European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Feb 2009
Endobronchial ultrasound-guided needle aspiration in the non-small cell lung cancer staging.
The aim of the study was to assess the diagnostic yield of the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-NA) in the mediastinal staging in non-small cell lung cancer (NSCLC) patients. ⋯ (1) EBUS-NA is an effective and safe technique for mediastinal staging in NSCLC patients. (2) In patients with negative results of EBUS-NA, surgical exploration of the mediastinum should be performed.
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Eur J Cardiothorac Surg · Feb 2009
Multicenter StudyProfitability of our lung retrieval program from non heart beating donors.
In 2002 the first lung transplant from non heart beating (NHB) donors took place in Madrid. The objective of this study was to analyse our Maastricht type I NHB lung donors retrieval program and to check out its profitability. ⋯ A total of 58.1% of preserved lungs were implanted. The ratio of obtained lungs was 11.4% of actual donors and 7.7% of total occurrences. However, this percentage could have been higher if we take into account the number of valid lungs that were not transplanted because of the lack of recipients.
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Eur J Cardiothorac Surg · Feb 2009
ReviewCombined videothoracoscopic and videomediastinoscopic approach improves radicality of minimally invasive mediastinal lymphadenectomy for early stage lung carcinoma.
To assess the feasibility and radicality of a combined thoracoscopic and mediastinoscopic approach to mediastinal lymphadenectomy compared to thoracoscopy only for minimally invasive management of early stage lung carcinoma. ⋯ A combined approach by VATS and VAMLA improves radicality of minimally invasive mediastinal lymphadenectomy without increase in operation time, morbidity, and drainage time.
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Eur J Cardiothorac Surg · Feb 2009
ReviewAlternatives to transplantation in the surgical therapy for heart failure.
Despite considerable improvements in the medical treatment of heart failure (HF), the gold standard for the treatment of these patients remains heart transplantation. Nevertheless, in consideration of the shortage of organ donors, this procedure can be offered only to a small percentage of patients who could benefit from a new heart. ⋯ Future therapies for HF could include stem cell therapy, associated with standard revascularization techniques or with other procedures such as ventricular assist devices implantation or ventricular restoration techniques, allowing the potential differentiation of implanted stem cells in a resting and unloaded heart. The modern approach to surgical treatment of HF is multidisciplinary, given that the number of alternative available options to heart transplantation requires a close collaboration between both cardiologists and cardiac surgeons in treating patients with end-stage HF who are not candidates for transplant.
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Eur J Cardiothorac Surg · Jan 2009
Aortic root replacement in children: a word of caution about valve-sparing procedures.
Evaluate the results of various surgical procedures used for aortic root replacement in children with aortic root aneurysm. ⋯ (1) composite valve graft aortic root replacement provides excellent long-term results in children with aortic root aneurysm due to connective tissue disorder. This remains the first choice procedure in patients with more than minimal aortic insufficiency, with distorted aortic leaflets or needing concomitant mitral valve replacement. (2) Valve-sparing remodeling surgery yields disappointing results and should probably be abandoned in the pediatric population. (3) Valve-sparing reimplantation repair may achieve superior outcome but needs further evaluation.