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 1999
Comparative Study Clinical TrialConservative treatment of the aortic root in acute type A dissection.
In acute type A dissection long-term results of conservative aortic root surgery were compared with the outcome of primary valve and/or root replacement. ⋯ Surgery for acute type A dissection still carries a considerable early risk. Preservation of the aortic root is safe in the absence of Marfan or annuloaortic ectasia, but a certain incidence of reoperations on the aortic valve and the aortic root has to be accepted. Root reconstruction using GRF-glue is the method of choice and is superior to suture resuspension, with a significantly better reoperation-free and event-free survival.
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Eur J Cardiothorac Surg · May 1999
Coronary artery bypass grafting in patients with systemic lupus erythematosus.
Few reports exist on the results of coronary artery bypass grafting (CABG) in patients with systemic lupus erythematosus (SLE). ⋯ CABG in SLE patients can be performed with acceptable morbidity and mortality. Our data so far reveals no evidence to preclude the use of ITA and vein grafts in SLE patients.
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Eur J Cardiothorac Surg · Apr 1999
Case ReportsBoth atrial resection and superior vena cava replacement in sleeve pneumonectomy for advanced lung cancer.
Extended sleeve pneumonectomy including removal of the superior vena cava, right atrium and parts of left atrium on cardiopulmonary bypass was successfully performed in a 40-year-old man. The tumour was histologically proven a T4 N1 stage with margins free from tumour. ⋯ Other metastatic deposits were not found at autopsy. More data from extended pulmonary resections are required to demonstrate a benefit.
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Eur J Cardiothorac Surg · Apr 1999
Ventilatory muscle recruitment and work of breathing in patients with respiratory failure after thoracic surgery.
Increased work of breathing (WOB) and respiratory muscle weakness have been identified as major causes of respiratory failure after thoracic surgery. This study was undertaken firstly to characterize the mechanical impairment in patients with respiratory failure after cardio-thoracic surgery, and secondly, to determine how diaphragmatic paralysis affects deterioration in the ventilatory mechanics. ⋯ These results demonstrated two different types of respiratory failure in thoracic surgery patients, focusing on the impact of phrenic nerve paralysis. Diaphragmatic dysfunction should not be overlooked in postoperative care, and the amelioration of this compromise in respiratory mechanics is an important aspect of good patient management.
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Eur J Cardiothorac Surg · Apr 1999
The hemodynamic effects of double-orifice valve repair for mitral regurgitation: a 3D computational model.
A 3D computational model has been implemented for the evaluation of the hemodynamics of the double orifice repair. Critical issues for surgical decision making and echo-Doppler evaluation of the results of the procedure are investigated. ⋯ The hemodynamic behaviour of a double orifice mitral valve does not differ from that of a physiological valve of same total area: pressure drops and flow velocity across the valve are not influenced by the configuration of the valve. Echo Doppler estimation of the maximum velocities is a reliable method for the calculation of pressure gradients across the repaired valve.