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Biomedical subjects

H Vanoverbeke

Publications and source records attributed to H Vanoverbeke.

3 recordsLinked to original sources

Operative outcome of minimal access aortic valve replacement versus standard procedure.

BACKGROUND: to determine the advantages and/or risks of minimal access aortic valve replacement compared to standard sternotomy procedure. METHODS: from January 1997 to December 2001, 271 consecutive adult patients underwent isolated aortic valve replacement of which 174 underwent a minimal access procedure (Group 1) and 97 a standard procedure (Group 2). The preoperative variables of both groups were comparable. Retrospective analysis of postoperative outcome was performed. RESULTS: follow-up was complete and ranged from 6 months to 4 years. Overall in-hospital mortality was 3.3% (respectively 2.8 and 4.1%). No statistical difference was noted regarding operative time variables, mortality rate and hospital stay. There was a significant higher incidence of revision (p = 0.018) and late pericardial effusion (p = 0.022) in the minimal access group. Also trends were in favour of the standard group for incidence of postoperative pneumothorax and pericarditis constrictiva. CONCLUSIONS: minimal access aortic valve replacement is a safe and reliable technique, but carries the risk of incision-related morbidity. Proper patient selection and perioperative management is mandatory.

Aged↗

Paradoxical embolism through a patent foramen ovale.

The high prevalence of clinically silent venous thrombosis and the presence of a patent foramen ovale in up to 35% of the general population suggests that paradoxical embolism (PDE) may be the cause of an ischaemic stroke or a peripheral thrombo-embolic occlusion more often than is presently considered. We report an ante-mortem diagnosed case of PDE and a review of the literature. Contrast echocardiography with provocative manoeuvres is suggested as the key investigation for diagnosis and anticoagulation is the mainstay of therapy.

Aged↗

Muscle-saving lateral axillary thoracotomy.

Seventy-five consecutive thoracotomies through a lateral axillary thoracotomy incision are reviewed. The limited approach is a muscle-splitting incision with preservation of the Latissimus Dorsi and Pectoralis Major muscles and splitting of the Serratus Anterior muscle. Detailed description of the operative technique is given, and a review of morbidity and mortality is included. We conclude that the lateral axillary incision is a good alternative to the standard postero-lateral approach, as it provides excellent visibility and allows for all pulmonary surgical procedures, with minimal postoperative discomfort.

Adult↗