Hybrid Totally Thoracoscopic Maze and Catheter Ablation for Persistent Atrial Fibrillation: Initial Experience.

Atrial fibrillation is now a pandemic in our ageing community. Although James L. Cox devised a surgical procedure with near-universal curative success in 1987, catheter-based interventions have flourished.

4D CT and lung cancer surgical resectability: a technical innovation.

A 74-year-old man presents with a left upper lobe lung adenocarcinoma, which demonstrated a wide base intimately with the aortic arch. We utilised 4D CT technique with a wide field of view CT unit to preoperatively determine likely surgical resectability. We propose that 4D CT may be of use in further investigating lung cancer with likely invasion of adjacent structures.

Prophylaxis against atrial fibrillation after cardiac surgery: beneficial effect of perioperative metoprolol.

Introduction: Multiple agents have been investigated to prevent atrial fibrillation (AF) after cardiac surgery. Several studies have investigated the use of β-blockers such as metoprolol or amiodarone with promising results. We aimed to investigate perioperative pharmacologic prophylaxis against AF using metoprolol, and amiodarone in combination with metoprolol.

KRAS mutation is associated with lung metastasis in patients with curatively resected colorectal cancer.

Purpose: Oncogene mutations contribute to colorectal cancer development. We searched for differences in oncogene mutation profiles between colorectal cancer metastases from different sites and evaluated these as markers for site of relapse.

Experimental Design: One hundred colorectal cancer metastases were screened for mutations in 19 oncogenes, and further 61 metastases and 87 matched primary cancers were analyzed for genes with identified mutations.

What causes post-traumatic empyema?

Background: Empyema post chest trauma is a morbid condition requiring operative intervention (thoracotomy and decortication). It is hypothesized that patients who have a complicated initial pleural drainage procedure are at increased risk of developing an empyema.

Methods: All patients who underwent operative decortication for post-traumatic empyema over a 24 month period (July 2003 to June 2005) were included in the study.

Epicardial high-intensity focused ultrasound cardiac ablation for surgical treatment of atrial fibrillation.

Background: The available alternatives to an effective but technically complex Cox maze procedure for surgical treatment of atrial fibrillation include ablation using radiofrequency, microwave, laser, cryotherapy or ultrasound energy sources. The purpose of this study was to evaluate the safety and efficacy profile of high-intensity focused ultrasound cardiac ablation for the surgical treatment of atrial fibrillation.

Methods: 14 patients underwent epicardial high-intensity focused ultrasound treatment for atrial fibrillation using the Epicor cardiac ablation system between August 2006 and August 2007.

Is informed consent in cardiac surgery and percutaneous coronary intervention achievable?

Background: Medical and legal published work regularly discusses informed consent and patient autonomy before medical interventions. Recent discussions have suggested that Cardiothoracic surgeons' risk adjusted mortality data should be published to facilitate the informed consent process. However, as to which aspects of medicine, procedures and the associated risks patients understand is unknown.

Experience with unipolar radiofrequency ablation for atrial fibrillation.

Background: The cut and sew Cox maze procedure for atrial fibrillation (AF), although effective, is not widely used because of technical complexity, prolonged duration and significant risk of postoperative bleeding. This study reviews our experience with the unipolar radiofrequency ablation (RFA) procedure, which was used to create a modified maze to treat AF.

Methods: A retrospective review of 31 patients undergoing consecutive cardiac surgery who had concomitant RFA for AF over a 16-month period was carried out.

Urgent and emergency coronary artery bypass grafting for acute coronary syndromes.

Background: Urgent and emergency coronary artery bypass grafting may be associated with significant mortality and morbidity. We report our recent experience with this group of patients.

Methods: A retrospective analysis of 441 patients undergoing urgent and emergency surgery over a 3-year period was carried out.

The outcome of cardiac surgery in dialysis-dependent patients.

Background: Patients on dialysis for end-stage renal failure (ESRF) are undergoing cardiac surgery with increasing frequency. Furthermore, ESRF is known to be an important risk factor for complications of cardiac operations performed with cardiopulmonary bypass.

Aims: To evaluate the outcome of dialysis-dependent patients undergoing cardiac surgery at one institution.