Staged bilateral lung volume reduction surgery - the benefits of a patient-led strategy.

Objective: Lung volume reduction surgery (LVRS) is conventionally a one-staged bilateral operation. We hypothesised that a more conservative staged bilateral approach determined by the patient not the surgeon would reduce operative risk and prolong the overall benefit.

Methods: In a population of 114 consecutive patients who were identified as suitable for bilateral LVRS an initial cohort of 26 patients (15 male; 11 female, median age: 58 years) underwent one-staged bilateral surgery: 18 by median sternotomy and eight by video-assisted thoracoscopic surgery (VATS) (group OB).

Two-center prospective randomized controlled trial of Blake versus Portex drains after cardiac surgery.

Objective: To compare the efficacy of two drain types after cardiac surgery in a randomized controlled trial, with primary outcome measure being depth of pericardial effusion 3 to 5 days after drain removal.

Methods: A prospective randomized controlled trial was conducted at two university hospitals. A total of 199 patients undergoing first-time cardiac procedures were randomized at surgery to receive either small-bore flexible Blake drains (19F) or larger Portex drains (28F).

Aspire porcine bioprosthesis: ten years' experience.

Background And Aim Of The Study: Clinical results of this multicenter study of the Aspire porcine valve were reported previously at eight years; the present report provides an update of valve performance to 10 years postoperatively.

Methods: A total of 749 patients (60% males; mean age 73+/-7 years) underwent implantation with the Aspire (Tissuemed) porcine bioprosthesis between 1991 and 2002, at three institutions. Follow up was complete for 98% of the cohort.

The increase in body mass index observed after lung volume reduction may act as surrogate marker of improved health status.

Objective: To assess the effects of lung volume reduction surgery (LVRS) on body mass index (BMI).

Methods: Prospective data was collected on a series of 63 patients undergoing LVRS (bilateral in 22 patients, unilateral in 41 patients). Median age was 58 (41-70) years.

The long-term health status improvements seen after lung volume reduction surgery.

Objectives: To correlate the long-term changes in respiratory physiology, body mass index (BMI) and health status after lung volume reduction surgery (LVRS).

Patients/methods: From 1995 to 2002 77 patients; 48 male: 29 female, median age 59 (41-72) years, have undergone LVRS (simultaneous bilateral in 27; staged bilateral in 3; unilateral in 47). FEV(1), total lung capacity (TLC), residual volume (RV) and RV/TLC ratio were measured preoperatively and at 3 months, 6 months, 1 year, 2 years, 3 years and 4 years post surgery.

Mitral valve relpair and revascularization for ischemic mitral regurgitation: predictors of operative mortality and survival.

Background And Aims Of The Study: Surgery for ischemic mitral regurgitation (IMR) is required in 4-5% of patients subjected to coronary artery surgery, and may be challenging. The study aim was to determine outcome following mitral valve repair and myocardial revascularization for moderate-to-severe IMR.

Methods: A total of 102 patients (mean age 68+/-7 years) underwent mitral valve repair for IMR between 1998 and 2001 at the authors' unit.