Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
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Ann Thorac Cardiovasc Surg · Jan 2011
ReviewThoracic endovascular aortic repair--indications and evidence.
Since its introduction more than a decade ago, thoracic endovascular aortic repair (TEVAR) has shown promising results for patients with various thoracic aortic diseases. The aim of the current review is to assess the current literature to evaluate the safety and efficacy of TEVAR. ⋯ Despite numerous encouraging results from a large number of publications in recent years, there remains a lack of level 1 evidence to support an improvement of long-term overall survival for patients who underwent TEVAR when compared with traditional treatment modalities. There appears to be an urgent need to conduct well-designed randomized-controlled trials in this rapidly expanding intervention.
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Ann Thorac Cardiovasc Surg · Jan 2011
Multicenter StudyFactors influencing permanent neurologic dysfunction and mortality after total arch replacement with separate arch vessel grafting using selective cerebral perfusion.
The present study was undertaken to identify risk factors for permanent neurological dysfunction (PND) and in-hospital mortality after total aortic arch replacement (TAR) with separate arch vessel grafting using selective cerebral perfusion (SCP) and hypothermic circulatory arrest. ⋯ The enhanced vulnerability of the brain in patients with a pre-existing old cerebral infarction or silent lacunar infarction is reflected by a high incidence of PND. Chronic renal failure had an impact on in-hospital mortality.
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Ann Thorac Cardiovasc Surg · Jan 2011
Randomized Controlled TrialThe effect of sivelestat sodium hydrate on severe respiratory failure after thoracic aortic surgery with deep hypothermia.
Patients who undergo thoracic aortic surgery with deep hypothermia frequently have postoperative respiratory failure as a complication. Severe lung injury in these patients results in a fatal outcome. A specific neutrophil elastase inhibitor, sivelestat sodium hydrate, is an innovative therapeutic drug for acute lung injury. ⋯ The duration of mechanical ventilation, the length of stay in the intensive care unit, and the length of hospital stay were shorter in Group S, but not significantly. Sivelestat sodium hydrate is a specific neutrophil elastase inhibitor that improves pulmonary function in patients with severe postoperative respiratory failure following thoracic aortic surgery with deep hypothermia. The drug may shorten the duration of postoperative ventilation, intensive care unit stay, and hospital stay.
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Ann Thorac Cardiovasc Surg · Jan 2011
Case ReportsMalignant melanoma of the lung: report of two cases.
Malignant melanoma (MM) is the most fatal cutaneous neoplasm. Primary MM of the lung is quite rare, and late recurrence of MM is also uncommon. We report 2 cases of pulmonary MM, the first involving primary MM of the lung and the second involving late recurrence 8 years after the initial surgery. ⋯ In the second case, the patient had a history of thumb amputation for MM 8 years ago. For pulmonary MM, extrapulmonary origin of the tumor must be excluded by detailed examination because melanomas involving the lung are almost always metastatic. Whether the diagnosis is primary or metastatic disease, the potential for recurrence should be considered even in patients with a long disease-free survival.
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Ann Thorac Cardiovasc Surg · Jan 2011
Do preoperative statins reduce atrial fibrillation after coronary artery bypass grafting?
Recent studies have demonstrated that statins have pleiotropic effects, including anti-inflammatory effects and atrial fibrillation (AF) preventive effects. The objective of this study was to assess the efficacy of preoperative statin therapy in preventing AF after coronary artery bypass grafting (CABG). ⋯ Our study indicated that preoperative statin therapy seems to reduce AF development after CABG.