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 2002
Is the reduction of forced expiratory lung volumes proportional to the lung parenchyma resection, 6 months after pneumonectomy?
To preoperatively estimate the degree of first-second forced expired volume (FEV1) and forced vital capacity (FVC) reduction 6 months after pneumonectomy, according to the preoperative performed spirometry and bronchoscopy, and to estimate if the expected postoperative values of FEV1 and FVC are in accordance with the actual values. ⋯ Only when a segmental bronchus was obstructed at the preoperative bronchoscopy or when lobar or lung atelectasis was the result of the main or lobar bronchus obstruction, the estimated, using the proposed formula, expected percent reduction of FEV1 and FVC values were close to the actual postoperative percent reduction of FEV1 and FVC.
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We report our initial 3 years 4 months' single institution experience in 31 consecutive patients with pectus excavatum treated with minimally invasive endoscopic pectus excavatum repair utilizing a modification of the 'Nuss' technique. ⋯ The minimally invasive endoscopic pectus repair is safe and effective and currently our procedure of choice for primary pectus excavatum in all ages. Endoscopic visualization facilitates the safe creation of the retrosternal tunnel. Short-term results have been excellent. Further follow-up will be necessary to determine long-term results.
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Eur J Cardiothorac Surg · May 2002
Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable?
The tight syndrome after open-heart procedures in neonates renders delayed sternal closure (DSC) a life-saving measure. The goal of this study is to analyze the risk factors that may predict the need for DSC. ⋯ Many of the factors thought to be associated with the need for delaying the sternal closure had no statistical significance as risk factors. On the other hand, the diagnosis of IAA or TAPVD, an age less than 7 days, aortic clamping more than 98 min, CPB time more than 185 min and a post-bypass central venous saturation less than 51% were statistically significant risk factors that could be used in predicting the need for delaying the sternal closure.
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Eur J Cardiothorac Surg · May 2002
Results of surgery for irreversible moderate to severe mitral valve regurgitation secondary to myocardial infarction.
Moderate to severe irreversible mitral regurgitation secondary to myocardial infarction is an independent risk factor for reduced long-term survival. Late effects of correction of mitral incompetence concomitant with coronary artery bypass grafting (CABG) are less well known and the choice of mitral valve procedure is still debated. ⋯ Combined mitral valve procedure and myocardial revascularization, as complete as possible, for moderate to severe mitral regurgitation secondary to myocardial infarction achieve satisfactory early and late outcome despite the increased operative mortality. Acute papillary muscle rupture, severe restriction of the mitral valve by major displacement of the papillary muscle are better managed by valve replacement.
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Eur J Cardiothorac Surg · Apr 2002
Comparative StudyEvolution of allograft aortic valve replacement over 13 years: results of 275 procedures.
We describe our center's experience with the use of allografts for aortic valve or root replacement, illustrating the impact on outcome of the changes made in surgical and preservation techniques. ⋯ Aortic valve replacement with allografts yields adequate midterm results. Although important changes have been made over the years to improve durability, allografts still have a limited life span especially in young patients.