J Cardiovasc Surg
-
Comparative Study
Dual-Source computed tomography of the chest in the surgical planning of repeated cardiac surgery.
When reoperative cardiac surgery is indicated, detailed, three-dimensional imaging of the thorax permits accurate depiction of cardiac anatomy and vascular structures potentially increasing the safety of the surgical procedure. We sought to evaluate the contribution of dual-source multidetector-row computed tomography (DSCT) of the heart and thorax in planning repeated open heart surgery. ⋯ DSCT of the heart and thorax is an effective, non-invasive tool for the preoperative planning of repeated cardiac surgery. The technique provides significant information to modify the surgical approach and may increase the safety of the procedure.
-
Multicenter Study Comparative Study
Influence of clinical presentation on the outcome of acute B aortic dissection: evidences from IRAD.
In-hospital outcome of acute type B dissection (ABAD) is strongly related to preoperative aortic conditions. In order to clarify the influence of the clinical presentation on the outcome, we analyzed the patients of the International Registry of Acute Aortic Dissection (IRAD). All patients affected by complicated ABAD, enrolled in the IRAD from 1996-2004, were included. Complications were defined as the presence of shock, periaortic hematoma, spinal cord ischemia, preoperative mesenteric ischemia/infarction, acute renal failure, limb ischemia, recurrent pain, refractory pain or refractory hypertension (group I). All other patients were categorized as uncomplicated (group II). A comprehensive analysis was performed of all clinical variables in relation to in-hospital outcome. ⋯ ABAD is a heterogeneous disease that produces dissimilar clinical subsets, each of which can have specific clinical signs, management and in-hospital results. In IRAD ABAD uncomplicated patients, medical therapy was associated with best hospital outcome, while endovascular interventions were associated with better results than surgery when invasive treatments were required. Although selection bias may be possible, and irrespective of treatments, knowledge of significant risk factors for mortality may contribute to a better management and a more defined risk-assessment in patients affected by ABAD.
-
Letter Case Reports
Anatomic repair of interrupted aortic arch in adult.
-
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.
-
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.