomes following elective cardiac surgery and if it provides additional prognostic information beyond the European System for Cardiac Operative Risk Evaluation (EuroSCORE). ⋯ Preoperative microalbuminuria is associated with an increased risk of long-term adverse outcomes in patients undergoing elective cardiac surgery, and it appears to provide prognostic information on mortality.
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Eur J Cardiothorac Surg · Jun 2011
The use of non-heart-beating lung donors category III can increase the donor pool.
The use of non-heart-beating (NHB) lung donors has been propagated as an alternative besides heart-beating (HB) lung donors to overcome organ shortage. We evaluated the effectiveness of NHB lung transplantation. ⋯ Lungs from nonheparinized category III NHB donors are well suited for transplantation and can safely increase the donor pool.