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Po Hui Chiang, Yi Yang Liu
PURPOSE: To conduct a retrospective, single institutional and comparative study for radical retropubic prostatectomy (RRP), high dose rate brachytherapy (HDRBT), cryoablation and high-intensity focused ultrasound (HIFU) in localized prostate cancer with respect to oncological and functional outcomes. METHODS: We reviewed 97, 161, 114 and 120 patients of RRP, HDRBT, cryoablation and HIFU respectively for localized prostate cancer from May 2008 to December 2013. PSA biochemical recurrence, salvage treatment-free rate, metastasis-free rate, and biochemical recurrence-free survival were analyzed for oncological outcomes...
2016: SpringerPlus
David J Paulucci, Ronney Abaza, Daniel D Eun, Ashok K Hemal, Ketan K Badani
OBJECTIVES: To evaluate trends in peri-operative outcomes of 250 consecutive cases beyond the initial learning curve (LC) of robot-assisted partial nephrectomy (RAPN) among multiple surgeons. PATIENTS AND METHODS: A multi-institutional database was used to evaluate trends in patient demographics (e.g. age, gender, comorbidities), tumour characteristics (e.g. size, complexity) and peri-operative outcomes (e.g. warm ischaemia time [WIT], operating time, complications, estimated blood loss [EBL], trifecta achievement) in consecutive cases 50-300 (n = 960) from 2008 to 2016 among four experienced surgeons...
November 8, 2016: BJU International
Christian Doose, Maximilian Kütting, Sandrine Egron, Pejman Farhadi Ghalati, Christoph Schmitz, Marc Utzenrath, Alexander Sedaghat, Buntaro Fujita, Thomas Schmitz-Rode, Stephan Ensminger, Ulrich Steinseifer
OBJECTIVES: Bioprosthetic aortic heart valves are increasingly implanted in younger patients. Therefore, a strategy for potential valve failure should be developed before implanting the 'first valve'. The goal of this in vitro study was to provide insight into the effects of the design of a bioprosthesis on a valve-in-valve implanted Sapien XT valve. METHODS: The hydrodynamic performance of a 23-mm Sapien XT valve implanted in Vascutek Aspire, Edwards Perimount, Medtronic Mosaic and St...
October 23, 2016: European Journal of Cardio-thoracic Surgery
Amedeo Anselmi, Vito Giovanni Ruggieri, Bernard Lelong, Erwan Flecher, Hervé Corbineau, Thierry Langanay, Jean-Philippe Verhoye, Alain Leguerrier
OBJECTIVE: To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR). METHODS: We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively. RESULTS: Operative mortality was 3...
August 30, 2016: Journal of Thoracic and Cardiovascular Surgery
Longfei Liu, Lin Qi, Yangle Li, Minfeng Chen, Chao Li, Xu Cheng, Peihua Liu, Xiongbing Zu
OBJECTIVES: T1 ventral renal hilar tumors (VRHTs) represent a very special type of tumor, for which laparoscopic partial nephrectomy (LPN) by the retroperitoneal approach is challenging. In this study, we report our surgical technique and Trifecta results. METHODS: Renal rotation technique has been established for retroperitoneal laparoscopic partial nephrectomy (RLPN) for VRHTs in our institution. Trifecta was used as a composite outcome measure for assessing quality of PLPN using this technique...
September 26, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Aly Ghoneim, Ismail Bouhout, Philippe Demers, Amine Mazine, Mary Francispillai, Ismail El-Hamamsy, Michel Carrier, Yoan Lamarche, Denis Bouchard
OBJECTIVE: Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging problem. The objective of this study was to compare 4 surgical approaches in terms of hemodynamics and perioperative outcomes. METHODS: A retrospective single-center study included 351 consecutive patients with a small aortic annulus (≤21 mm) who underwent aortic valve surgery between January 2007 and December 2014. Surgical techniques included standard AVR in 259 (74%) patients, aortic root enlargement in 20 (6%), implantation of a stentless bioprosthesis in 23 (6%), and sutureless AVR in 49 (13%)...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Ali Abdel Raheem, Atalla Alatawi, Irela Soto, Dae Keun Kim, Lawrence Hc Kim, Glen Denmer Santok, Trenton Gh Lum, Young Deuk Choi, Koon Ho Rha
OBJECTIVES: To analyze long-term outcomes of robot-assisted partial nephrectomy for treatment of complex cystic renal tumors. METHODS: We retrospectively analyzed the data of patients who underwent robot-assisted partial nephrectomy for cystic (n = 32) and solid (n = 263) renal masses at Severance Hospital, Seoul, Korea. The primary outcome was assessment of perioperative safety for cystic tumor. Secondary outcomes were evaluation of long-term oncological and functional results...
December 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Giuseppe Santarpino, Jurij M Kalisnik, Theodor Fischlein, Steffen Pfeiffer
Aortic valve bioprostheses are commonly implanted in the current era (also in younger patients) as they may obviate the need for anticoagulation while providing better hemodynamic performance and a more favorable quality of life. The steady increase in the use of biological valves has prompted the development of several different models of conventional stented bioprostheses. At present, there are four main types of stented aortic bioprostheses that compete in the market: the LivaNova Crown PRT (LivaNova Group, Burnaby, Canada), the St...
October 2016: Minerva Cardioangiologica
Brian C Gulack, Ehsan Benrashid, Robert D B Jaquiss, Andrew J Lodge
BACKGROUND: Outcomes after surgical pulmonary valve replacement (PVR) in patients with congenital cardiac disease are limited by long-term valve deterioration, which may be hastened by turbulent flow. The use of the Trifecta valve (St. Jude Medical, Little Canada, MN) at our institution (Duke University Medical Center, Durham, NC) appears to result in low postimplantation transvalvular gradients. This study was performed to compare the early transvalvular gradient associated with the Trifecta valve with that associated with two other valves commonly used for PVR...
August 25, 2016: Annals of Thoracic Surgery
Christian Buchholz, Andreas Mayr, Ariawan Purbojo, Martin Glöckler, Okan Toka, Robert A Cesnjevar, André Rüffer
OBJECTIVES: This retrospective single-centre review presents mid- and long-term results of stented biological valves (SBVs) in the pulmonary position. METHODS: Fifty-two SBVs (17 Carpentier-Edwards Supraannular; 13 Carpentier-Edwards Perimount; 12 St. Jude Medical Trifecta; 4 Sorin Mitroflow; 4 Sorin Soprano; 2 Sorin More) were implanted between 2000 and 2015. The median valve size, patient age and weight were 23 mm (range 19-27), 22.8 years (range 5-77) and 62...
August 22, 2016: Interactive Cardiovascular and Thoracic Surgery
Steffen Lebentrau, Sven Rauter, Daniel Baumunk, Frank Christoph, Frank König, Matthias May, Martin Schostak
INTRODUCTION: If technically feasible, organ-preservation is indicated for T1 renal cell carcinoma (RCC), since partial nephrectomy (PN) is equivalent to radical nephrectomy with regard to tumor-specific survival and probably achieves better overall survival. Treatment results of a training clinic were assessed with regard to guideline adherence and treatment quality. METHODS: Based on 220 open interventions in the time periods 2006-2009 (TP1) and 2010-2013 (TP2), a retrospective single center examination was performed to determine the influence of patient-age, sex, BMI, ASA-score, preoperative eGFR, PADUA-score and surgeon's experience on PN-rate and trifecta-outcome (R0 resection, warm ischemia time ≤25 min, no intraoperative complications and no blood-transfusion and postoperative complications grade ≤1 Clavien and Dindo)...
August 12, 2016: World Journal of Urology
Takehiro Sejima, Shuichi Morizane, Kazunori Fujiwara, Keigo Ashida, Hiroaki Saito, Yuji Taniguchi, Hiroshige Nakamura, Atsushi Takenaka
BACKGROUND: To ensure safe performance in robotic surgery, the Minimal Invasive Surgery Center (MISC) is composed of the anesthesiology department, five surgery departments and co-medical staff in our institution. The objective of this study was to evaluate the outcomes of different types of robotic surgeries for cancer treatment (n = 326) from different surgery departments in the MISC. METHODS: The outcomes of robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), transoral robotic surgery (TORS) for pharyngeal cancer, and robotic surgery for lung, gastric and rectal cancer were evaluated using the similar concept of pentafecta in RARP...
June 2016: Yonago Acta Medica
Yoshie Sakasai, Akinobu Sasaki, Osamu Shigeta, Yasuaki Tsumagari, Hidekazu Tsuneoka, Masako Misaki, Noriyuki Takeyasu
A 77-year-old woman presented with a 3-week history of low grade fever, appetite loss and dizziness. An electrocardiogram showed complete heart block. Echocardiography demonstrated severe aortic valve stenosis and a mass of probable vegetation 2 cm in diameter on the atrioventricular septum in the right atrium (RA), but no obvious intra-cardiac fistula. There was no growth of organism in blood cul tures. In the 4th week after admission, a harsh and continuous cardiac murmur was detected for the 1st time. Portable echocardiography revealed disappearance of the mass in the RA, and showed an intra-cardiac shunt from the left ventricle( LV) to RA...
August 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Fraser D Rubens, Yen-Yen Gee, Janet M C Ngu, Li Chen, Ian G Burwash
OBJECTIVES: We sought to assess the effect of 2 contemporary pericardial valves on left ventricular mass regression and clinical outcomes after aortic valve replacement (AVR) in patients with aortic stenosis (AS). METHODS: Patients were followed postoperatively in a dedicated valve clinic. A propensity score was derived for each patient and used to adjust all analyses. Longitudinal analysis was performed using a repeated measures growth curve model. Survival analysis was assessed with a Cox proportional hazards model...
June 18, 2016: Journal of Thoracic and Cardiovascular Surgery
Paolo Verze, Paolo Fedelini, Francesco Chiancone, Vito Cucchiara, Roberto La Rocca, Maurizio Fedelini, Clemente Meccariello, Alessandro Palmieri, Vincenzo Mirone
PURPOSE: In recent times there has been a trend in mininvasive renal tumour surgery. Very limited evidence can be found in literature of the outcomes of laparoscopic partial nephrectomy (LPN) for highly complex renal tumours. The aim of the present study was to assess the feasibility and safety of LPN for renal tumours of high surgical complexity in our single-institutional experience, comparing perioperative and functional data between clampless and clamped procedures. MATERIALS AND METHODS: We enrolled 68 patient who underwent a clampless LPN (Group A) and 41 patients who underwent a clamped LPN (Group B) for a renal tumour with a R...
June 20, 2016: World Journal of Urology
Sina Stock, Michael Scharfschwerdt, Roza Meyer-Saraei, Doreen Richardt, Efstratios I Charitos, Hans-Hinrich Sievers, Thorsten Hanke
Background The transcatheter aortic valve-in-valve implantation (TAViVI) is an evolving treatment strategy for degenerated surgical aortic valve bioprostheses (SAVBs) in patients with high operative risk. Although hemodynamics is excellent, there is some concern regarding coronary obstruction, especially in SAVB with externally mounted leaflet tissue, such as the Trifecta (St. Jude Medical Inc., St. Paul, Minnesota, United States). We investigated coronary flow and hydrodynamics before and after TAViVI in a SAVB with externally mounted leaflet tissue (St...
June 15, 2016: Thoracic and Cardiovascular Surgeon
Kazufumi Yoshida, Naoto Fukunaga, Yoshito Sakon, Tadaaki Koyama
No abstract text is available yet for this article.
August 2016: Journal of Cardiac Surgery
John B Chambers, Denise Parkin, James Roxburgh, Vinayak Bapat, Christopher Young
AIM: To compare the classical and simplified form of the continuity equation in small Trifecta valves. METHODS: This is a retrospective analysis of post-operative echocardiograms performed for clinical reasons after implantation of Trifecta bioprosthetic valves. RESULTS: There were 60 patients aged 74 (range 38-89) years. For the valves of size 19, 21 and 23mm, the mean gradient was 11.3, 10.7 and 9.7mmHg, respectively. The effective orifice areas by the classical form of the continuity equation were 1...
March 2016: Echo Research and Practice
Giordano Tasca, Gianfranco Beniamino Fiore, Andrea Mangini, Claudia Romagnoni, Amando Gamba, Alberto Redaelli, Carlo Antona, Riccardo Vismara
Pericardial and porcine stented aortic valves have different leaflet kinematics. To study the biomechanics of a prosthesis thoroughly, the in vitro setting is the most appropriate. The aim of our study was to find out whether the prosthesis design in which the pericardial sheet is outside the stent post might influence the opening and closing patterns of the leaflets. Four pericardial prostheses (Magna Ease [MG] 21, Trifecta [TRI] 21, Soprano-Armonia [SA] 20 and Mitroflow [MF] 23) that fitted aortic roots with a native annulus diameter of 2...
May 26, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Ali Abdel Raheem, Atalla Alatawi, Dae K Kim, Abulhasan Sheikh, Ibrahim Alabdulaali, Woong K Han, Young D Choi, Koon H Rha
OBJECTIVES: To compare perioperative trifecta achievement and long-term oncological and functional outcomes between patients with renal tumours of low [Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score 6-7], intermediate (PADUA score 8-9) and high (PADUA score ≥10) complexity undergoing robot-assisted partial nephrectomy (RAPN), and to determine predictors for trifecta achievement. PATIENTS AND METHODS: Data were retrospectively analysed from 295 patients, who underwent RAPN, between 2006 and 2015, at a high-volume tertiary centre...
April 22, 2016: BJU International
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