European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 2005
Charlson comorbidity index as a predictor of long-term outcome after surgery for nonsmall cell lung cancer.
To evaluate the impact of the Charlson comorbidity index on long-term survival in nonsmall cell lung cancer surgery and determine whether this index is a better predictor of long-term survival than individual comorbid conditions. ⋯ The Charlson comorbidity index is a better predictor of survival than individual comorbid conditions in nonsmall cell lung cancer surgery. We recommend the use of a validated comorbidity index in the selection of patients for NSCLC surgery.
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Eur J Cardiothorac Surg · Nov 2005
New insights into the pathophysiology of flail segment: the implications of anterior serratus muscle in parietal failure.
The wisdom of surgery facing multiple and multi-focal ribs fractures (flail segment) remains controversial. By the present retrospective study, we sought to determine the advisability of surgery as well as the anatomical and biomechanical features of flail segment leading to secondary dislocation. ⋯ The anterolateral and posterolateral flail segments are rendered susceptible to secondary dislocation through a complex set of factors, of which the action of anterior serratus muscle is obvious. Restoration of parietal mechanics by early surgical reduction/fixation is a reliable therapeutic option in selected patients and offers encouraging results.
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Eur J Cardiothorac Surg · Oct 2005
Intermediate-term outcome following the fontan operation: a survival, functional and risk-factor analysis.
To investigate survival and risk factors influencing intermediate outcome after the Fontan procedure. ⋯ Atrio-pulmonary connection results in a higher incidence of arrhythmias and failure than the lateral tunnel Fontan. Even in patients with a lateral tunnel Fontan there is a continuing hazard phase in the intermediate term. Mid-term outcome appears to be favorably influenced by an intermediate BCPS.
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Eur J Cardiothorac Surg · Oct 2005
Aprotinin attenuated ischemia-reperfusion injury in an isolated rat lung model after 18-hours preservation.
Ischemia-reperfusion injury is a major factor in the early phase of lung transplantation. We hypothesized that aprotinin, a nonspecific serine protease inhibitor, attenuates ischemia-reperfusion lung injury by inhibiting the inflammatory response and suppressing NADPH oxidase. ⋯ Aprotinin attenuates ischemia-reperfusion lung injury by inhibiting the early inflammatory response, neutrophil extravasation and the production of oxygen free radicals through inhibition of the activation of the NADPH oxidase. The inhibition of p47(phox) translocation in alveolar macrophage seemed involved in this mechanism of aprotinin.
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Eur J Cardiothorac Surg · Oct 2005
Randomized Controlled TrialFibrinolytic inhibitors in off-pump coronary surgery: a prospective, randomized, double-blind TAP study (tranexamic acid, aprotinin, placebo).
To evaluate and compare hemostatic effects of tranexamic acid vs. aprotinin vs. placebo in off-pump coronary artery bypass (OPCAB) surgery and, in addition, to assess the safety of fibrinolytic inhibitors therapies. ⋯ Both tranexamic acid and aprotinin seem to be similarly effective in the reduction of postoperative blood loss in OPCAB. Tranexamic acid appears to be cost-effective and safe alternative to aprotinin.