European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2004
Repair of atrioventricular valve regurgitation in the modified Fontan operation.
To evaluate the prevalence, impact and outcome of repair of atrioventricular valve regurgitation (AVVR) in Fontan patients. ⋯ Trivial to mild AVVR remains stable and their repair during the Fontan operation provides no additional benefits. Valve repair in patients with moderate to severe AVVR improved the regurgitation with comparable operative mortality and long-term outcome; however, similar benefits could be achieved without repair of the atrioventricular valve. We should not deny patients with similar AVVR the Fontan operation.
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Eur J Cardiothorac Surg · Jul 2004
Randomized Controlled Trial Multicenter Study Clinical TrialChemotherapy for patients with non-small cell lung cancer: the surgical setting of the Big Lung Trial.
The non-small cell lung cancer (NSCLC) meta-analysis suggested a survival benefit for cisplatin-based chemotherapy when given in addition to surgery, radical radiotherapy or 'best supportive care'. However, it included many small trials and trials with differing eligibility criteria and chemotherapy regimens. The aim of the Big Lung Trial was therefore to run a large pragmatic trial to confirm the survival benefits seen in the meta-analysis. ⋯ This trial has failed to observe a survival benefit with adjuvant chemotherapy following complete resection of stage I-III NSCLC. However, the hazard ratio and 95% confidence intervals are consistent with the previously reported meta-analysis and two large recently reported trials, which suggest a small survival benefit with cisplatin-based chemotherapy.
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Eur J Cardiothorac Surg · Jul 2004
Case ReportsEndovascular stent-graft for thoracic aorta aneurysm caused by Salmonella.
We describe the placement of an endovascular stent-graft in a patient with mycotic aneurysm of the descending thoracic aorta caused by Salmonella. Endovascular grafting combined with antibiotic therapy in thoracic mycotic aneurysms might represent an alternative to conventional surgery in patients with high operative risk.
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Eur J Cardiothorac Surg · Jul 2004
Factors affecting patency of internal thoracic artery graft: clinical and angiographic study in 1434 symptomatic patients operated between 1982 and 2002.
The purpose is to define factors influencing long-term patency of the internal thoracic artery (ITA) to optimize the operative strategy. ⋯ Even in a patient cohort that had adverse symptoms, excellent LITA and RITA patency was achieved which almost remained constant through all time intervals studied.
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Eur J Cardiothorac Surg · Jul 2004
The RACHS-1 risk categories reflect mortality and length of hospital stay in a large German pediatric cardiac surgery population.
The Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) was published in January 2002, based on 4370 operations registered by the Pediatric Cardiac Care Consortium. It is designed for being easily applicable also for retrospective analysis of hospital discharge data sets; the classification was not developed for patients with heart transplantations, ventricular assist devices or patients above 18 years. We apply this classification to our 2368 correspondent procedures that were performed consecutively on 2223 patients between June 1996 and October 2002 in Bad Oeynhausen and analyze its relation to mortality and length of hospital stay. ⋯ The RACHS-1 classification is applicable to European pediatric populations, too. Category Distribution, outcome class distinction capacity, distribution and mortality are similar. RACHS-1 is able to classify patients into significantly different groups concerning total and postoperative hospital stay duration, although there remains a large variability within the groups.