MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Interactive CardioVascular and Thoracic Surgery' source. Sun, 21 Mar 2010 17:27:08 +0100 http://www.medworm.com/index.php?rid=3311406&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F489%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311406 Fri, 26 Feb 2010 01:18:45 +0100 3311406 http://www.medworm.com/index.php?rid=3311405&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F486%3Frss%3D1 We report an uncommon case of thrombogenesis in the distal aortic arch after apicoaortic conduit (AAC) for severe aortic stenosis (AS). A 71-year-old woman underwent AAC with a bioprosthetic valve for severe AS because of heavy calcification of the ascending aorta. Although anticoagulant therapy with warfarin was performed, a postoperative computed tomographic (CT) scan revealed a thrombus in the distal aortic arch. Cine magnetic resonance imaging (MRI) revealed stagnation of the blood flow at that site. Administration of warfarin was continued. A follow-up CT-scan showed a marked reduction of the thrombus at six months after the surgery. A follow-up MRI revealed that the antegrade flow through the native aortic valve was decreased at one year after the surgery. We suggest that thrombogene... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311405 Fri, 26 Feb 2010 01:18:45 +0100 3311405 http://www.medworm.com/index.php?rid=3311404&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F485%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311404 Fri, 26 Feb 2010 01:18:45 +0100 3311404 http://www.medworm.com/index.php?rid=3311403&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F484%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311403 Fri, 26 Feb 2010 01:18:45 +0100 3311403 http://www.medworm.com/index.php?rid=3311402&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F483%3Frss%3D1 We describe the surgical management with a three-step procedure: antibiotherapy-debridement, vacuum-assisted closure and delayed surgical reconstruction. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311402 Fri, 26 Feb 2010 01:18:45 +0100 3311402 http://www.medworm.com/index.php?rid=3311401&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F481%3Frss%3D1 We present our experience with a 60-year-old patient, who developed necrotizing fasciitis of the chest wall after initial bedside drainage of a SM empyema. He required extensive debridement with significant soft tissue loss and subsequent latissimus dorsi flap reconstruction to cover the defect. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311401 Fri, 26 Feb 2010 01:18:45 +0100 3311401 http://www.medworm.com/index.php?rid=3311400&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F478%3Frss%3D1 We present a case of flail chest with sternum and left anterior rib fractures secondary to CPR in a cardiac surgical patient, which was mechanically ventilated due to respiratory complications. Open reduction and operative fixation with titanium osteosynthesis plates and locking screws in sternum and ribs was performed by a thoracic surgeon assisted by an orthopaedic surgeon. Anterior plating achieved chest stability and facilitated weaning from mechanical ventilation. The patient had an uneventful postoperative course, painfree, and experienced no sternal instability or infection throughout a six-month follow-up period. Sternal instability after cardiac surgery occurs infrequently but can be challenging to manage. Titanium plate fixation is an effective method to stabilize complicated fla... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311400 Fri, 26 Feb 2010 01:18:45 +0100 3311400 http://www.medworm.com/index.php?rid=3311399&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F476%3Frss%3D1 A 45-year-old man had a history of myocardial infarction at one month prior to admission. Coronary angiography revealed a dilated fistula originating from the left anterior descending coronary artery to the pulmonary artery. Two orifices of the draining artery were closed through pulmonary arteriotomy. Ligation of the fistulous vessels was performed at three places to ensure complete closure of the fistula. Before and after the cardiopulmonary bypass, fluorescent dye angiography was performed with indocyanine green. Fluorescence imaging revealed complete closure of the fistula and no residual shunt flow. Postoperative coronary angiography revealed neither a residual fistula nor injury to the coronary artery. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311399 Fri, 26 Feb 2010 01:18:45 +0100 3311399 http://www.medworm.com/index.php?rid=3311398&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F473%3Frss%3D1 We reported a successful cavo-atrial thrombectomy, along with left hemi-hepatectomy, under hypothermic cardio-circulatory arrest (HCA). To our knowledge, this technique has been used only once for primary liver cancer on chronic liver disease, this being the second case reported in literature. We conclude that this technique should be considered for atrial thrombi removal in patients affected by liver tumours in the presence of a healthy liver or of a well compensated liver cirrhosis in order to prolong the patient's life span. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311398 Fri, 26 Feb 2010 01:18:45 +0100 3311398 http://www.medworm.com/index.php?rid=3311397&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F472-b%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311397 Fri, 26 Feb 2010 01:18:45 +0100 3311397 http://www.medworm.com/index.php?rid=3311396&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F472-a%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311396 Fri, 26 Feb 2010 01:18:45 +0100 3311396 http://www.medworm.com/index.php?rid=3311395&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F472%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311395 Fri, 26 Feb 2010 01:18:45 +0100 3311395 http://www.medworm.com/index.php?rid=3311394&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F470%3Frss%3D1 We present a case of RV wall perforation due to infection in a recurrent postoperative mediastinitis with a closed chest. The current literature on treatment of postoperative mediastinitis is also reviewed. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311394 Fri, 26 Feb 2010 01:18:45 +0100 3311394 http://www.medworm.com/index.php?rid=3311393&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F468%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311393 Fri, 26 Feb 2010 01:18:45 +0100 3311393 http://www.medworm.com/index.php?rid=3311392&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F467%3Frss%3D1 We describe a successful outcome of a young patient with injuries to the left internal mammary artery, upper lobe and main pulmonary artery following a stab injury to his left chest. He was transferred to the nearest cardiac centre for emergency sternotomy. Thoracotomy is the classical surgical approach in emergency setting but sternotomy allows adequate exposure to repair any cardiac injury, institution of cardiopulmonary bypass, and careful inspection of the mediastinal structures to prevent any late complications including pulmonary artery pseudoaneurysm. An immediate transfer, where possible, to the nearest trauma centre with cardiothoracic expertise for ‘resuscitative’ sternotomy is advocated in penetrating thoracic injury for optimal outcome. An emergency room thoracotomy... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311392 Fri, 26 Feb 2010 01:18:45 +0100 3311392 http://www.medworm.com/index.php?rid=3311391&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F465%3Frss%3D1 This report describes the case of a fractured thermoreactive clip following trauma, resulting in sternal dehiscence necessitating sternal rewiring. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311391 Fri, 26 Feb 2010 01:18:45 +0100 3311391 http://www.medworm.com/index.php?rid=3311390&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F463%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311390 Fri, 26 Feb 2010 01:18:45 +0100 3311390 http://www.medworm.com/index.php?rid=3311389&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F462%3Frss%3D1 We report the case and discuss about the diagnosis and treatment of thoracic aortic intimal sarcoma. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311389 Fri, 26 Feb 2010 01:18:45 +0100 3311389 http://www.medworm.com/index.php?rid=3311388&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F459%3Frss%3D1 A 76-year-old woman had a chest pain and high fever, and was admitted to the intensive care unit diagnosed as acute pericarditis. Enhanced CT-scan showed a 47-mm aneurysm in the aortic arch which seemed to be impending rupture and the part of the aorta looked like a pseudoaneurysm. Emergent total aortic arch replacement with a rifampicin-bonded Dacron graft was performed. Pericardial effusion was purulent and the aorta was infected with pus discharge in the aortic wall. There were some ulcerations on the surface of the luminal wall of the aorta. One of them was penetrating into the pericardial space causing a pseudoaneurysm. Both pericardial effusion and excised aortic wall were sent to culture study and resulted in positive for Streptococcus pneumoniae. The infection of the aorta, with er... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311388 Fri, 26 Feb 2010 01:18:45 +0100 3311388 http://www.medworm.com/index.php?rid=3311387&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F457%3Frss%3D1 We report a case of a patient who underwent removal of an external stent of the bronchus. She had undergone external stenting for tracheobronchomalacia. After removal of the external stent, the bronchus was just as widely patent as preoperative state. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311387 Fri, 26 Feb 2010 01:18:45 +0100 3311387 http://www.medworm.com/index.php?rid=3311386&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F454%3Frss%3D1 We present a successfully treated case of tracheal perforation secondary to DNM. A 34-year-old man with a history of type 1 diabetes mellitus, diagnosed as pharyngeal abscess and subsequent DNM affecting the anterior mediastinum and paratracheal space, was referred to our institute. The patient underwent cervico-mediastinal drainage for DNM. Nine days after the drainage operation, the membranous portion of the trachea perforated, resulting in life-threatening ventilation failure. The patient underwent closure of the fistula with the pedicled intercostal muscle flap under posterolateral thoracotomy with veno-venous extracorporeal membranous oxygenation support. Before complete recovery, open window thoracostomy was required to control residual air leak. (Source: Interactive CardioVascular a... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311386 Fri, 26 Feb 2010 01:18:44 +0100 3311386 http://www.medworm.com/index.php?rid=3311385&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F451%3Frss%3D1 We report a case of a male patient with a giant left-sided thymoma, nearly fulfilling the whole hemithorax. Due to the sheer size of the tumor and its location in the anterior-inferior mediastinum, we performed a lateral approach for thymectomy. On resection the specimen measured 18x16x12 cm. Histology revealed a mixed stage I thymoma. The patient is doing well 36 months after resection and has no signs of recurrence. In literature, a significant increase in the risk of recurrence for thymomas >8 cm is reported. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311385 Fri, 26 Feb 2010 01:18:44 +0100 3311385 http://www.medworm.com/index.php?rid=3311384&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F448%3Frss%3D1 We report a resected case of esophageal cyst producing CA19-9 and CA125. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311384 Fri, 26 Feb 2010 01:18:44 +0100 3311384 http://www.medworm.com/index.php?rid=3311383&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F446%3Frss%3D1 This report presents the case of a patient that developed a postoperative metastatic tumor in the cardiophrenic lymph node as a rare pattern of distant lymph node metastases of hepatocellular carcinoma (HCC) after a complete resection. This is the case of surgically and pathologically proved cardiophrenic lymph node metastasis of HCC using video-assisted thoracic surgery. General thoracic surgeons should therefore be aware of the possibility of this rare form of extrahepatic recurrence when a growing nodule is found in the pericardial fat pad during the follow-up of a malignancy in the liver. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311383 Fri, 26 Feb 2010 01:18:44 +0100 3311383 http://www.medworm.com/index.php?rid=3311382&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F443%3Frss%3D1 We report an unusual case of IMT which had undergone malignant transformation in the chest wall at the pacemaker site. A 64-year-old male presented with a history of high fever, loss of appetite and weight loss of three months duration. He had a dual chamber pacemaker reinserted in the left infraclavicular region in the previous year. This was followed by a gradually enlarging hard swelling at the insertion site. The CT-scan showed a soft tissue mass encasing the pacing box, without intrathoracic extension. The trucut biopsy was suspicious of soft tissue sarcoma. A well encapsulated hard mass, with pacemaker embedded within it was resected en-bloc ensuring wide resection margins. Histology revealed fascicles of spindle cell proliferation with prominent inflammatory component, occasional sp... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311382 Fri, 26 Feb 2010 01:18:44 +0100 3311382 http://www.medworm.com/index.php?rid=3311381&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F441%3Frss%3D1 We present a case of a young woman with right pleuritic pain. A computed tomography confirmed the existence of a solid right pleural tumor which had compressed and displaced the lung, mediastinum and heart. Percutaneous biopsy showed a ‘proliferation of smooth muscle cells without evidence of malignancy’. Surgical excision was done and the tumor was not associated to vascular, broncho-pulmonary or mediastinal structures. The definitive diagnosis was primary pleural leiomyoma. Primary pleural leiomyoma should be included in a differential diagnosis of pleural tumors and suspected in asymptomatic patients with radiologically-apparent benign tumors and the presence of smooth muscle fibers in the biopsy. Complete resection and follow-up is advised because it can grow very large and... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311381 Fri, 26 Feb 2010 01:18:44 +0100 3311381 http://www.medworm.com/index.php?rid=3311380&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F439%3Frss%3D1 This report is a preliminary communication demonstrating the technique. Telescopic exploration of the mediastinum was performed in seven patients. The goiters were located in the middle mediastinum in five patients and in the anterior and middle mediastinum in one, respectively. The use of a telescope can help the surgeon during the removal of a large mediastinal goiter. It facilitates a) the visualization of the intrathoracic tributaries reducing the risk of hemorrhage, b) the research of ectopic thyroid gland, and finally c) minimizes the risk of complications of a median sternotomy. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311380 Fri, 26 Feb 2010 01:18:44 +0100 3311380 http://www.medworm.com/index.php?rid=3311379&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F438%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311379 Fri, 26 Feb 2010 01:18:44 +0100 3311379 http://www.medworm.com/index.php?rid=3311378&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F437%3Frss%3D1 The optimal myocardial protection method for aortic valve replacement in the setting of prior coronary artery bypass surgery remains a subject of debate. Protection is particularly challenging when a patent pedicled internal thoracic artery graft supplies a proximally obstructed left anterior descending artery. Herein, we describe a modification of an old technique; continuous coronary perfusion, which can be used in selected, anatomically suitable cases. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311378 Fri, 26 Feb 2010 01:18:44 +0100 3311378 http://www.medworm.com/index.php?rid=3311377&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F434%3Frss%3D1 Local recurrence of the tumor after lung excision often occurs in cases with positive cytology results at the surgical stump. Some reports have described the efficacy of margin cytology examinations with various sampling procedures, though an optimum method has not been established. In the period between 2005 and 2008, 58 patients underwent a lung excision followed by a margin cytology examination at our hospital, of whom 49 were finally diagnosed with malignancy. Cytology samples were obtained by scratching the staple lines of both resected and residual lungs, and collecting lavage from washed stapler cartridges used in the procedure, with the results compared. Of the 49 cases with malignancy, 44 underwent both sampling techniques, of which four had positive results, three detected in lav... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311377 Fri, 26 Feb 2010 01:18:44 +0100 3311377 http://www.medworm.com/index.php?rid=3311376&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F428%3Frss%3D1 In a Fontan circuit the mechanisms involved in control of cardiac output at rest and during exercise differ significantly from normal. The classical model presumes an unlimited preload which is not available in the Fontan circuit. This review critically analyses the role of contractility, heart rate, and afterload and highlights the importance of pulmonary vascular resistance (PVR) in determining adequate preload and, therefore, cardiac output in these patients. A conceptual model of the determinants of cardiac output in Fontan patients is presented. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311376 Fri, 26 Feb 2010 01:18:44 +0100 3311376 http://www.medworm.com/index.php?rid=3311375&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F423%3Frss%3D1 Conclusions: The use of a free RIMA as Y-graft from the LIMA performed off pump eradicates aortic manipulations and provides complete revascularization to high-risk patients with mortality similar to the one of a lower risk population operated on pump. The morbidity and cost was lower in the off-pump group. This advocates for the widespread usage of the technique in high-risk patients. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311375 Fri, 26 Feb 2010 01:18:44 +0100 3311375 http://www.medworm.com/index.php?rid=3311374&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F418%3Frss%3D1 Conclusions: The presence of high titre of IgG isotype a-PL antibodies significantly influences preoperative characteristics of patients undergoing PEA. Furthermore, despite that no significant differences were shown in major end points, the presence of high titre of a-PL did interfere with postoperative course as caused by an increased rate of minor and transient neurological impairment (TNI). An accurate monitoring especially during hypothermic circulatory arrest (CA) period seems, therefore, mandatory in this subgroup of patients undergoing PEA. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311374 Fri, 26 Feb 2010 01:18:44 +0100 3311374 http://www.medworm.com/index.php?rid=3311373&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F416%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311373 Fri, 26 Feb 2010 01:18:44 +0100 3311373 http://www.medworm.com/index.php?rid=3311372&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F413%3Frss%3D1 Conclusion: Postoperative cTnI level, measured within the first hour after cardiac surgery, can identify a subgroup of patients with increased risk for hospital mortality. These patients may benefit from better monitoring, eventually with specific diagnostic and therapeutic interventions. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311372 Fri, 26 Feb 2010 01:18:44 +0100 3311372 http://www.medworm.com/index.php?rid=3311371&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F408%3Frss%3D1 Conclusions: The new devitalizing technology seems effective in decreasing immune response to homologous tissue. It does not affect elasto-mechanic properties and collagenous structure of allografts. The presented data stimulate interest to the anticalcinosis devitalisation technology as an affective tool for improving biocompatibility of allografts. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311371 Fri, 26 Feb 2010 01:18:44 +0100 3311371 http://www.medworm.com/index.php?rid=3311370&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F407%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311370 Fri, 26 Feb 2010 01:18:44 +0100 3311370 http://www.medworm.com/index.php?rid=3311369&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F406%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311369 Fri, 26 Feb 2010 01:18:44 +0100 3311369 http://www.medworm.com/index.php?rid=3311368&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F403%3Frss%3D1 The impact of meteorological conditions on the occurrence of various cardiovascular events has been reported. The aim of this work was to study the correlations between weather conditions and the occurrence of type A acute aortic dissections (AADs). Between 1997 and 2007, all the medical records of patients who underwent surgery for type A AADs in Toulouse University Hospital (France) were reviewed. The clinical data were confronted with the meteorological data provided by the French national meteorological office (MétéoFrance) over the same period. Two hundred and six patients with spontaneous type A AADs underwent surgery during this period. The incidence of aortic dissection was higher in winter time than in summer (P=0.018). The days with aortic dissections were colder th... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311368 Fri, 26 Feb 2010 01:18:44 +0100 3311368 http://www.medworm.com/index.php?rid=3311367&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F402%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311367 Fri, 26 Feb 2010 01:18:44 +0100 3311367 http://www.medworm.com/index.php?rid=3311366&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F399%3Frss%3D1 We set to examine the mid-term outcome after aortic valve replacement (AVR) with Soprano pericardial stented bioprosthesis measuring ≤20 mm. Sixty-eight patients underwent AVR between June 2003 and January 2006 (50 women; median age 77 years; range 60–89 years). Preoperatively, 60 patients (88.2%) were in New York Heart Association (NYHA) class III/IV. The mean EuroSCORE was 6.7±2.3. Supra-annular aortoplasty was performed in 21 patients (30.9%), out of which 11 patients received an 18 mm prosthesis (55%). The median follow-up was 45.5 months (0.1–62 months). The 30-day mortality was 4.4% (n=3) with no early valve-related deaths. No patient suffered a cerebrovascular accident and no patient required replacement of prosthesis for coronary ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311366 Fri, 26 Feb 2010 01:18:44 +0100 3311366 http://www.medworm.com/index.php?rid=3311365&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F394%3Frss%3D1 Systematic assessment of care pathways may identify areas of potential improvement beyond that generated by traditional outcome measures alone. This approach was used to audit a single-surgeon's practice of pulmonary resection [182 patients over 21 months, median age of 69 (range 18–86) years] by choosing 10 gold standards in three areas of care. Preoperative: 1) Percentage cancer patients undergoing PET scan prior to surgery, 2) Percentage of patients with predicted postoperative FEV1 (ppoFEV1) <40% who had gas transfer (DLCO) measured. Perioperative: 3) Percentage of operations postponed, 4–5) Percentage of cancer patients undergoing anatomical resections and systematic lymph node excision, 6) Rate of exploratory thoracotomies. Postoperative: 7–8) Risk-adjusted ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311365 Fri, 26 Feb 2010 01:18:44 +0100 3311365 http://www.medworm.com/index.php?rid=3311364&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F389%3Frss%3D1 Previous studies have suggested that South Asian (SA) ethnicity is a predictor of poorer outcome after coronary artery bypass grafting (CABG). Our aim was to identify potential reasons for the higher postoperative mortality in SA patients and investigate all these reasons. All individuals undergoing isolated CABG in a tertiary cardiac centre from April 2002 to September 2007. In total, there were 2897 subjects (2623 white subjects; 274 SA subjects) who were included in an observational study showing the effect of ethnicity on the medium-term survival following CABG. Survival at 30 days and survival up to five years (median 2.7 years) were measured. SA subjects undergoing CABG were younger (62±9 vs. 66±9 years, P<0.001), less obese [body mass index (BMI) 26&p... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311364 Fri, 26 Feb 2010 01:18:43 +0100 3311364 http://www.medworm.com/index.php?rid=3311363&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F383%3Frss%3D1 Little is known about the outcome of acute thrombotic occlusion of segments of the cavopulmonary connections (CPC) in infants and children with univentricular hearts. Early recognition and aggressive therapy may result in successful salvage of some of these patients. Five consecutive patients (age range 4–8 months) presenting with acute occlusion of a CPC segment underwent emergency cardiac catheterization. After angiographic confirmation, the occluded segment was crossed using an endhole catheter and guidewire combination. Serial balloon dilation and stent implantation (ten stents in total) were undertaken to recanalize the occlusion. The stents used were mounted on balloons ranging in diameter from 6 mm to 8 mm, depending on the size of the native vessel. The sites o... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311363 Fri, 26 Feb 2010 01:18:43 +0100 3311363 http://www.medworm.com/index.php?rid=3311362&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F377%3Frss%3D1 In conclusion, impaired body weight gain before surgery is followed by a catch-up growth after surgery. However, there is no relationship to neurodevelopmental outcome. Genetic comorbidity is the most significant factor for poor weight gain. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311362 Fri, 26 Feb 2010 01:18:43 +0100 3311362 http://www.medworm.com/index.php?rid=3311361&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F371%3Frss%3D1 This prospective randomized study compares novel hyaluronan-based heparin-bonded circuits vs. uncoated controls across EuroSCORE patient risk strata including biomaterial evaluation. Over a two-year period, 90 patients undergoing coronary artery bypass grafting were prospectively randomized to one of the two perfusion protocols: Group 1 was treated with hyaluronan-based heparin-bonded preconnected circuits (Vision HFO-GBSTM, Gish, CA, USA) and Group 2 with identical uncoated controls. Each group was composed of three subgroups (n=15) with respect to preoperative evaluation of low (EuroSCORE 0–2), medium (3–5) and high (6+) risk patients. Blood samples were collected after induction (T1) and heparinization (T2), 15 min after cardiopulmonary bypass start (T3), before cessation of... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311361 Fri, 26 Feb 2010 01:18:43 +0100 3311361 http://www.medworm.com/index.php?rid=3311360&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F370%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311360 Fri, 26 Feb 2010 01:18:43 +0100 3311360 http://www.medworm.com/index.php?rid=3311359&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F366%3Frss%3D1 Gastrointestinal (GI) complications are serious consequences of cardiac surgery. The aim of this study was to develop, evaluate and validate a new risk score model for GI complications after cardiac surgery. The risk score model, named gastrointestinal complication score (GICS), was developed using prospectively collected data from 5593 patients who underwent 5636 cardiac surgical procedures between 1996 and 2001. The model was validated on 1031 cardiac surgery patients between 2005 and 2006. The scoring system's ability to predict GI complications was estimated by receiver operating characteristic (ROC)-curves and Hosmer–Lemeshow test. Fifty GI complications were identified in 47 patients (0.8%) in the developmental data set and eight (0.8%) in the validation data set. The ROC area ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311359 Fri, 26 Feb 2010 01:18:43 +0100 3311359 http://www.medworm.com/index.php?rid=3311358&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F365%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311358 Fri, 26 Feb 2010 01:18:43 +0100 3311358 http://www.medworm.com/index.php?rid=3311357&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F360%3Frss%3D1 Fatal aortic dissection commonly occurs in Marfan syndrome. Prevention currently relies on elective replacement of the aortic root. We are evaluating the placement of a manufactured, bespoke external support derived from a computer aided design in a prospective study. In the first ten patients, measurements were made consistently of the ascending aorta at the level of closure of the aortic valve cusps from magnetic resonance imaging (MRI) studies taken preoperatively and at fixed intervals thereafter. Before and after images were presented for measurement amongst duplicate images of 37 unoperated Marfan patients to permit assessment of intra-observer measurement reproducibility. All images were presented in random sequence to a radiologist unaware of the research question. The largest diff... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311357 Fri, 26 Feb 2010 01:18:43 +0100 3311357 http://www.medworm.com/index.php?rid=3311356&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F356%3Frss%3D1 The aim of this study was to compare the morphology of the bronchial stump after lobectomy between mechanical stapler closure and manual suture closure. The effect of fibrin glue application on each method of closure was also observed. Right upper lobectomy was performed in beagles (n=31) using staplers (ST group) or sutures (SU group). In a separate experiment, fibrin glue was sprayed onto the stump after each respective method of closure. After one week, the stump region was examined macroscopically, and also by histology. 2-Test and Mann–Whitney test were used for comparative analysis. The incidence of adhesion formation between the surrounding tissues was significantly reduced in the ST group in comparison to the SU group (22 vs. 80%, P=0.04). The thickness of granulation tissue ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311356 Fri, 26 Feb 2010 01:18:43 +0100 3311356 http://www.medworm.com/index.php?rid=3311355&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F3%2F353%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3311355 Fri, 26 Feb 2010 01:18:43 +0100 3311355 http://www.medworm.com/index.php?rid=3193541&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F352%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193541 Wed, 20 Jan 2010 23:13:43 +0100 3193541 http://www.medworm.com/index.php?rid=3193539&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F350%3Frss%3D1 Prolonged support with left ventricular assist system (LVAS) increases the risk of device-related infection. We experienced a rare complication of LVAS: an infectious aneurysm at the apical cannula, which appeared with atypical presentation. A 27-year-old male, who developed acute aggravation of dilated cardiomyopathy, was placed on extra-corporeal type LVAS. Six months later, the patient suffered from methicillin-resistant Staphylococcus aureus (MRSA) sepsis that lasted for as long as three months despite intensive antibiotic therapy. At 17 months after the implantation, he presented with obstructive ileus. Monthly assessment with transthoracic echocardiography (TTE) did not document any abnormalities around the ventricle. A contrast computed tomographic (CT) scan revealed a huge api... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193539 Wed, 20 Jan 2010 23:13:43 +0100 3193539 http://www.medworm.com/index.php?rid=3193538&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F348%3Frss%3D1 We present a case in which a redo patient in whom advanced gastric cancer was detected after coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA), and in which re-grafting to the distal RGEA using the right internal thoracic artery (RITA) was performed. To minimize the surgical invasion before gastrectomy, we performed a thoracoscopic RITA harvest and small subxyphoid incision. A month later, distal gastrectomy was carried out and no complications occurred during the operation. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193538 Wed, 20 Jan 2010 23:13:43 +0100 3193538 http://www.medworm.com/index.php?rid=3193537&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F346%3Frss%3D1 We report the diagnosis and surgical treatment of an aneurysm on a CAA associated with an anomalous origin of the left main coronary artery. The surgical procedure consisted in the resection of the aneurysm, a direct aorto aortic anastomosis and a coronary artery bypass to the left anterior descending (LAD) artery with a good result at 11 months. This first case reported of an anomaly of a coronary artery origin associated with an aneurysm on a CAA, underlines the interest of a preoperative complete anatomical and functional diagnosis, to define an optimal intraoperative strategy. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193537 Wed, 20 Jan 2010 23:13:43 +0100 3193537 http://www.medworm.com/index.php?rid=3193536&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F344%3Frss%3D1 We present a case of a cardiac fibroma affecting the base of the anterior papillary muscle resected under cardiopulmonary bypass with cardioscopy and video-assisted thoracic surgery (VATS) instruments through the mitral valve. The surgical approach and instrumentation of previous case reports are reviewed. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193536 Wed, 20 Jan 2010 23:13:43 +0100 3193536 http://www.medworm.com/index.php?rid=3193535&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F341%3Frss%3D1 Left ventricular rupture may occur as a complication of acute myocardial infarction and is associated with significant morbidity and mortality. The risk associated with impending rupture of the left ventricular free wall has not been quantified but it is likely a predisposing factor to complete rupture. Few cases of impending rupture of the left ventricular free wall have been discussed in the literature; we present one such case and describe simple operative management with an autologous pericardial patch and subsequent outcome. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193535 Wed, 20 Jan 2010 23:13:43 +0100 3193535 http://www.medworm.com/index.php?rid=3193534&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F338%3Frss%3D1 Foregut duplication cysts are rare congenital anomalies of enteric origin that arise during early embryonic development. They are usually incidentally found on routine imaging studies. The diagnosis can usually be made by computed tomography (CT) and endoscopic ultrasound (EUS) appearance. On CT, cyst attenuation values usually measure 0±20 Hounsfield units (HU). Higher HU is possible with hemorrhage, proteinaceous material or septations. At EUS, characteristic location and anechoic as well as hypoechoic but not necessarily anechoic appearance may be suggestive of a foregut duplication cyst. EUS-guided fine needle aspiration (FNA) has been thought to provide a safe, minimally invasive approach to establish the diagnosis. The purpose of this report is to highlight the potential ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193534 Wed, 20 Jan 2010 23:13:43 +0100 3193534 http://www.medworm.com/index.php?rid=3193533&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F337%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193533 Wed, 20 Jan 2010 23:13:43 +0100 3193533 http://www.medworm.com/index.php?rid=3193532&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F334%3Frss%3D1 The surgical strategy for infected thoracic aortic aneurysms (ITAA) remains controversial. Effective antibiotic therapy is mandatory and surgical intervention is indicated only to prevent an aneurysmal rupture. In-situ reconstruction through an aseptic route is ideal; however, urgent surgery is often required in the uncontrolled infectious phase. Five patients were recently treated surgically for ITAA. They were all males with a mean age of 61.2 (range: 58–66) years. Two patients were operated on urgently in the active infectious phase due to impending aneurysmal rupture. A total arch reconstruction with an extra-anatomical bypass between the ascending aorta and both femoral arteries in one and an extended aortic arch resection with an in-situ graft reconstruction were performed in t... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193532 Wed, 20 Jan 2010 23:13:43 +0100 3193532 http://www.medworm.com/index.php?rid=3193531&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F333%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193531 Wed, 20 Jan 2010 23:13:43 +0100 3193531 http://www.medworm.com/index.php?rid=3193530&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F331%3Frss%3D1 We describe four cases as examples of operations in which we have found innominate artery cannulation to be advantageous. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193530 Wed, 20 Jan 2010 23:13:43 +0100 3193530 http://www.medworm.com/index.php?rid=3193529&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F328%3Frss%3D1 We describe here an alternative method to deal with such complication, which proved effective in a patient with active bleeding from the left anterior descending (LAD) coronary artery. By temporary pressing on beating heart patches of TachoSil®, a sponge impregnated with human fibrinogen and thrombin, on the bleeding site, complete and stable hemostasis was achieved. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193529 Wed, 20 Jan 2010 23:13:43 +0100 3193529 http://www.medworm.com/index.php?rid=3193528&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F325%3Frss%3D1 In patients with left-sided mechanical aortic prostheses, it is recommended that the mechanical valve be replaced with a bioprosthesis, or excluded, at implantation of left ventricular assist device (LVAD). As changes in flow across the valve leads to potential thromboembolic complications, mechanical valves within the native heart are a relative contraindication to LVAD therapy. We here describe a patient who had long-standing valvular cardiomyopathy with mitral Starr-Edwards mechanical valve (Edwards Lifesciences, CA, USA) and aortic bileaflet tilting disc (St Jude Medical, St Paul, MN, USA) where LVAD was placed without explantation of the mechanical heart valves. The patient was bridged successfully to transplantation without thromboembolic events. (Source: Interactive CardioVascular a... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193528 Wed, 20 Jan 2010 23:13:42 +0100 3193528 http://www.medworm.com/index.php?rid=3193527&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F322%3Frss%3D1 Mycotic aneurysms located on aortic arch are rare and have extremely high mortality. The presented case is a 75-year-old man with a thoracic aortal mycotic aneurysm successfully treated with surgical intervention. To prevent recurrent infection and postoperative pulmonary complications, we performed single-stage surgery including extensive debridement, graft replacement using rifampicin soaked prosthetic graft and omental wrapping. Although mycotic aneurysm with inflammation tissue usually interferes with surgical manipulation because of severe adhesion to the lung, semi-clamshell approach helped us perform all these procedures. The patient rapidly recovered from the surgery, and has shown no recurrence after 35 months follow-up. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193527 Wed, 20 Jan 2010 23:13:42 +0100 3193527 http://www.medworm.com/index.php?rid=3193526&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F320%3Frss%3D1 A 74-year-old man was diagnosed to have a ventricular septal defect (VSD), which was detected shortly following transvenous pacemaker implantation. Transoesophageal echocardiography suggested the presence of two VSDs, one of which was closed with a device. At surgery, a single large VSD was seen, with the implanted device having embolised into the left ventricle. The defect was successfully closed using a pericardial patch, and the embolised device explanted. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193526 Wed, 20 Jan 2010 23:13:42 +0100 3193526 http://www.medworm.com/index.php?rid=3193525&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F318%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193525 Wed, 20 Jan 2010 23:13:42 +0100 3193525 http://www.medworm.com/index.php?rid=3193524&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F317%3Frss%3D1 We report a case of a 22-year-old man with Kawasaki disease presenting with features of cardiac tamponade following rupture of giant aneurysm of his right coronary artery. He underwent an emergency operation. Aneurysmal sac was of size 4x4 cm. The entry point of the aneurysm was sutured. Right coronary artery was grafted with left radial artery. He had an uneventful recovery in the postoperative period. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193524 Wed, 20 Jan 2010 23:13:42 +0100 3193524 http://www.medworm.com/index.php?rid=3193523&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F315%3Frss%3D1 The Ionescu–Shiley pericardial valve (Shiley, Inc, Irvine, CA, USA) is a first generation bioprosthesis made from bovine pericardium. Despite its excellent hemodynamic performance, use of this prosthesis ceased because it had an unacceptably high rate of early structural deteriorations, especially in the era of the standard profile valve. We experienced a rare case of very long durability of an Ionescu–Shiley standard profile (ISSP) bioprosthesis. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193523 Wed, 20 Jan 2010 23:13:42 +0100 3193523 http://www.medworm.com/index.php?rid=3193522&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F312%3Frss%3D1 We describe a laryngoscope-assisted technique of saphenous vein harvesting, performing a few small skin incisions and with minimum additional cost. We have used our technique in 20 patients up to now without infection or other wound-related complications and with good cosmetic results. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193522 Wed, 20 Jan 2010 23:13:42 +0100 3193522 http://www.medworm.com/index.php?rid=3193521&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F311%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193521 Wed, 20 Jan 2010 23:13:42 +0100 3193521 http://www.medworm.com/index.php?rid=3193520&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F306%3Frss%3D1 A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Should patients undergoing cardiac surgery with atrial fibrillation (AF) have left atrial appendage (LAA) exclusion?’ Altogether 310 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that despite finding five clinical trials including one randomised controlled trial, that studied around 1400 patients who underwent LAA occlusion, the results of these studies do not clearly show a benefit for appendage occlusion. Indeed of the five stud... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193520 Wed, 20 Jan 2010 23:13:42 +0100 3193520 http://www.medworm.com/index.php?rid=3193519&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F305%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193519 Wed, 20 Jan 2010 23:13:42 +0100 3193519 http://www.medworm.com/index.php?rid=3193518&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F299%3Frss%3D1 A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, ‘Does severe asymptomatic mitral regurgitation (MR) require surgery or is watch and wait the optimal strategy?’. Over 103 papers were found using the reported search, and 10 represented the best evidence to answer this clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. No studies in the modern era have shown significant survival benefit for patients undergoing surgery for asymptomatic severe MR if they have good left ventricular (LV) function. The progression rate to surgery on developing symptoms is 10% per year in these patients. Ling et al. re... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193518 Wed, 20 Jan 2010 23:13:42 +0100 3193518 http://www.medworm.com/index.php?rid=3193517&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F293%3Frss%3D1 In conclusion, patency rates exceeded 95% in 10 studies for a follow-up of up to three months postoperatively. The evidence which supports the use of a ‘skeletonized’ RGEA is growing and this paper demonstrates clearly that in terms of patency, a skeletonized RGEA to the PDA should be considered as a conduit for CABG surgery especially when total arterial revascularization strategy with in situ conduits and no manipulation of the ascending aorta is the treatment of choice. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193517 Wed, 20 Jan 2010 23:13:42 +0100 3193517 http://www.medworm.com/index.php?rid=3193516&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F289%3Frss%3D1 A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether skeletonization of the radial artery (RA) improves conduit patency in coronary artery bypass grafting (CABG). Altogether 15 papers were found using the reported search, of which four papers represented the best evidence to answer the clinical question. Two papers compared patency rates between skeletonized and pedicled radial arteries. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes and results are tabulated. We acknowledge that evidence is limited in this area of cardiac surgery. When assessing the skeletonized RA, three studies provided patency data one year after CABG. No patency data were available five ye... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193516 Wed, 20 Jan 2010 23:13:42 +0100 3193516 http://www.medworm.com/index.php?rid=3193515&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F283%3Frss%3D1 A best evidence topic was constructed according to a structured protocol. The question addressed was whether the use of transcutaneous electrical nerve stimulation (TENS) is effective in reducing post-thoracotomy pain. Of the 74 papers found with a report search, nine prospective randomized controlled trials (RCT), among which three were double-blind, presented the best evidence to answer the clinical question. All investigated the effect of TENS as an adjunct therapy for relieving acute post-thoracotomy pain in patients undergoing thoracic surgery. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that a vast majority – seven of the nine retrieved studies – were in favor of TEN... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193515 Wed, 20 Jan 2010 23:13:42 +0100 3193515 http://www.medworm.com/index.php?rid=3193514&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F271%3Frss%3D1 In conclusion, there is evidence to suggest that the best technique to follow in the management of acid-base in patients undergoing deep hypothermic circulatory arrest during cardiac surgery is dependent upon the age of the patient with better results using pH-stat in the paediatric patient and alpha-stat in the adult patient. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193514 Wed, 20 Jan 2010 23:13:42 +0100 3193514 http://www.medworm.com/index.php?rid=3193513&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F266%3Frss%3D1 The long saphenous vein remains the most commonly used conduit in coronary artery bypass surgery. Vein harvest is a critical component of this operation with significant morbidity associated with large leg wounds from open techniques. Here, we analyse the available literature comparing minimally invasive techniques vs. the traditional open method for vein harvest. A systematic literature search of Medline, Embase and Cochrane databases was performed using the following terms; ‘saphenous vein’, ‘coronary artery bypass’, ‘tissue and organ harvesting’ and ‘endoscopic’. Relevant papers were then analysed using Statsdirect software. There was significantly reduced leg wound infection, leg wound haematoma and postoperative pain in the minimally inv... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193513 Wed, 20 Jan 2010 23:13:42 +0100 3193513 http://www.medworm.com/index.php?rid=3193512&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F262%3Frss%3D1 Ventricular dysfunction is frequently encountered in Fontan patients. Cardiologists and cardiac surgeons have, therefore, mainly focused on preservation of cardiac function, limiting the early volume overload as much as possible both in magnitude and duration. This resulted in improved cardiac function but, in some patients, also in poor pulmonary artery (PA) growth which in turn resulted in a poor final Fontan circuit. The volume requirements for optimal growth and development of the ventricle and the lungs are different and divergent. Avoiding overload of the ventricle is important, but excessive protection from volume overload may not be necessary and may result in PA hypoplasia, which in turn will severely affect the Fontan circuit. (Source: Interactive CardioVascular and Thoracic Surg... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193512 Wed, 20 Jan 2010 23:13:42 +0100 3193512 http://www.medworm.com/index.php?rid=3193511&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F258%3Frss%3D1 Conclusions: The novel sealant effectively prevented arterial bleeding from the anastomosis under full heparinization. In addition, the elastomeric property of the sealant prevented thinning of the aortic wall. The novel sealant may be a promising hemostatic agent for arterial anastomosis. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193511 Wed, 20 Jan 2010 23:13:42 +0100 3193511 http://www.medworm.com/index.php?rid=3193510&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F256%3Frss%3D1 Multiple coronary artery fistulae are rare, complications can be life-threatening, and with large or symptomatic fistulae, intervention is mandatory. Both surgical and percutaneous interventions are well-described. We believe this is the first report of the embolization of an acquired fistula following initial surgical treatment of multiple congenital fistulae. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193510 Wed, 20 Jan 2010 23:13:42 +0100 3193510 http://www.medworm.com/index.php?rid=3193509&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F249%3Frss%3D1 Conclusions: Mortality and adverse postoperative outcome increase in anemic octogenarians undergoing cardiac surgery. Although mortality is directly related to immediate postoperative anemia, adverse outcomes mainly depend on associated co-morbidities. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193509 Wed, 20 Jan 2010 23:13:42 +0100 3193509 http://www.medworm.com/index.php?rid=3193508&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F245%3Frss%3D1 Conclusion: This series contributes to a better characterization of a rare pathology demonstrating that both surgical and endovascular treatment can be performed with very low morbidity and mortality. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193508 Wed, 20 Jan 2010 23:13:42 +0100 3193508 http://www.medworm.com/index.php?rid=3193507&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F244%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193507 Wed, 20 Jan 2010 23:13:42 +0100 3193507 http://www.medworm.com/index.php?rid=3193506&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F239%3Frss%3D1 Conclusions: For the subgroup of patients undergoing isolated AVR, the use of the EuroSCORE provides a comparable precision concerning the estimation of early mortality compared with the simple factor ‘age’. The extended use of the EuroSCORE in view of percutaneous AVR, the insufficient accuracy of the score bears the risk of incorrect decision-making. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193506 Wed, 20 Jan 2010 23:13:41 +0100 3193506 http://www.medworm.com/index.php?rid=3193505&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F232%3Frss%3D1 Conclusions: Compared to men, women have worse preoperative and postoperative QOL. Female sex was an independent predictor of QOL worsening six months after CABG. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193505 Wed, 20 Jan 2010 23:13:41 +0100 3193505 http://www.medworm.com/index.php?rid=3193504&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F228%3Frss%3D1 Tyrosine kinase inhibitors against the receptors of vascular endothelial growth factor (VEGFR), epidermal growth factor (EGFR) and the platelet derived growth factor (PDGFR) are increasingly used in the treatment of progressive cancers. However, the expression of these receptors especially in lung metastases has not been examined. Tissue specimen from 35 lung metastases of 33 patients with renal cell carcinoma (n=8), sarcoma (n=10), colorectal carcinoma (n=6), otolaryngologic carcinoma (OLC, n=4), testicular and endometrial cancer (n=1 each), malignant melanoma (n=1), adrenal cancer (n=2), malignant fibrous histiocytoma and malignant peripheral nerve sheath tumor (n=1 each) have been immunohistochemically tested for the expression of PDGFR /β, VEGFR and EGFR. None of the patients had ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193504 Wed, 20 Jan 2010 23:13:41 +0100 3193504 http://www.medworm.com/index.php?rid=3193503&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F227%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193503 Wed, 20 Jan 2010 23:13:41 +0100 3193503 http://www.medworm.com/index.php?rid=3193502&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F222%3Frss%3D1 Parabolic resection, named for the shape of the cut edges of the excised tissue, expands on a common ‘trick’ used by experienced mitral surgeons to preserve tissue and increase the probability of successful repair. Our objective was to describe and clinically analyze this simple modification of conventional resection. Thirty-six patients with mitral regurgitation underwent valve repair using parabolic resection in combination with other techniques. Institution specific mitral data, Society of Thoracic Surgeons data and preoperative, post-cardiopulmonary bypass (PCPB) and postoperative echocardiography data were collected and analyzed. Preoperative echocardiography demonstrated mitral regurgitation ranging from moderate to severe. PCPB transesophageal echocardiography demonstrat... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193502 Wed, 20 Jan 2010 23:13:41 +0100 3193502 http://www.medworm.com/index.php?rid=3193501&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F217%3Frss%3D1 Recently, morphometric measurements of the ascending aorta have been done with ECG-gated multidector computerized tomography (MDCT) to help the development of future novel transcatheter therapies (TCT); nevertheless, the variability of such measurements remains unknown. Thirty patients referred for ECG-gated CT thoracic angiography were evaluated. Continuous reformations of the ascending aorta, perpendicular to the centerline, were obtained automatically with a commercially available computer aided diagnosis (CAD). Then measurements of the maximal diameter were done with the CAD and manually by two observers (separately). Measurements were repeated one month later. The Bland–Altman method, Spearman coefficients, and a Wilcoxon signed-rank test were used to evaluate the variability, t... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193501 Wed, 20 Jan 2010 23:13:41 +0100 3193501 http://www.medworm.com/index.php?rid=3193500&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F213%3Frss%3D1 Reduction of sternal adhesions is still an issue in cardiac surgery. To evaluate a new fibrillar porcine collagen absorbable membrane (CovaTM CARD), 16 sheep underwent a sternotomy followed by scratching of surface of the heart. They were then divided into three groups: pericardium left opened (n=4), placement of Seprafilm®, the reference absorbable substitute (hyaluronic acid and carboxymethylcellulose, n=6) or of CovaTM CARD membrane (n=6). Four months thereafter, the animals underwent repeat sternotomy and were macroscopically assessed for the degree of resorption of the material and the intensity of adhesions. Explanted hearts were blindly evaluated for the magnitude of the inflammatory response and fibrosis. The CovaTM CARD membrane was almost totally absorbed by four months and r... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193500 Wed, 20 Jan 2010 23:13:41 +0100 3193500 http://www.medworm.com/index.php?rid=3193499&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F208%3Frss%3D1 We hypothesized that left ventricular (LV) and subvalvular geometries could be restored in a less invasive manner by circumferential plication without a ventriculotomy or a cardiopulmonary bypass (CPB). Continuous sutures were placed circumferentially on the epicardial surface of the LV wall without using a CPB in six healthy pigs. Coronary artery occlusion was precluded by placing the sutures underneath the peripheral coronary artery. After the circumferential sutures were plicated to 75% of the original length, hemodynamics were recorded and LV geometries and function were measured. All animals survived after plication without arrhythmia or hemodynamic deterioration. Angiogram findings demonstrated that plication reduced the LV end-diastolic volume (LVEDV) (72±10 vs. 58±12&... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193499 Wed, 20 Jan 2010 23:13:41 +0100 3193499 http://www.medworm.com/index.php?rid=3193498&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F204%3Frss%3D1 The aim of this study was to establish a practical simplified formula to facilitate the management of a frequently occurring postoperative complication, pleural effusion. Chest ultrasonography with better sensitivity and reliability in the diagnosis of pleural effusions than chest X-ray can be repeated serially at the bedside without any radiation risk. One hundred and fifty patients after cardiac surgery with basal pleural opacity on chest X-ray have been included in our prospective observational study during a two-year period. Effusion was confirmed on postoperative day (POD) 5.9±3.2 per chest ultrasound sonography. Inclusion criteria for subsequent thoracentesis based on clinical grounds alone and were not protocol-driven. Major inclusion criteria were: dyspnea and peripheral oxy... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193498 Wed, 20 Jan 2010 23:13:41 +0100 3193498 http://www.medworm.com/index.php?rid=3193497&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F200%3Frss%3D1 Integrated positron emission tomography and computed tomography (PET/CT) scanning has become the standard for oncologic imaging. We sought to determine the role of PET/CT in mediastinal non-small cell lung cancer staging. One hundred and twenty-seven consecutive patients were enrolled in the study where PET/CT was performed due to pathologically defined non-small cell carcinoma from a single center. They all underwent complete resection with a thoracotomy and systemic lymph node dissection (SLND) between October 2005 and January 2007. Postoperative pathology results of lymph node stations regarding the nodal spread and stage were compared with clinical stage obtained by PET/CT. The sensitivity, specificity, accuracy, negative predictive value (NPV) and positive predictive value (PPV) of PE... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193497 Wed, 20 Jan 2010 23:13:41 +0100 3193497 http://www.medworm.com/index.php?rid=3193496&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F195%3Frss%3D1 Changes in smoking behaviour and attitudes of 2642 patients, undergoing cardiac surgery, between January 2000 and July 2008 were studied. All patients completed a preoperative questionnaire concerning smoking behaviour and attitude. Study endpoints are behaviour and attitude in relation to tobacco use in hospitals, cessation smoking before and after the operation. Over the years there have been no notable differences in smoking behaviour, however, significantly less patients accept smoking in the hospital (0.9% vs. 5.3%). Significantly more patients stopped within the two weeks before surgery (9.4% vs. 5.3%). The percentage of patients who did not have the intention to stop smoking after the operation did not decrease significantly. Significantly less older patients smoke (1.6% vs. 13.4%) ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193496 Wed, 20 Jan 2010 23:13:41 +0100 3193496 http://www.medworm.com/index.php?rid=3193495&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F190%3Frss%3D1 Immunosuppressive regimens for lung transplantation frequently fail to prevent rejection and are toxic. Alemtuzumab was used as induction to investigate whether oral immunosuppression could be reduced. From November 2006 to March 2008, 20 consecutive lung transplant patients received alemtuzumab induction, with reduced maintenance immunosuppression; tacrolimus (target level 10 ng/ml), mycophenolate mofetil (MMF) 250 mg bid and prednisone 7.5 mg. Twenty control cases transplanted before 2006 were treated with standard immunosuppression; tacrolimus (target level 10 ng/ml), MMF 750 mg bid and prednisone 15 mg qd. End-points included patient and graft survival, acute rejection (AR) and infection rate. There were no significant differences in six-month and 12-month survival ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193495 Wed, 20 Jan 2010 23:13:41 +0100 3193495 http://www.medworm.com/index.php?rid=3193494&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F185%3Frss%3D1 An algorithm of preoperative mediastinal nodal staging with endobronchial/endoesophageal ultrasonography (EBUS/EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) combined with laparoscopy/peritoneal lavage and cytology was analyzed to establish the realistic criteria for radical multimodality treatment of malignant pleural mesothelioma (MPM). The algorithm included computed tomography (CT), thoracoscopy with multiple pleural biopsies and talc pleurodesis, EBUS/EUS and one-stage TEMLA and laparoscopy/peritoneal lavage and cytology of the fluid. Forty-two patients were diagnosed from 1 January 2004 to 31 December 2008. There were 16 women and 26 men in ages ranging from 43 to 77 years (mean 57.8); 31 epithelioid, 2 sarcomatoid and 9 biphasic type MPM. 21/42 patients wer... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193494 Wed, 20 Jan 2010 23:13:41 +0100 3193494 http://www.medworm.com/index.php?rid=3193493&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F181%3Frss%3D1 This study showed that the novel modified HTK-1 solution improves myocardial contractility and relaxation after heart transplantation. Nevertheless, addition of the iron-chelators deferoxamine and LK-614 diminished these beneficial effects. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193493 Wed, 20 Jan 2010 23:13:40 +0100 3193493 http://www.medworm.com/index.php?rid=3193492&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F176%3Frss%3D1 This article describes the experience of introducing this technique in a training hospital, the first reported cohort in The Netherlands. From March 2006 to November 2008, all patients operated on for proven or suspected lung cancer were analyzed. Prospective data from these patients were evaluated. A subgroup analysis for the c-VATS lobectomy is presented. A total of 184 operations were performed on 172 patients. In 122 (66.3%) of the operations the resection ended in a lobectomy of which 70 were done by complete thoracoscopic procedure. For the c-VATS lobectomy the mean operating time was 179 min, with a mean blood loss of 444 ml. The median hospital stay was four days. Complications were present in 10% of c-VATS lobectomies. No mortality was seen in the c-VATS group. After tho... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193492 Wed, 20 Jan 2010 23:13:40 +0100 3193492 http://www.medworm.com/index.php?rid=3193491&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F172%3Frss%3D1 Osseous metastases of renal cell carcinoma (RCC) are the second most frequent location after lung metastases. They rarely present as isolated location. When isolated, resection may offer five-year survival rates of 30–60%. The purpose of the current study is to focus on a particular subset, the isolated rib metastases (IRM). The files of six patients who underwent radical resection for IRM were reviewed. All had previous radical nephrectomy for clear-cell renal cancer. The mean age of these six men was 55.3 years. Preoperative evaluation included in all patients a conventional chest radiograph and thoracic computed tomography (CT) scanning. Chest wall resections were wide and curative. The mean disease-free interval (DFI) after renal cancer treatment was 25 months. There wa... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193491 Wed, 20 Jan 2010 23:13:40 +0100 3193491 http://www.medworm.com/index.php?rid=3193490&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F171%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193490 Wed, 20 Jan 2010 23:13:40 +0100 3193490 http://www.medworm.com/index.php?rid=3193489&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F168%3Frss%3D1 Aortic cross-clamping during cardiac operations may injure the vessel wall and cause tissue lesions. This experimental study analyses the influence of the intravascular and external pressure and the duration of aortic cross-clamping on endothelial tissue damage. Fresh porcine aortas (n=20) were tested with intravascular pressures from 30 to 80 mmHg. The external clamp pressure, necessary to occlude the aorta, was applied by using the second cog of a commercial aortic clamp and cross-clamping was performed for 1 and 30 min. The observed pressure curves were compared to the histological findings. For occlusion of the aorta, an external pressure of at least 10-fold higher than the intravascular pressure (max. 812 mmHg) had to be applied. After 30 min of clamping, a complet... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193489 Wed, 20 Jan 2010 23:13:40 +0100 3193489 http://www.medworm.com/index.php?rid=3193488&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F165%3Frss%3D1 Mitral valve repair is the procedure of choice to treat mitral valve regurgitation. However, the feasibility and durability of repair are influenced strongly by the valve pathology. The classic features of degenerative mitral valve disease include leaflet prolapse and annular dilatation. Risk of repair failure is increased by isolated anterior leaflet prolapse or bileaflet prolapse. A variety of techniques have been used to treat this pathology. The most popular include partial leaflet resection, chordal shortening, chordal transfer and chordal replacement. Use of artificial chordae with expanded polytetrafluoroethylene (e-PTFE) sutures is a well-known technique for mitral valve repair and long-term data validate this approach. The primary challenges with this technique are judging the pro... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193488 Wed, 20 Jan 2010 23:13:40 +0100 3193488 http://www.medworm.com/index.php?rid=3193487&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F161%3Frss%3D1 In past years, we developed expandable devices (type I and II) for sutureless aortic anastomosis. We have now further modified the device (type III) incorporating a second expandable ring, external to the main one, which can be operated contrariwise in such a way that the aortic wall (i.e. the dissection layers) is compressed between the two expandable rings, providing full control on both the layers compression pressure and the anastomosis final diameter. The device was evaluated in ex vivo experimental models of swine aortic arch fresh samples; air-tight sealing at increasing endovascular pressures was also evaluated and compared with sealing achieved by standard suturing. Ex vivo data suggest that the present version of the device can be used easily and quickly also in elliptical, asymm... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193487 Wed, 20 Jan 2010 23:13:40 +0100 3193487 http://www.medworm.com/index.php?rid=3193486&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F2%2F159%3Frss%3D1 We present the interest of using lung retractors and vascular clamps that can be released inside the chest cavity without blocking a trocar access. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3193486 Wed, 20 Jan 2010 23:13:40 +0100 3193486 http://www.medworm.com/index.php?rid=3100475&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F156%3Frss%3D1 We report on the successful surgical treatment of an esophageal-bibronchial fistula originating from an iatrogenic mediastinal abscess. Endoscopic treatment had been excluded due to the extensive damage to the right main stem bronchus wall. The surgical treatment was carried out as follows: 1) Endoscopic stenting of the left main bronchus with a self-expanding metallic stent followed by selective left main bronchus intubation; 2) Laparotomic harvesting of the omentum pedicled on both gastro-epiploic vessels; 3) Right thoracotomy, complete dissection of both main bronchi and esophageal wall at the site of the leakage; 4) Harvesting of a pericardial vascularized graft; 5) Deployment of a self-expanding metallic stent from the surgical field into the right main stem bronchus; 6) Reconstructio... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100475 Thu, 17 Dec 2009 16:35:41 +0100 3100475 http://www.medworm.com/index.php?rid=3100474&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F154%3Frss%3D1 We present a case in which a left ventricular assist device (LVAD) was implanted in a patient with terminal heart failure and preoperatively diagnosed asymptomatic thrombus in the right pulmonary artery. LVAD implantation was performed with concomitant thromboembolectomy in deep hypothermic circulatory arrest (DHCA) and intra-operatively right ventricular assist device (RVAD) implantation for the treatment of acute right ventricular failure became necessary. The patient was weaned from the RVAD after eight days of support. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100474 Thu, 17 Dec 2009 16:35:41 +0100 3100474 http://www.medworm.com/index.php?rid=3100473&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F152%3Frss%3D1 Barotraumatic oesophageal perforation with bilateral tension pneumothorax is extremely rare and this is a first case reported in the literature. The possibility of the oesophageal perforation due to high-pressure gas flow should be kept in mind and the standard of diagnosis is oesophagography. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100473 Thu, 17 Dec 2009 16:35:41 +0100 3100473 http://www.medworm.com/index.php?rid=3100472&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F150%3Frss%3D1 We present the case of a man with heparin-induced thrombocytopenia (HIT) and acute idiopathic decompensated cardiomyopathy who underwent successful heart transplantation with the use of bivalirudin as anticoagulant. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100472 Thu, 17 Dec 2009 16:35:41 +0100 3100472 http://www.medworm.com/index.php?rid=3100471&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F148%3Frss%3D1 A 76-year-old female had suffered from distal arch aortic aneurysm and chronic DeBakey IIIB type dissecting aneurysm. The patient underwent thoracic endovascular aortic repair (TEVAR). After TEVAR the patient had a motor and proprioceptive loss on the left side and a pain and body temperature loss on the right side below the level of T7. At diagnosis of Brown-Sequard syndrome, corticosteroid and free radical scavenger were administered soon afterwards. Her neurological deficits gradually improved and the patient was discharged with the aid of a walking stick three months after TEVAR. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100471 Thu, 17 Dec 2009 16:35:41 +0100 3100471 http://www.medworm.com/index.php?rid=3100470&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F146%3Frss%3D1 We present a case with an unusual cause of poor venous drainage during cardiopulmonary bypass for robotic-assisted mitral valve repair. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100470 Thu, 17 Dec 2009 16:35:41 +0100 3100470 http://www.medworm.com/index.php?rid=3100469&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F144%3Frss%3D1 We diagnosed a non-small cell lung carcinoma in a 49-year-old female patient with the histopathological diagnosis of stage IIIB mixed bronchioloalveolar and papillary adenocarcinoma with extensive micropapillary feature, which was not visualized on the preoperative multimodality imaging with positron emission tomography (PET) and computed tomography (CT). The micropapillary component characterized by a unique growth pattern with particular morphological features can be observed in all subtypes of lung adenocarcinoma. Micropapillary component is increasingly recognized as a distinct entity associated with higher aggressiveness. Even the most modern multimodality PET/CT imaging technology may fail to adequately visualize this important component with highly relevant prognostic implications. ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100469 Thu, 17 Dec 2009 16:35:41 +0100 3100469 http://www.medworm.com/index.php?rid=3100468&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F142%3Frss%3D1 To compare F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG-PET) and 99mTc-hexamethylpropylene amine oxime (99mTC-HMPAO) labelled leukocyte scintigraphy for the diagnosis of vascular graft infection. A thoraco-abdominal CT-angiography and a 99mTC-HMPAO labelled leukocyte scintigraphy did not show any graft infection in this case report whereas an F-18 FDG-PET showed a metabolic uptake around and all along the vascular graft. Further comparison between these two explorations is needed since the two techniques have not been compared in vascular graft infection. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100468 Thu, 17 Dec 2009 16:35:41 +0100 3100468 http://www.medworm.com/index.php?rid=3100467&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F140%3Frss%3D1 Primary malignant cardiac neoplasms are extremely rare. The occurrence of a malignant lymphoid tumour within a left atrial myxoma is highly atypical, with only one such case previously reported. Here, we describe a patient who presented with symptoms and signs of a left atrial myxoma. Subsequent specimen histology demonstrated the presence of lymphoma within the myxoma. We discuss the importance of histological diagnosis in order to best direct treatment and prognosis of such cases. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100467 Thu, 17 Dec 2009 16:35:41 +0100 3100467 http://www.medworm.com/index.php?rid=3100466&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F139%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100466 Thu, 17 Dec 2009 16:35:41 +0100 3100466 http://www.medworm.com/index.php?rid=3100465&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F138%3Frss%3D1 We describe a 30-year-old female who presented to us with a history of dry cough and hiccups within the last four months. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100465 Thu, 17 Dec 2009 16:35:41 +0100 3100465 http://www.medworm.com/index.php?rid=3100464&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F135%3Frss%3D1 We report a case of PG after coronary artery bypass grafting (CABG) in a patient with chronic idiopathic myelofibrosis (CIMF). Diagnosis was made with punch skin biopsy and he was treated with systemic steroids. His lesions showed remarkable improvement with this therapy. Cardiothoracic surgeons need to consider this diagnosis in all rapidly expanding postoperative lesions, especially those that do not improve with debridement or antibiotics or conservative wound care. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100464 Thu, 17 Dec 2009 16:35:41 +0100 3100464 http://www.medworm.com/index.php?rid=3100463&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F133%3Frss%3D1 We present a case of an endobronchial schwannoma presenting with bronchial obstruction and review the literature of this unusual entity. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100463 Thu, 17 Dec 2009 16:35:41 +0100 3100463 http://www.medworm.com/index.php?rid=3100462&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F131%3Frss%3D1 Familial hypercholesterolemia (FH) is a genetic disease caused by a mutation in low-density lipoprotein (LDL) receptor gene. It causes various presentations including tendon xanthoma and cardiac manifestations. Herein, we present a young patient with homozygous FH (HFH) who presented with dyspnea and chest pain caused by coronary arteries stenosis and treated with coronary artery bypass graft (CABG) surgery at the age of 13 years. To the best of our knowledge, he is one of the youngest patients in the English language literature for whom coronary revascularization has been done in childhood. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100462 Thu, 17 Dec 2009 16:35:40 +0100 3100462 http://www.medworm.com/index.php?rid=3100461&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F128%3Frss%3D1 A 48-year-old man with neurofibromatosis type 1 (NF1) presented with a right pleural effusion. A 3D computed tomography (CT) angiogram showed an aneurysm of the right 11th intercostal artery. He had no history of chest trauma so we diagnosed a spontaneous rupture of the aneurysm causing a massive effusion. We opened his pleural cavity and found lacerated pleura and active bleeding in the posterior 11th intercostal space. After controlling the active bleeding, we treated a persistent oozing from the region of the 10th–12th vertebrae with pressure hemostasis by absorbable oxidized cellulose packing. The next day, the patient gradually developed a paraplegia affecting both lower limbs. Magnetic resonance imaging (MRI) showed spinal cord compression at the level of the 9th and 10th verte... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100461 Thu, 17 Dec 2009 16:35:40 +0100 3100461 http://www.medworm.com/index.php?rid=3100460&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F125%3Frss%3D1 We present a case of a male patient diagnosed with a large inferior pancreaticoduodenal artery (IPDA) aneurysm, associated with a fresh thrombotic occlusion of the celiac trunk. Given the risk of splanchnic ischaemia, radiologic embolisation of the aneurysm combined with celiac axis stenting was deemed unsafe. Management was therefore modified to elective revascularisation of the celiac axis prior to surgical resection of the aneurysm. A retropancreatic aorto-gastroduodenal artery bypass graft was performed prior to exposing and resecting the pancreaticoduodenal artery aneurysm. This ensured near uninterrupted retrograde supply to the celiac axis during the procedure. This is an effective, efficient and expeditious patient pathway for these rare and complex aneurysms complicated by celiac ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100460 Thu, 17 Dec 2009 16:35:40 +0100 3100460 http://www.medworm.com/index.php?rid=3100459&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F122%3Frss%3D1 We report the case of a 35-year-old patient with an incidental finding of an asymptomatic large (9.5 cm in diameter) anterior mediastinal tumour. Radiological findings favoured the diagnosis of a benign mediastinal teratoma. During surgical resection, we found a tumour adhering to the surrounding tissues, and encompassing the innominate vein which was totally occluded. Total tumoural exeresis was performed as well as the double cross-section of the innominate vein. Postoperatively, there was no left upper limb swelling, probably because of a chronic occlusion of the innominate vein. The hospital stay was uneventful. Immunohistochemistry diagnosed a mediastinal ‘epithelioid haemangioendothelioma’, which is a tumour of vascular origin. We believe that the tumour took origin ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100459 Thu, 17 Dec 2009 16:35:40 +0100 3100459 http://www.medworm.com/index.php?rid=3100458&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F120%3Frss%3D1 A 64-year-old male developed chest pain while gardening. Aortic dissection and coronary artery disease were excluded but chest computed tomography (CT) scan showed an aneurysmic enlargement of the pulmonary artery and a fluttering structure within. He underwent immediate sternotomy for replacement of the pulmonary artery. Histology showed an intimal sarcoma of both branches of the pulmonary artery. The pulmonary artery was replaced by a T-shaped Gore-Tex-prosthesis. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100458 Thu, 17 Dec 2009 16:35:40 +0100 3100458 http://www.medworm.com/index.php?rid=3100457&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F119%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100457 Thu, 17 Dec 2009 16:35:40 +0100 3100457 http://www.medworm.com/index.php?rid=3100456&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F118-a%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100456 Thu, 17 Dec 2009 16:35:40 +0100 3100456 http://www.medworm.com/index.php?rid=3100455&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F118%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100455 Thu, 17 Dec 2009 16:35:40 +0100 3100455 http://www.medworm.com/index.php?rid=3100454&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F116%3Frss%3D1 Pregnant women with a mechanical heart prosthesis are at a higher risk of thromboembolic complications. The optimal anticoagulation strategy in this setting remains unclear. When prosthesis thrombosis happens and cardiac surgery must be performed, the risk of fetal mortality is high. Special attention must be paid to improve the placental perfusion during cardiopulmonary bypass (CPB) in order to improve fetal outcomes. A 31-year-old woman, nine weeks pregnant, was admitted to our institution due to a mitral mechanical prosthesis thrombosis. She had been receiving low molecular weight heparin (LMWH) since pregnancy was detected. She underwent a mitral valve replacement with CPB at 34 °C and a short cardiac arrest time. Both mother and fetus survived. We briefly review the diff... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100454 Thu, 17 Dec 2009 16:35:40 +0100 3100454 http://www.medworm.com/index.php?rid=3100453&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F114%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100453 Thu, 17 Dec 2009 16:35:40 +0100 3100453 http://www.medworm.com/index.php?rid=3100452&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F113%3Frss%3D1 Big pulmonary artery-left atrial fistula malformation (PALAF) was diagnosed in a 5-year-old boy. Although transcatheter therapy would be preferred as a treatment of PALAF, the lesion, which was 20 mm in diameter and almost totally shunting the right main pulmonary artery, it was decided to treat by surgical approach. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100452 Thu, 17 Dec 2009 16:35:40 +0100 3100452 http://www.medworm.com/index.php?rid=3100451&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F110%3Frss%3D1 We report a symptomatic patient with right coronary artery to coronary sinus (RCA-CS) fistula, complicated by aneurysmal dilatation and thrombosis of the CS, causing severe mitral regurgitation (MR) and tricuspid regurgitation (TR). (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100451 Thu, 17 Dec 2009 16:35:40 +0100 3100451 http://www.medworm.com/index.php?rid=3100450&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F107%3Frss%3D1 An 88-year-old woman with advanced Parkinson's disease (stage V on the Yahr scale) had difficulty in expectoration and underwent tracheostomy in 1999. In July 2004, granulation tissue was formed in the tracheal lumen at the tip of the tracheostomy tube, and a standard type silicone T-tube was inserted. Thereafter, she was cared for at home, where she was doing well until early March 2009, when a decrease in SaO2 and difficulty in sputum aspiration were noted. Bronchoscopy showed crescent type tracheobronchomalacia involving the trachea down to the orifice of the left main bronchus. Considering its localization, an intact right main bronchus, a history of tracheostomy tube placement resulting in granulation tissue formation in the lower trachea, and the future need for frequent sputum aspir... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100450 Thu, 17 Dec 2009 16:35:40 +0100 3100450 http://www.medworm.com/index.php?rid=3100449&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F105%3Frss%3D1 We present a case of a huge axillary mass deforming the chest wall. Surgery treated a well-encapsulated lipoma. Six months postoperatively, the chest wall restored to normal shape with active respiratory physiotherapy. This is the first reported case of spontaneous ‘remodelling’ of the chest wall without surgery. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100449 Thu, 17 Dec 2009 16:35:40 +0100 3100449 http://www.medworm.com/index.php?rid=3100448&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F104%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100448 Thu, 17 Dec 2009 16:35:40 +0100 3100448 http://www.medworm.com/index.php?rid=3100447&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F97%3Frss%3D1 A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether skeletonization of the internal thoracic artery (ITA) improves graft patency in coronary artery bypass grafting (CABG). Altogether >60 papers were found using the reported search, of which 17 papers represented the best evidence to answer the clinical question. Grafts used were either as single ITAs (left or right, LITA or RITA) or bilateral ITAs (BITAs). The author, journal, date and country of publication, patient group studied, study type, relevant outcomes and results are tabulated. We acknowledge that evidence is limited in this area of cardiac surgery. The skeletonized ITA has not been used long enough to establish whether a decline in patency will occur afte... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100447 Thu, 17 Dec 2009 16:35:40 +0100 3100447 http://www.medworm.com/index.php?rid=3100446&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F92%3Frss%3D1 A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients undergoing thoracic surgery is paravertebral block (PVB) as effective as epidural analgesia for pain management? Altogether >184 papers were found using the reported search, seven of which represented the best evidence to answer the clinical question. All studies agreed that PVB is at least as effective as epidural analgesia for pain control post-thoracotomy. In one paper, the visual analogue pain score (VAS) at rest and on cough was significantly lower in the paravertebral group (P=0.02 and 0.0001, respectively). Pulmonary function, as assessed by peak expiratory flow rate (PEFR), was significantly better preserved in the paravertebral group. The lowest PEFR ... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100446 Thu, 17 Dec 2009 16:35:39 +0100 3100446 http://www.medworm.com/index.php?rid=3100445&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F91%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100445 Thu, 17 Dec 2009 16:35:39 +0100 3100445 http://www.medworm.com/index.php?rid=3100444&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F86%3Frss%3D1 This article reviews the different facets of cardiac stunning, i.e. myocardial, vascular/microvascular/endothelial, metabolic, neural/neuronal, and electrical stunning. This review also displays where these facets exist and which clinical relevance they might have. Particular attention is directed to the different therapeutic interventions that the various facets of this I/R-induced cardiac injury might require. A final outlook considers possible alternatives to further reduce the detrimental consequences of brief episodes of ischemia and reperfusion. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100444 Thu, 17 Dec 2009 16:35:39 +0100 3100444 http://www.medworm.com/index.php?rid=3100443&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F81%3Frss%3D1 Conclusions: MPA is a durable and stable alternative for repair of non-ischemic mitral regurgitation of different etiologies. The technique gives an objective measure of the length of the band and no patient is left with a significant MR or mitral valve stenosis (MS). First-time success rate is very high and instant repairs few and minor. Freedom of MPA related reoperations is 100%. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100443 Thu, 17 Dec 2009 16:35:39 +0100 3100443 http://www.medworm.com/index.php?rid=3100442&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F76%3Frss%3D1 Conclusion: Our findings in this randomized trial do not support a role for hypothermia as a major cause of altered thyroxin responses in children undergoing CPB. Our finding may also suggest that in addition to IL-6, other inflammatory cytokines, such as chemokines, should be further investigated for their possible influence on the thyroid axis during CPB. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100442 Thu, 17 Dec 2009 16:35:39 +0100 3100442 http://www.medworm.com/index.php?rid=3100441&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F75%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100441 Thu, 17 Dec 2009 16:35:39 +0100 3100441 http://www.medworm.com/index.php?rid=3100440&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F70%3Frss%3D1 We report population-based follow-up in children operated on for ALCAPA. In total, 29 patients underwent aortic reimplantation of ALCAPA between 1979 and 2006. Twenty (69%) children were repaired with direct aortic implantation, five (17%) with a modified tubular extension technique, and four (14%) patients with an intrapulmonary baffling technique. Early postoperative mortality (<30 days) was 17%. No late mortality (>30 days) was detected. The median length of follow-up was 11 years (range 10 months–27 years). Global left ventricular function by echocardiography (M-mode) was within normal limits (>30%) in all patients one year after operation. Functionally, 80% of patients were classified in NYHA class I, 20% in NYHA II, and 0% in NYHA classes III/I... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100440 Thu, 17 Dec 2009 16:35:39 +0100 3100440 http://www.medworm.com/index.php?rid=3100439&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F68%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100439 Thu, 17 Dec 2009 16:35:39 +0100 3100439 http://www.medworm.com/index.php?rid=3100438&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F67%3Frss%3D1 We present a 25-year-old woman with sickle cell disease (SCD) and severe aortic insufficiency. A minimally invasive, warm, beating heart approach was adopted to try and minimize the risk of sickling due to cardiopulmonary bypass (CPB), low-flow states, cold cardioplegia and aortic cross-clamping. Compared to classical methods, we believe our technique further reduces the risk of systemic and organ hypothermia and thus, sickling. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100438 Thu, 17 Dec 2009 16:35:39 +0100 3100438 http://www.medworm.com/index.php?rid=3100437&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F63%3Frss%3D1 Conclusion: Simultaneous open repair of AAA and cardiac surgery is a feasible option for this high-risk and anatomically challenging patient group. This experience highlights the need for close cooperation between vascular and cardiac teams. (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100437 Thu, 17 Dec 2009 16:35:39 +0100 3100437 http://www.medworm.com/index.php?rid=3100436&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F58%3Frss%3D1 Delirium and transient neurologic dysfunctions (TND) often complicate the postoperative course after surgery for acute type-A aortic dissection (AAD). We evaluated the role of clonidine on neurological outcome and respiratory function in 30 consecutive patients undergoing surgery for AAD. Patients were prospectively randomized to receive either clonidine (0.5 µg/kg bolus, followed by continuous infusion at 1–2 µg/kg/h) or placebo (NaCl 0.9%) in on starting and throughout the weaning period from the mechanical ventilation. Incidence of delirium and TND, Delirium Detection Score (DDS), weaning parameters [respiratory rate to tidal volume ratio – f/VT; pressure–frequency product (PFP); partial pressure of arterial oxygen to fractional inspired oxygen co... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100436 Thu, 17 Dec 2009 16:35:39 +0100 3100436 http://www.medworm.com/index.php?rid=3100435&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F53%3Frss%3D1 Widely used low dose helical thoracic computed tomography (CT) scan in screening results is detecting more and more small-sized lung cancers. Whether systematic lymph node (LN) dissection should be done or not on subcentimeter lung cancers still remains controversial. From June 2000 to December 2008, the records of all patients who underwent resection of primary non-small cell lung cancer (NSCLC) 1 cm or less in diameter were reviewed. LN metastases and lymphatic vessel invasion (LVI) were studied between different subgroups to determine the predictors of metastases. Of all 41 patients, there were 35 (85%) cases of adnocarcinoma, 3 (7%) cases of squamous cell carcinoma, 3 (7%) cases of other types. There were 6 (15%) cases with nodal metastase. Lymphatic invasion was found in 11 (27%)... Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100435 Thu, 17 Dec 2009 16:35:39 +0100 3100435 http://www.medworm.com/index.php?rid=3100434&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F52%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3100434 Thu, 17 Dec 2009 16:35:39 +0100 3100434 http://www.medworm.com/index.php?rid=3126492&cid=s_32942_157_f&fid=32942&url=http%3A%2F%2Ficvts.ctsnetjournals.org%2Fcgi%2Fcontent%2Fshort%2F10%2F1%2F26%3Frss%3D1 (Source: Interactive CardioVascular and Thoracic Surgery) Interactive CardioVascular and Thoracic Surgery journals http://www.medworm.com/rss/comments.php?id=3126492 Thu, 17 Dec 2009 16:35:38 +0100 3126492