European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of median sternotomy on the psychosomatic outcome in coronary artery single-vessel bypass grafting.
New less invasive surgical techniques for the treatment of coronary artery single-vessel disease have been developed by either avoiding median sternotomy or cardiopulmonary bypass or both, however, until now no prospective randomized trial has been carried out to compare these techniques to the conventional approach with special respect to the psychosomatical effects. ⋯ Even if surgery is successful in all procedures, operative time is longer in lateral minithoracotomy procedures without compromising intensive care unit stay and hospital stay. More pain with multiple post-traumatic stress disorders is related to median sternotomy, and post-operative convalescence is superior for lateral minithoracotomy procedures.
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Eur J Cardiothorac Surg · Nov 1999
Comparative Study Clinical TrialA contrastive analysis of release patterns of biochemical markers of brain damage after coronary artery bypass grafting and valve replacement and their association with the neurobehavioral outcome after cardiac surgery.
The present study aimed at a comparative analysis of neurobiochemical markers of brain damage and the neurobehavioral outcome in patients undergoing either valve replacement (VR) or isolated coronary artery bypass surgery (CABG). In order to control for well known risk factors both samples were strictly matched according to age, sex and preoperative neuropsychological performance. ⋯ Our data indicate that--apart from patients' age and preoperative neuropsychological performance--type of surgery remains a risk factor for postoperative neurobehavioral disorders. The different vulnerability of neurobehavioral disorders might be mirrored in different postoperative release patterns of NSE. We assume that both, NSE release and neurobehavioral disorders might be caused by a higher amount of intraoperative cerebral embolic events in VR patients.
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Eur J Cardiothorac Surg · Nov 1999
Comparative StudyComparison of post-operative pain, stress response, and quality of life in port access vs. standard sternotomy coronary bypass patients.
Although it has been postulated that minimally invasive cardiac surgery using the port access method would reduce operative stress and postoperative pain and accelerate postoperative recovery to a good quality of life, few data are currently available to document this intuitively appealing claim. Therefore, this study was designed to examine differences in stress response, postoperative pain, rapidity of recovery, and quality of life after port access (PA) isolated coronary artery bypass surgery compared with standard sternotomy (STD) isolated coronary bypass surgery. ⋯ These results show that compared with STD coronary bypass patients PA patients enjoyed significant postoperative physiologic and quality of life advantages with less pain, less early stress response, better pulmonary function, and superior Duke Activity scores during the first 2 postoperative months.
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Eur J Cardiothorac Surg · Nov 1999
Comparative StudyQuality assessment in minimally invasive coronary artery bypass grafting.
The most important determinant for the success of minimally invasive coronary artery bypass grafting (MIDCAB) is the quality and long-term patency of the graft and anastomosis. Intra and postoperative quality assessment is important to confirm the safety and effectiveness of minimally invasive techniques. ⋯ A standardized protocol for quality assessment is mandatory for MIDCAB surgery. The proposed algorithm serves to ensure the safety and effectiveness of this new technique. Our recent series document an excellent outcome of the MIDCAB approach. Postoperative multiplan angiography is the only technique to achieve valid information about the quality of graft and anastomosis.
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Eur J Cardiothorac Surg · Oct 1999
Comparative StudyThe effects of caffeic acid phenethyl ester (CAPE) on spinal cord ischemia/reperfusion injury in rabbits.
Oxygen-derived free radicals have been implicated in the pathogenesis of spinal cord neuronal injury after both trauma and ischemia-reperfusion. Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, exhibits antioxidant properties. This experimental study was designed to determine the effect of CAPE on ischemia-reperfusion of spinal cord in rabbits. ⋯ These results suggest that CAPE may be an available agent to protect the spinal cord from ischemia-reperfusion injury.