European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2009
Recommended changes for T and N descriptors proposed by the International Association for the Study of Lung Cancer - Lung Cancer Staging Project: a validation study from a single-centre experience.
The International Association for the Study of Lung Cancer (IASLC) recently recommended changes for T and N descriptors for the next TNM (Tumour, Node, Metastasis) edition. We re-classify our operated patients to evaluate the effectiveness of the IASLC suggestions. ⋯ Our experience confirms the IASLC recommendations to subdivide patients by tumour size at 2, 3 and 7 cm, to re-assign PM1 tumours to T3 and to group patients according to the number of involved lymph nodal zones are valid and provide excellent survival stratification.
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Eur J Cardiothorac Surg · Dec 2009
Comparative StudyHypothermic extracorporeal circulation in immature swine: a comparison of continuous cardiopulmonary bypass, selective antegrade cerebral perfusion and circulatory arrest.
Selective antegrade cerebral perfusion (SCP) has been widely used during complex congenital heart surgery and theoretically affords some degree of neuroprotection. There are limited data to support this claim, however. This study was designed to compare, at profound hypothermia, continuous cardiopulmonary bypass, SCP and circulatory arrest in a survival model of extracorporeal circulation in immature swine. ⋯ In this survival model of hypothermic extracorporeal circulatory support in immature swine, histologic brain injury was similar in piglets subjected to FF, SCP or HCA. Although the HCA group tended to have worse early neurologic outcome, any difference clearly disappeared by POD 5. These data raise the possibility that profound hypothermia alone during extracorporeal support may produce this observed brain injury. Additional study is required to define the precise aetiology of the brain injury observed in this animal model.
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Eur J Cardiothorac Surg · Dec 2009
Clinical TrialPreoperative statin treatment reduces systemic inflammatory response and myocardial damage in cardiac surgery.
To determine if preoperative statin treatment is associated with a reduction in systemic inflammatory response (SIR) and myocardial damage markers following cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Preoperative treatment with statins is associated with a lower biochemical parameters of SIR and myocardial damage following cardiac surgery with CPB, regardless of it being coronary bypass grafting (CABG) or valvular surgery.
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Eur J Cardiothorac Surg · Dec 2009
Prophylactic treatment with levosimendan: a retrospective matched-control study of patients with reduced left ventricular function.
Levosimendan is a calcium-sensitising inotropic agent and a vasodilator used in the treatment of heart failure. Post-cardiotomy cardiac failure is more common in patients with a low preoperative left ventricular ejection fraction (LVEF). We aim at investigating how prophylactic treatment with levosimendan before weaning from cardiopulmonary bypass (CPB) affects postoperative haemodynamics and outcome in patients with low preoperative LVEF. ⋯ Prophylactic infusion of levosimendan initiated before weaning from CPB did not lead to superior haemodynamic parameters (CI, SVI, SvO(2)) compared to controls. Levosimendan reduced MAP and increased the need for norepinephrine postoperatively.
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Eur J Cardiothorac Surg · Dec 2009
Early results of bilateral pulmonary artery banding for hypoplastic left heart syndrome.
To compare the haemodynamics and perioperative course of initial palliation with bilateral pulmonary artery banding (PAB) and the Norwood procedure. ⋯ Bilateral PAB with continuous lipo-prostaglandin E1 administration may improve early and intermediate mortality in infants with HLHS. Intimate care with hospitalisation may contribute to the results.