Search results for "operative"
showing 10 items of 2781 documents
Patterns and diagnostic value of cardiac troponin I vs. troponin T and CKMB after OPCAB surgery.
2001
Cardiac troponin I (cTnI) has been shown to be a specific marker for myocardial injury in cardiac surgery. The object of this prospective study was to determine the patterns and kinetic and diagnostic value of cTnI, cardiac troponin T (cTnT), and creatine kinase MB (CKMB) activity after minimally invasive coronary revascularization using an octopus device on the beating heart (OPCAB).48 patients (33 male/15 female, mean age 68.3 +/- 8.7 years) underwent their first elective OPCAB surgery with median sternotomy without mortality. The mean number of grafts was 2.0 +/- 0.8 per patient. Preoperative mean ejection fraction was 56.6 % +/- 14.9%. CTnI and T levels, total creatine kinase (CK) and C…
In-hospital mortality following lung cancer resection: nationwide administrative database.
2016
Our aim was to determine the effect of a national strategy for quality improvement in cancer management (the “Plan Cancer”) according to time period and to assess the influence of type and volume of hospital activity on in-hospital mortality (IHM) within a large national cohort of patients operated on for lung cancer.From January 2005 to December 2013, 76 235 patients were included in the French Administrative Database. Patient characteristics, hospital volume of activity and hospital type were analysed over three periods: 2005–2007, 2008–2010 and 2011–2013.Global crude IHM was 3.9%: 4.3% during 2005–2007, 4% during 2008–2010 and 3.5% during 2011–2013 (p<0.01). 296, 259 and 209 centres p…
Change from Hybrid to Fully Minimally Invasive and Robotic Esophagectomy is Possible without Compromises.
2018
Background The incidence of esophageal carcinoma is increasing in the western world, and esophageal resection is the essential therapy. Several studies report advantages of minimally invasive esophagectomies (MIEs) versus conventional open procedures (OPs). The benefits of the use of fully MIE or robot-assisted MIE (RAMIE) compared with the hybrid approaches (laparoscopic gastric preparation and open transthoracic esophagectomy) remain unclear. Methods Between July 2015 and August 2017, the data of 75 patients with esophageal carcinoma were prospectively registered. Of the 75 patients, 25 treated with a hybrid MIE (hybrid), 25 with total MIE (MIE), and 25 with RAMIE. All patients were oper…
Strategies for endovascular aortic repair in aortobronchial and aortoesophageal fistulas.
2013
Objective To report our experience of thoracic endovascular aortic repair (TEVAR) for acute bleeding originating from the thoracic aorta in patients with aortobronchial fistula (ABF) or aortoesophageal fistula (AEF). Patients and Methods A total of nine patients (three woman) were treated from September 1995 to March 2012 by TEVAR for ABF (n = 5) and AEF (n = 4). The implants (N = 14) were introduced with fluoroscopic guidance via the aorta (n = 1), the iliac (n = 2), or femoral (n = 11) artery, respectively. Results All aortic lesions could be sealed successfully. Perioperative morbidity was 0% in the ABF group and 50% (2 of 4) in the AEF group and no procedure-related morbidity was noted …
Feasibility of transcatheter aortic valve implantation in patients with coronary heights ≤7 mm: insights from the transcatheter aortic valve implanta…
2018
OBJECTIVES Transcatheter aortic valve implantation (TAVI) in patients with low coronary heights is generally denied but is not impossible. Information about these high-risk procedures is sparse. METHODS Since May 2008, data of more than 3000 patients who had TAVI were prospectively collected in the institutional TAVI Karlsruhe registry. Characteristics, peri- and postoperative outcome of patients with low coronary heights of ≤7 mm were analysed according to the Valve Academic Research Consortium-2. RESULTS Eighty-six patients with an average coronary height of 6.4 ± 1.1 mm (mean age 81.0 ± 5.3 years, logistic EuroSCORE I 19.6 ± 13.3%) were treated. TAVI was performed in 72 transfemoral (83.…
Intraoperative cryoablation of atrial fibrillation with the old-fashioned cryode tips: a simple, effective, and inexpensive method.
2006
Nowadays atrial fibrillation is usually treated simultaneously with cardiac procedures, and new cryo-systems have been developed for performing easier and faster intraoperative ablation. However, the old cryode designs can still be useful in surgical practice and represent a more cost-effective method. In this article we present a technique using old-fashioned cryodes for intraoperative treatment of atrial fibrillation and comment on its advantages and limitations.
Training Cardiac Surgeons: Safety and Requirements.
2021
To analyze whether cardiac surgical residents can perform their first surgeries without compromising patients' safety or outcomes, by comparing their performance and results to those of senior surgeons. All documented CABGs conducted between 2002 and 2020 were included. Surgeries were divided according to the experience level of the main surgeon (defined by the number of CABG conducted by him/her) using the following thresholds: 1000; 150; 80 and 35. This resulted in 5 groups: senior surgeons (the reference group); attending surgeons; fellow surgeons; advanced residents and new residents. Primary endpoint was 30 day mortality. Secondary endpoints included a list of intra and post-operative …
Peri-Partum respiratory management in neuro-muscular disorders (IT-NEUMA-Pregn study): A proposal by an italian panel and a call for an international…
2023
Advances in the management of patients with neuromuscu- lar diseases (NMDs) have improved patient survival1 3 with increasing pregnancies prevalence.4 NMDs have a broad spectrum of presentation and a subgroup of these women are at risk of developing pulmonary complications (PCs) mainly due to respiratory muscle weakness leading to hypoventilation and ineffective cough
Prognostic scoring system predictive of survival after surgical resection of esophageal carcinoma.
2013
BACKGROUND The aim of our study was to develop a prognostic index score for patients undergoing surgical resection for esophageal cancer that accurately determines survival with specific clinicopathological characteristics. METHODS Clinical, histological, and demographical variables of 475 patients were entered in an univariate and multivariate regression model, followed by individual calculation of the Prognostic Indicator Score and model validation via simulation. RESULTS Significant variables included in the scoring system were number of positive lymph nodes, pT, pL, R, obesity, and American Society of Anesthesiologist classification. Survival probability and its associated hazard functi…
Is the Parsonnet's score a good predictive score of mortality in adult cardiac surgery: assessment by a French multicentre study.
1997
Objecti6e: Parsonnet proposed a preoperative score (‘‘initial Parsonnet’s score’’, which predicts the hospital mortality of adult cardiac surgery. This score was then modified by including several risk factors used in the ‘SUMMIT’ system (‘‘modified Parsonnet’s score’’, 44 variables). We wanted to assess the predictive value of these two scores in a French surgical population. Methods: From December 1992 to April 1993, in France, we organised a prospective multicentre study on adult cardiac surgery mortality and morbidity. Data on 6649 patients were included. We analysed statistically the predictive value of each risk factor and of the two scores on mortality and morbidity at one month. Res…