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1.
Artigo em Inglês | MEDLINE | ID: mdl-38626902

RESUMO

BACKGROUND: The benefits of minimally invasive techniques in cardiac surgery remain poorly defined. We evaluated the short- and mid-term outcomes after surgical aortic valve replacement through partial upper versus complete median sternotomy (MS) in a large, German multicenter cohort. METHODS: A total of 2,929 patients underwent isolated surgical aortic valve replacement via partial upper sternotomy (PUS, n = 1,764) or MS (n = 1,165) at nine participating heart centers between 2016 and 2020. After propensity-score matching, 1,990 patients were eligible for analysis. The primary end point was major adverse cardiac and cerebrovascular events (MACCE), a composite of death, myocardial infarction, and stroke at 30 days and in follow-up, up to 5 years. Secondary end points were acute kidney injury, length of hospital stay, transfusions, deep sternal wound infection, Dressler's syndrome, rehospitalization, and conversion to sternotomy. RESULTS: Unadjusted MACCE rates were significantly lower in the PUS group both at 30 days (p = 0.02) and in 5-year follow-up (p = 0.01). However, after propensity-score matching, differences between the groups were no more statistically significant: MACCE rates were 3.9% (PUS) versus 5.4% (MS, p = 0.14) at 30 days, and 9.9 versus 11.3% in 5-year follow-up (p = 0.36). In the minimally invasive group, length of intensive care unit (ICU) stay was shorter (p = 0.03), Dressler's syndrome occurred less frequently (p = 0.006), and the rate of rehospitalization was reduced significantly (p < 0.001). There were 3.8% conversions to full sternotomy. CONCLUSION: In a large, German multicenter cohort, MACCE rates were comparable in surgical aortic valve replacement through partial upper and complete sternotomies. Shorter ICU stay and lower rates of Dressler's syndrome and rehospitalization were in favor of the partial sternotomy group.

2.
Heart Surg Forum ; 14(3): E207-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21676692

RESUMO

Cardiac hemangiomas are quite rare benign tumors of vascular origin often detected incidentally during routine examinations. Here we present the diagnostic evaluation and excisional biopsy of such a cardiac tumor in a 20-year-old man.


Assuntos
Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração/patologia , Ventrículos do Coração/cirurgia , Hemangioma/diagnóstico , Hemangioma/cirurgia , Humanos , Achados Incidentais , Masculino , Resultado do Tratamento , Adulto Jovem
3.
Clin Cardiol ; 34(3): E6-8, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21268029

RESUMO

Alveolar soft part sarcoma is a rare soft-tissue neoplasm that accounts for <1% of all soft-tissue sarcomas. Most cases arise in the extremities and head and neck region of young adults. The common sites of metastasis are lung, brain, and bone. Cardiac metastasis is extremely rare, in particular. Here we present the diagnostic evaluation and successful surgical resection of such a cardiac tumor in a patient aged 50 years with a histology-confirmed diagnosis of metastatic alveolar soft part sarcoma.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Cardíacas/patologia , Sarcoma Alveolar de Partes Moles/secundário , Biomarcadores Tumorais/análise , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Terapia Combinada , Ecocardiografia , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Ventrículos do Coração , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Sarcoma Alveolar de Partes Moles/diagnóstico por imagem , Sarcoma Alveolar de Partes Moles/cirurgia
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