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 2002
Comparative StudyImpact of junctional ectopic tachycardia on postoperative morbidity following repair of congenital heart defects.
To determine the incidence of postoperative junctional ectopic tachycardia (JET), we reviewed 343 consecutive patients undergoing surgery between 1997 and 1999. The impact of this arrhythmia on in-hospital morbidity and our protocol for treatment were assessed. ⋯ Postoperative JET adds considerably to morbidity after congenital cardiac surgery, and is particularly frequent after TOF repair. Aggressive treatment with cooling and/or amiodarone is mandatory, but correlates with increased mechanical ventilation time and CICU stay. Better understanding of the mechanism underlying JET is required to achieve prevention, faster arrhythmic conversion, and reduction of associated in-hospital morbidity.
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Eur J Cardiothorac Surg · Feb 2002
Comparative StudyThe elephant trunk technique: operative results in 100 consecutive patients.
To describe morbidity and mortality in patients undergoing the elephant trunk (ET) implantation as the first stage in the repair of their mega aorta and to assess determinants for the occurrence of complications. ⋯ The first step in the repair of a mega aorta, the implantation of an ET, can be performed with a low mortality and an acceptable morbidity. The risk of central neurologic damage is higher in emergency interventions.
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Eur J Cardiothorac Surg · Feb 2002
Comparative StudyLong-term follow-up of video-assisted talc pleurodesis in malignant recurrent pleural effusions.
Recurrent pleural effusion is a common condition and often presents a challenge for treatment. The aim of this report is to evaluate the long-term follow-up of thoracoscopic management of malignant recurrent pleural effusions. ⋯ VATS represents the method of choice for both diagnosis and treatment of malignant recurrent pleural effusions. Talc poudrage is safe and effective in obtaining pleurodesis.
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Eur J Cardiothorac Surg · Feb 2002
Surgical management of acute aortic root endocarditis with viable homograft: 13-year experience.
Cryopreserved homograft valves have been used for acute infective aortic root endocarditis with great success but it is compounded by its availability in all sizes. The long-term clinical results of geometric mismatched homografts are not well defined and addressed. ⋯ Early aggressive valve replacement with homograft for active infective aortic root endocarditis with periannular abscesses is more successful than delayed last resort surgery. Homografts exhibit excellent clinical performance and durability with a low rate of reinfection, if properly inserted. Undersized homograft is an incremental risk factor for early and late reoperation.
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Eur J Cardiothorac Surg · Feb 2002
Comparative StudyInaccuracy of four coronary surgery risk-adjusted models to predict mortality in individual patients.
This study was undertaken to evaluate the accuracy of four different risk-adjusted models in predicting mortality in individual patients who are undergoing coronary artery by-pass graft surgery. In the last decade several models to stratify patients before open heart surgery, according to factors affecting mortality, were developed with the aim of retrospectively comparing outcomes of open heart surgery, based on reliable stratification of case-mix, and of prospectively identifying high risk patients as a basis for a meaningful informed consent for patients counseling. ⋯ The four pre-surgical predictive models were similarly able to discriminate favorable vs. unfavorable outcomes and highly accurate to predict overall mortality, but very inaccurate to predict mortality in individual patients.