J Cardiovasc Surg
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Comparative Study
Superiority of topical negative pressure over closed irrigation therapy of deep sternal wound infection in cardiac surgery.
We sought to compare clinical outcomes, in-hospital mortality and 1-year survival of two different treatment modalities of deep sternal wound infection, topical negative pressure and the closed irrigation therapy. ⋯ Topical negative pressure is a superior method of treatment for deep sternal wound infection, which is based on lower therapeutic failure rate, significant decrease in-hospital stay, and the decrease of the 1-year mortality rate, compared with primarily applied closed irrigation.
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Randomized Controlled Trial Comparative Study
Influence of temperature management on neurocognitive function in biological aortic valve replacement. A prospective randomized trial.
Aim of this study was to elucidate if postoperative neurocognitive function after biological aortic valve replacement (AVR) can be influenced by temperature management during cardiopulmonary bypass (CPB). ⋯ Normothermic temperature management during CPB is non-inferior to hypothermic in means of neuroprotection. Since patients after biological aortic valve replacement show a subclinical but measurable cognitive deficit up to four months after surgery, other factors have to be addressed to add further benefit to the extremely good results of open biological AVR.
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Review
Evidence-based management of carotid stenosis: recommendations from international guidelines.
A 50-99% stenosis of the extracranial internal carotid artery can be in detected in 1-3% of all adults. Embolising plaques or acute carotid occlusions cause cerebral ischemia in 1-5% of all patients with an asymptomatic 50-99% stenosis of the internal carotid artery. ⋯ Therefore all recent national and international guidelines for stroke management, stroke prevention and carotid artery disease published between 2008 and 2011 were reviewed. This paper gives an overview about these guidelines and their most important recommendations with respect to carotid artery stenosis.
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Comparative Study
Endovascular treatment of ruptured abdominal aortic aneurysm: is there a long-term benefit at follow-up?
Several studies have shown the feasibility of endovascular repair of ruptured abdominal aortic aneurysms (rEVAR). However, the role and value of rEVAR remains controversial due to selection bias and lack of long-term results. In the present study we describe our short- and long-term results of treating patients with rEVAR irrespective of hemodynamic condition and challenging anatomy. ⋯ Our study shows that rEVAR is feasible irrespective of hemodynamic condition and that it is associated with relative low mortality rates. Challenging rAAA anatomy may not affect overall long-term survival, but six out of ten patients remain unsuitable for rEVAR because of inappropriate anatomy.