Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
Mais filtros











Base de dados
Intervalo de ano de publicação
1.
J Thorac Cardiovasc Surg ; 164(6): 1712-1724.e10, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-34452760

RESUMO

OBJECTIVES: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. METHODS: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. RESULTS: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, .83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. CONCLUSIONS: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics.


Assuntos
Bioprótese , Endocardite , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Humanos , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Estudos Retrospectivos , Xenoenxertos , Desenho de Prótese , Resultado do Tratamento , Endocardite/cirurgia , Seguimentos
2.
Scand Cardiovasc J ; 51(4): 228-232, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28413911

RESUMO

OBJECTIVES: There is an on-going discussion regarding the recurrence rate after surgery for primary spontaneous pneumothorax by video assisted thoracic surgery (VATS) or by thoracotomy access. This study aimed to describe the recurrence rate, and to identify a possible learning curve, following surgery for primary spontaneous pneumothorax by VATS. DESIGN: All patients who underwent surgery for primary spontaneous pneumothorax by VATS at Karolinska University Hospital 2004-2013 were reviewed. Preoperative and operative characteristics were obtained from medical records. Patients were followed-up through telephone interviews or questionnaires and by review of medical records. The primary outcome of interest was time to recurrence of pneumothorax requiring intervention. Outcomes were compared between patients operated during 2004-June 2010 and July 2010-2013. RESULTS: 219 patients who underwent 234 consecutive procedures were included. The mean follow-up times were 6.3 and 2.9 years in the early and late period, respectively. The postoperative recurrence rate in the early period was 16% (11%-25%), 18% (12%-27%), and 18% (12%-27%), at 1, 3 and 5 years, compared to 1.7% (0.4%-6.8%), 7.6% (3.7%-15%), and 9.8% (4.8%-19%) at 1, 3 and 5 years, in the late period (p = 0.016). CONCLUSIONS: We found that the recurrence rate after thoracoscopic surgery for primary spontaneous pneumothorax decreased significantly during the study period. Our results strongly suggest that thoracoscopic surgery for pneumothorax involve a substantial learning curve.


Assuntos
Pneumotórax/cirurgia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Adulto , Competência Clínica , Feminino , Humanos , Curva de Aprendizado , Masculino , Pneumotórax/diagnóstico , Recidiva , Fatores de Risco , Cirurgiões , Suécia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
3.
Eur J Cardiothorac Surg ; 50(6): 1210-1211, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27261076

RESUMO

Isolated pulmonary atresia is an uncommon condition, which can go undiagnosed for a long time in asymptomatic patients. Sometimes, diagnosis can be made at pregnancy due to respiratory symptoms. There is no known increased risk of pneumothorax. We here present a case where a second-time pregnant woman with an unknown atresia of the right pulmonary artery received a left-sided pneumothorax. The diagnosis was initially missed in spite of adequate imaging and the condition progressed to respiratory stop. We describe the course of diagnostics and the chosen strategy of treatment.


Assuntos
Pneumotórax/etiologia , Complicações Cardiovasculares na Gravidez/diagnóstico , Atresia Pulmonar/complicações , Adulto , Erros de Diagnóstico , Feminino , Humanos , Pneumotórax/diagnóstico por imagem , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Atresia Pulmonar/diagnóstico , Atresia Pulmonar/diagnóstico por imagem , Radiografia , Tomografia Computadorizada por Raios X
5.
Ann Thorac Surg ; 101(3): 1164-6, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26897197

RESUMO

Ventricular rupture is a well-known complication of mitral valve replacement. We report a rare complication in which the strut of a recently implanted mitral bioprosthesis eroded through the ventricular septum. We present the strategy of the reoperation in which the sutures holding the repair patch were also used to support the new prosthesis. In addition to ventricular rupture and obstruction of the left ventricular outflow tract by a mitral bioprosthesis, the risk of iatrogenic ventricular septal defect (VSD) should be considered when choosing, sizing, and implanting a mitral bioprosthesis.


Assuntos
Bioprótese/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Doença Iatrogênica , Insuficiência da Valva Mitral/cirurgia , Ruptura do Septo Ventricular/etiologia , Ruptura do Septo Ventricular/cirurgia , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Ponte Cardiopulmonar/métodos , Ecocardiografia/métodos , Feminino , Seguimentos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Insuficiência da Valva Mitral/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Falha de Prótese , Radiografia , Reoperação/métodos , Medição de Risco , Esternotomia/métodos , Resultado do Tratamento , Ruptura do Septo Ventricular/diagnóstico por imagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA