European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Dec 2014
Aortic valve repair with patch in non-rheumatic disease: indication, techniques and durability†.
To analyse the long-term outcomes of aortic valve (AV) repair with biological patch in patient with non-rheumatic valve disease. ⋯ AV repair with biological patch is feasible for various aetiologies. The techniques are safe and medium-term durability is acceptable, even excellent for perforation repair in tricuspid valve morphology. Bovine pericardium is a good alternative to autologous pericardium.
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Eur J Cardiothorac Surg · Dec 2014
Advanced hybrid closed chest revascularization: an innovative strategy for the treatment of multivessel coronary artery disease†.
Conventional hybrid revascularization (CHR) combines minimally invasive placement of an internal mammary artery graft to the anterior wall and percutaneous coronary intervention (PCI) of non-anterior wall targets. In this study we assess perioperative and midterm outcomes of advanced hybrid revascularization (AHR) defined as the combination of single or multivessel (MV) totally endoscopic coronary artery bypass grafting (TECAB) with single or multivessel PCI. ⋯ AHR yields comparable results with CHR and can be taken into consideration as a sternum-sparing technique for the treatment of MV-coronary artery disease in selected patients.
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Eur J Cardiothorac Surg · Dec 2014
Prognostic significance of combined pulmonary fibrosis and emphysema in patients with resected non-small-cell lung cancer: a retrospective cohort study.
Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder that is usually diagnosed on the basis of high resolution computed tomography (HRCT) findings. It is unclear whether CPFE is an independent prognostic factor in patients with non-small-cell lung cancer (NSCLC). Therefore, we conducted a retrospective analysis to assess the impact of CPFE on the prognosis of patients with completely resected NSCLC. ⋯ CPFE is a significant, unfavourable prognostic factor for NSCLC patients after curative resection.
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Eur J Cardiothorac Surg · Dec 2014
Single-position, minimally invasive Ivor Lewis oesophagectomy for lower thoracic oesophageal cancer.
Although several surgical approaches exist for lower thoracic oesophageal cancer, standardized techniques for minimally invasive oesophageal resection and intrathoracic anastomosis have not yet been established. Thus, optimization of the approach and identification of the ideal anastomosis technique are needed. ⋯ No adverse events occurred intraoperatively, no failures in the intrathoracic oesophagogastrostomy were detected and favourable short-term outcomes were obtained. Thus, the procedure described is safe and technically feasible and appears to be promising as an alternative approach for the treatment of patients with lower thoracic oesophageal cancer.
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The robotic approach in thoracic surgery has rapidly gained popularity in recent years. As with the introduction of any new technology, this warrants not only adaptation of the operative technique itself, but also the evolution of appropriate troubleshooting strategies. A selected number of helpful tips and technical procedural manoeuvres have been compiled to prevent intraoperative problems, as well as to overcome challenging situations that can arise during robotic lobectomies. ⋯ All the assembled recommendations have proved their effectiveness and have been successfully used by the authors in many procedures. Furthermore, these manoeuvres have been found to be of great importance in the training and proctoring of thoracic surgeons, fellows and residents (bed-side assistants). This guide of clearly arranged tips and troubleshooting strategies offers surgeons a useful tool to overcome difficult situations in robotic lobectomy and preferably improve the reproducibility and safety of their procedures.