Apologia for change in management of blunt rupture of the thoracic aorta

Abstract

EuroSCORE topicality. In this work, we have tried to compare EuroSCORE and CABG models. Although 'comparisons' represent interesting and informative analyses, epidemiologists know that a complete variable definition overlapping between studies is quite impossible to reach. We often have to accept intermediate situations, provided that differences are declared in advance and findings interpreted with caution. This concept suits our usual behavior and represents what we actually did in this work.In conclusion, debate on results represents a worthy instrument for the development of scientific research. This is true also for outcome research studies, which can be carried out only with the contribution of different professional figures. Each of them with his own knowledge and limits, admitting and respecting competence and values of all the others. Unfortunately, this does not always happen!

Clinical databases – a double-edged sword!

“…Even if a surgeon has excellent results with open repair of descending thoracic aortic aneurysms like zero mortality and zero paraplegia, there can be little doubt that endovascular aneurysm repair is less invasive (no thoracotomy), can be realized in local anaesthesia without the pump oxgenator and other adjuncts, without intensive care unit in many cases, and a shorter hospital stay [1]. The difference between the open and the endovascular approach is so self-speaking [2,3], that post-traumatic aortic ruptures are now routinely addressed with endovascular techniques in many centres, and this despite the fact that, to the best of this author's knowledge, no double blind randomized trial with sufficient power has been published.…”