European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · May 2005
Extended donor criteria for lung transplantation--a clinical reality.
Standard lung donor criteria have been established on opinions and individual experiences rather than on existing evidence. Since the scarcity of donor organs is one of the major limitations to lung transplantation, extension of donor lung criteria might considerably increase the donor pool. This study therefore evaluates the outcome, achieved with the use of extended donors versus standard donors and aims to redefine lung donor criteria. ⋯ The use of lung donors who fail to meet standard criteria does not impair short and medium term results compared to standard lung donors. The impact on long term development of BOS has yet to be evaluated. The strict application of standard lung donor criteria excludes a considerable number of lungs potentially suitable for transplantation, thus liberalisation of donor criteria might help to overcome donor shortage.
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Eur J Cardiothorac Surg · May 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialTriflusal versus oral anticoagulation for primary prevention of thromboembolism after bioprosthetic valve replacement (trac): prospective, randomized, co-operative trial.
Antiplatelet agents are used for prevention of thromboembolism in surgical patients and in patients with chronic atrial fibrillation. Up to date, however, results of randomized studies comparing antiplatelet agents and oral anticoagulation have not been reported. The aim of this study was to compare the efficacy and safety of triflusal (an antiplatelet agent) versus acenocoumarol for primary prevention of thromboembolism in the early postoperative period after implantation of a bioprosthesis. ⋯ There were no significant differences in efficacy between both groups, however, triflusal showed a significantly lower incidence of bleeding episodes.
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Eur J Cardiothorac Surg · May 2005
Comparative StudyHealth related quality of life after percutaneous coronary intervention versus coronary artery bypass graft surgery in patients with acute coronary syndromes without ST-segment elevation. 12-month follow up.
The efficacy of percutaneous and surgical revascularization in acute coronary syndromes without ST-segment elevation is similar. Therefore, other factors, like health-related quality of life, should play an important role in choosing the revascularization method. ⋯ This study has shown that there is a significant difference in health-related quality of life 12-months after percutaneous coronary intervention and coronary artery bypass graft surgery. This difference arises from better physical function (physical component summary) for coronary artery bypass graft surgery patients compared with percutaneous coronary intervention patients. Despite impairment of the physical health status (physical component summary), the mental health status (mental component summary) remained similar in both groups.
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Eur J Cardiothorac Surg · May 2005
Comparative StudyArch-first technique performed under hypothermic circulatory arrest with retrograde cerebral perfusion improves neurological outcomes for total arch replacement.
From 1998, we have adopted the arch first technique (reconstruction of arch vessels first and distal anastomosis second) instead of the distal anastomosis first technique for total arch replacement. The aim is to reduce the period of deep hypothermic circulatory arrest and the retrograde cerebral perfusion time. We evaluate the surgical results of the arch first technique. ⋯ The arch first technique is clearly superior to the conventional distal first technique in surgical mortality and morbidity regarding neurological outcome, and provides a higher survival rate and better quality of life. The arch first technique is an excellent method for total arch replacement.
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Eur J Cardiothorac Surg · May 2005
Case ReportsA simple method to adapt the height of the sinotubular junction of the De Paulis Valsalva graft to the height of the patient's sinuses in David reimplantation procedure.
De Paulis and associated introduced a new aortic root conduit for valve-sparing operation. The use of this prosthesis for David I (reimplantation) procedure occasionally may be problematic when the top of the commissures, do not match the new sinotubular junction of the graft. We propose a simple method that allows to create a new sinotubular junction at the desired level in the skirt portion of the Valsalva prosthesis.