Abstract:
:A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the of vegetations in endocarditis is an indication for surgery. Altogether, 102 papers were found using the reported search; 16 papers were identified that provided the best evidence to answer the question. The authors, journal, date, country of publication, patient group, study type, relevant outcomes and results were tabulated. The vegetation size was classified into small (<5 mm), medium (5-9 mm), or large (≥10 mm) using echocardiography and a vegetation size of ≥10 mm was a predictor of embolic events and increased mortality in most of the studies with left-sided infective endocarditis. For large vegetations--that commonly resulted from the failure of antibiotics to decrease the vegetation size during 4-8 weeks' therapy--and complications such as perivalvular abscess formation, valvular destruction and persistent pyrexia necessitated surgical intervention. In a multicentre prospective cohort study of 384 consecutive patients with infective endocarditis, it was observed that a vegetation size of >10 mm and severe vegetation mobility were predictors of new embolic events. Equally, a meta-analysis showed that the echocardiographic detection of a vegetation size of ≥10 mm in patients with left-sided infective endocarditis posed significantly increased risk of embolic events. In another prospective cohort study of 211 patients, it was observed that there was an increased risk of embolization with vegetations of ≥10 mm. In similarly another study of 178 consecutive patients with infective endodarditis assessed by echocardiographic study, it was found out that there was a significantly higher incidence of embolism with a vegetation size >10 mm (60%, P<0.001). When using the area of the vegetation, a vegetation size of >1.8 cm(2) predicted the development of a complication. Assuming that the vegetation was a sphere, the calculated diameter will be 8 mm when using 4Ωr(2) for the area. However, for right-sided infection endocarditis, a vegetation size of >20 mm was associated with a higher mortality when compared with a vegetation size of ≤20 mm. There is strong evidence to suggest that a vegetation size of ≥10 mm especially for left-sided infective endocarditis is an indication for surgery.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Okonta KE,Adamu YBdoi
10.1093/icvts/ivs365subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1052-6issue
6eissn
1569-9293issn
1569-9285pii
ivs365journal_volume
15pub_type
杂志文章,评审abstract::There is still no consensus on the optimal management to treat pediatric mediastinitis. We assessed the efficacy of continuous irrigation and vacuum-assisted closure (VAC) for mediastinitis in children. This study retrospectively reviewed 20 patients aged <5 years with mediastinitis from December 2002 to December 2009...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.235903
更新日期:2010-09-01 00:00:00
abstract::A 80-year-old lady was admitted because of dyspnea, complete AV block and ventricular rate of 15 bpm. A DDDR pacemaker was successfully implanted. Postoperative EKG showed right bundle branch block and X-ray the ventricular lead in the left ventricle. It traveled all the way through a foramen ovale being later relocat...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00185-3
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abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether treatment with magnesium in addition to an anti-arrhythmic is beneficial to patients who have gone into atrial fibrillation after cardiac surgery. Altogether 466 papers were identified using the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.106419
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:Although the use of transcatheter aortic valve replacement (TAVR) has recently become an attractive strategy in extremely high-risk patients undergoing aortic valve replacement (AVR), the most appropriate treatment option in patients with an intermediate- to high-risk profile with conventional surgery (sAVR)...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu340
更新日期:2015-01-01 00:00:00
abstract::Success of the modified maze procedure after valvular operation with giant atria and permanent atrial fibrillation (AF) remains suboptimal. We report an aggressive approach for these patients utilizing biatrial reduction plasty with a reef imbricate suture technique concomitantly with valvular and maze procedure for A...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.220012
更新日期:2010-04-01 00:00:00
abstract::The re-entries are still a problem for the endovascular treatment of aortic dissections. A 60-year-old man was treated for an abdominal aortic dissection using aortic monoiliac endograft until the left iliac external artery and a femoro-femoral bypass with occlusion of the right common iliac artery and the left hypoga...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.195164
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of body mass index (BMI) on early outcomes after revascularization using either on-pump or off-pump surgery. METHODS:Data for 3714 of 4314 patients who underwent surgical revascularization at our institution between 1999 and 2008 were analysed. Patients were divided into two group...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu246
更新日期:2014-11-01 00:00:00
abstract::A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was, 'is there an increased risk of cancer in a non-resected corrosive oesophageal stricture?' Altogether, 133 papers were found using the reported search; six papers were identified that provided the...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs320
更新日期:2012-10-01 00:00:00
abstract::Fontan operation and importance of fenestration in the treatment of unusual and complex forms of double outlet right ventricle (DORV) are well established. Nonetheless, rarely, the creation of fenestration becomes challenging in complex morphologies. We present one such child with situs solitus, dextrocardia, DORV, hy...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw190
更新日期:2016-10-01 00:00:00
abstract::The inflammatory myofibroblastic tumour of the lung is considered a rare diagnosis of lung masses. We report the case of a five-year-old girl who presented with recurrent pyrexia, dry cough, and shortness of breath. Chest X-ray and computed tomography showed a total atelectasis of the left lower lobe and a segmental a...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.219089
更新日期:2010-05-01 00:00:00
abstract::Plombage, a variant of collapse therapy for patients with pulmonary tuberculosis that uses a variety of foreign materials, was undertaken until the 1950s before the invention of effective antimicrobial therapy. Complications related to previous plombage procedures are not uncommon. Management of these complications ca...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.220699
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:Dividing the intersegmental planes with a stapler during pulmonary segmentectomy leads to volume loss in the remnant segment. The aim of this study was to assess the influence of segment division methods on preserved lung volume and pulmonary function after segmentectomy. METHODS:Using image analysis softwa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw188
更新日期:2016-10-01 00:00:00
abstract::Ascending aortic dissection with aortic coarctation has a high mortality. There are few reports of successful surgical management of the combined condition. We report a case of a successful one-stage repair of type A aortic dissection with aortic coarctation, using an extra-anatomic bypass to connect the ascending to ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.157685
更新日期:2008-02-01 00:00:00
abstract::Indications for transcatheter valve implantation have been extended to treat native valve aortic regurgitation in case of disproportionate risk for open surgery. Transcatheter aortic valves are also an attractive alternative in patients who refuse blood transfusions. We report the successful off-label implantation of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw180
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:The purpose is to evaluate in vivo at rest and under stress conditions hemodynamic performance of the small size St. Jude Medical Regent (SJMR) prosthetic valve in patients with a body surface area (BSA) of 1.8 ± 0.11 m(2) and to define the role of valve prosthesis- patient mismatch on left ventricular mass ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.283218
更新日期:2011-12-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx026
更新日期:2017-06-01 00:00:00
abstract::Primary spontaneous pneumothorax (PSP) is a very common disease and recurrence is a major concern for the post-first-time victims. Owing to the convenience and popularity of video-assisted thoracoscopic surgery (VATS), should we still wait for recurrence before we perform this minimal invasive procedure to cure the di...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00143-9
更新日期:2003-12-01 00:00:00
abstract::Few studies have described video-assisted thoracic surgery (VATS) to bronchoplasty with pulmonary resection. Here, we report the successful implementation of VATS bronchoplasty, as determined retrospectively. Between 2005 and 2010, 362 patients underwent elective lung resection for malignant or benign lung tumors. Of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.258228
更新日期:2011-04-01 00:00:00
abstract::Infective endocarditis (IE) and surgical procedures related to cardiac surgery are accompanied by inflammatory responses that may alter production of oxidants by phagocytes. This study evaluates luminol enhanced whole blood chemiluminescence (LBCL) as a measure of oxidative production by circulating phagocytes in 26 I...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.183285
更新日期:2009-01-01 00:00:00
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.185702
更新日期:2009-03-01 00:00:00
abstract::Post-myocardial infarction (MI) ventricular septal defect (VSD) is a serious condition that is, fortunately, less diagnosed nowadays due to the advances in early diagnosis and treatment of ischaemic heart disease (incidence 1-2%). Despite the lower mortality of both surgical and interventional closure of the defect (2...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa127
更新日期:2020-10-01 00:00:00
abstract::Although surgical outcomes of total arch replacement have improved, the strategy for extended arch aneurysms remains controversial. We have applied the L-incision approach (combination of left anterior thoracotomy and upper half-median sternotomy) for total arch replacement for single-stage repair of extensive arch an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.266791
更新日期:2011-09-01 00:00:00
abstract::Transcatheter aortic valve implantation (TAVI) is a relatively new treatment option for inoperable patients with severe aortic stenosis (AS). This case describes how a planned conventional surgical aortic valve replacement (AVR) on a 73-year-old woman was successfully converted to a TAVI procedure. On extracorporal ci...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.211144
更新日期:2009-11-01 00:00:00
abstract::We describe a 24-year-old construction worker who was unaware that he had been shot by a pneumatic nail gun in the chest during work. After returning home, he felt some palpitations and mild shortness of breath, and in the mirror discovered a non-bleeding pinpoint skin wound in his upper chest. He admitted himself to ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.272120
更新日期:2011-09-01 00:00:00
abstract::Surgery of aspergilloma has been renowned to be technically challenging and has a high complication rate. We have already demonstrated an improved outcome as a result of a reduction in complex cases related to history of tuberculosis. In this paper we will evaluate whether this time trend has continued during recent y...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.265553
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Our goal was to evaluate the impact of the adult congenital heart disease anatomical and physiological (ACHD AP) classification system on the surgical management of Ebstein anomaly (EA) in adult patients. METHODS:From February 2000 through August 2017, data of patients aged at least 16 years, who underwent ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa294
更新日期:2020-12-13 00:00:00
abstract::Bilateral coronary artery fistulas with the coronary artery stenosis are rare. In this case, we successfully performed closure of coronary artery fistulas with coronary artery bypass grafting. Furthermore, we were able to measure the flow in the coronary artery fistulas using transit-time flow measurement. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr003
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To explore the rule of subcarinal lymph node metastasis in thoracic oesophageal cancer and its clinical significance in the radical resection of oesophageal cancer. METHODS:We retrospectively analysed 2223 patients with oesophageal cancer who were admitted to Henan Cancer Hospital during 2004-2011 and under...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt070
更新日期:2013-06-01 00:00:00
abstract::A best evidence topic was written according to a structured protocol. The question addressed was 'In patients requiring an aortic valve replacement, are rapid deployment aortic valve systems better than conventional aortic valve prostheses in terms of mortality, morbidity and/or valve function?' A total of 508 papers ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivw226
更新日期:2016-11-01 00:00:00
abstract::Prosthetic graft infection with methicillin-resistant Staphylococcus aureus (MRSA) is one of the most serious complications of cardiovascular surgery. Seeking to prevent graft infection, we evaluated the efficacy of a new biodegradable hydrogel glue (new-glue) composed of aldehyded dextran and epsilon-poly(L-lysine) w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.232447
更新日期:2010-07-01 00:00:00