European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Sep 2011
Conventional aortic valve replacement for high-risk aortic stenosis patients not suitable for trans-catheter aortic valve implantation: feasibility and outcome.
High-risk patients with aortic stenosis are increasingly referred to specialist multidisciplinary teams (MDTs) for consideration of trans-catheter aortic valve implantation (TAVI). A subgroup of these cases is unsuitable for TAVI, and high-risk conventional aortic valve replacement (AVR) is undertaken. We have studied our outcomes in this cohort. ⋯ MDT assessment of high-risk aortic stenosis in the era of TAVI has increased the number of referrals. Conventional open surgery remains a valid option for these patients, with acceptable in-hospital mortality and early/midterm outcomes but high in-hospital morbidity.
-
Eur J Cardiothorac Surg · Sep 2011
ReviewModified simple sliding aortoplasty for preserving the sinotubular junction without using foreign material for congenital supravalvar aortic stenosis.
The surgical approach for treating supravalvar aortic stenosis (SVAS) has evolved from a plain patch technique to a three-dimensional patch repair, which has some drawbacks. Here, we report on the midterm outcomes after using our modified simple sliding aortoplasty preserving sinotubular junction without foreign material for surgical correction of SVAS. ⋯ Our modified simple sliding aortoplasty showed excellent surgical results, and may be a good option for discrete SVAS.
-
Eur J Cardiothorac Surg · Sep 2011
Multicenter Study Clinical TrialClinical experience with the ATS 3f Enable® Sutureless Bioprosthesis.
The ATS 3f Enable® Bioprosthesis is a self-expanding valve with a tubular design that allows for decreased leaflet stress and preservation of aortic sinuses. We report the midterm results of a prospective, multicenter clinical study evaluating the safety and efficacy of this stented bioprosthesis in patients undergoing isolated aortic valve replacement with or without concomitant procedures. ⋯ The sutureless valve implantation technique is feasible and safe with the ATS 3f Enable Bioprosthesis. Valve implantation resulted in excellent hemodynamics and significant clinical improvement. Overall, these data confirm the safety and clinical utility of the Enable® Bioprosthesis for aortic valve replacement.
-
We introduced a fast-track program for our cardiac operations requiring adjustment in anaesthesia techniques to facilitate rapid extubation and discharge from the intensive care unit (ICU). Our objective was to investigate the quality of analgesia in fast-track paediatric cardiac patients. ⋯ Our data showed that our program achieves high-quality analgesia in fast-track paediatric cardiac patients.
-
Eur J Cardiothorac Surg · Sep 2011
Randomized Controlled Trial Multicenter StudyWarm-blood cardioplegia with low or high magnesium for coronary bypass surgery: a randomised controlled trial.
Magnesium (Mg²⁺) is cardioprotective and has been routinely used to supplement cardioplegic solutions during coronary artery bypass graft (CABG) surgery. However, there is no consensus about the Mg²⁺ concentration that should be used. The aim of this study was to compare the effects of intermittent antegrade warm-blood cardioplegia supplemented with either low- or high-concentration Mg²⁺. ⋯ Warm-blood cardioplegia supplemented with 16 mmol l⁻¹ Mg²⁺, compared with 5 mmol l⁻¹ Mg²⁺, does not reduce the frequency of postoperative atrial fibrillation in patients undergoing CABG but may reduce cardiac injury. (This trial was registered as ISRCTN95530505.).