European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2000
Clinical TrialNeonatal pulmonary artery banding does not compromise the short-term function of a Damus-Kaye-Stansel connection.
The surgical approach of neonates with a functionally univentricular heart, transposition of the great arteries and excessive pulmonary bloodflow remains a challenge. Pulmonary artery banding remains a valuable option, but may induce ventricular hypertrophy, restriction of the bulboventricular foramen and dysplastic changes of the pulmonary valve. These secondary changes might compromise a later Damus-Kaye-Stansel connection because of pulmonary regurgitation but also a subsequent Fontan repair because of ventricular hypertrophy. The aim of this study is to investigate whether a previous pulmonary artery banding might compromise the function of a Damus-Kaye-Stansel connection. ⋯ This experience demonstrates that a neonatal pulmonary artery banding does not compromise the function neither of a Damus-Kaye-Stansel connection nor a Fontan repair.
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Eur J Cardiothorac Surg · Jun 2000
Primary repair of aortic arch obstruction with ventricular septal defect in preterm and low birth weight infants.
Previous reports have suggested that prematurity and low birth weight are risk factors for definitive surgical intervention in congenital cardiac malformations. The following data review our experience with primary repair of the complex malformation of aortic arch obstruction with ventricular septal defect (VSD) in this patient population. ⋯ Complete primary repair of aortic arch obstruction with VSD can be achieved with good results, even in the preterm and low birth weight infant. Therefore, early surgical repair of this congenital malformation is recommended.
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Eur J Cardiothorac Surg · Jun 2000
Clinical Trial'Needlescopic' video-assisted thoracic surgery for palmar hyperhidrosis.
The video-assisted thoracic surgery (VATS) approach for thoracodorsal sympathectomy has been well accepted. We report the use of ultra-fine thoracoscopic equipment for this procedure, based on the experience from two centers in Asia. ⋯ Thoracodorsal sympathectomy using 2-mm instruments is technically feasible and is associated with an excellent clinical outcome. Limitations of the equipment, however, exist (narrow field of vision, lower resolution and difficulty in maintaining fine control), and we are currently restricting its use to relatively simple procedures.
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Eur J Cardiothorac Surg · Jun 2000
Comparative StudyChronic sequels after thoracoscopic procedures for benign diseases.
Chronic pains after lateral thoracotomy are present in up to 40% of cases. Chronic sequels after thoracoscopy are less common, but nevertheless, a cause for complaints by patients. Pain often reflects a recurrence of malign disease. For this reason, we only investigated patients with benign disease. ⋯ The thoracoscopic approach is not likely to impact on the prevalence of long-term postthoracotomy sequels, and therefore, further strengths are necessary to reduce this number.
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Eur J Cardiothorac Surg · Jun 2000
Emergency reinstitution of cardiopulmonary bypass following cardiac surgery: outcome justifies the cost.
Crash back on bypass (crash-BOB) is occasionally required in the resuscitation of patients developing life-threatening complications following cardiac surgery. This study aims to determine the incidence, aetiology and cost-effectiveness of such intervention. ⋯ Crash-BOB occurred in 0.8% of cases and was associated with a survival to discharge of 42%, and a justifiable cost of only pound7170 per life saved. Establishing an accurate diagnosis for the cause of clinical deterioration resulting in crash-BOB intervention was important, and the need for a further period of aortic cross-clamping did not preclude a favourable outcome.