European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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We studied the long-term results of vertical plication repair of Ebstein's anomaly according to Carpentier. ⋯ This study demonstrates favourable long-term results following vertical plication repair of Ebstein's anomaly with low mortality, acceptable morbidity and good haemodynamic and functional results.
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Eur J Cardiothorac Surg · Jul 2008
Factors predicting the time until atrial fibrillation recurrence after concomitant left atrial ablation.
Treatment of atrial fibrillation, a risk factor for morbidity and mortality, by left atrial ablation is a less complex procedure which is increasingly performed in conjunction with surgery for various heart diseases. Although restoration of sinus rhythm is effective initially, atrial fibrillation may recur. We investigated factors predicting the time until its recurrence. ⋯ Preoperative atrial fibrillation duration and left atrial diameter predict the time until atrial fibrillation recurrence after concomitant left atrial ablation, whereas age, type of primary cardiac surgery, ablation technology and antiarrhythmic therapy do not.
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Eur J Cardiothorac Surg · Jul 2008
Effect of clopidogrel on bleeding and transfusions after off-pump coronary artery bypass graft surgery: impact of discontinuation prior to surgery.
The use of antiplatelet drugs to treat acute myocardial infarction, unstable angina, acute coronary syndrome and secondary prevention following percutaneous coronary interventions is well accepted. However, it constitutes a serious risk of bleeding for patients undergoing coronary artery bypass grafting surgery (CABG). We evaluated the effect of aspirin and clopidogrel (CPDG), both irreversible platelet aggregation inhibitors, on operative bleeding and determined the optimal timing for their discontinuation before surgery. ⋯ Blood loss is higher in OPCAB patients receiving clopidogrel before surgery. However, discontinuation of clopidogrel three days (72 h) prior to the operation demonstrated a similar blood loss pattern compared to a control group. Clopidogrel is associated with more platelets, but not red blood cell transfusions following OPCAB surgery.
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Eur J Cardiothorac Surg · Jul 2008
Incidence, associated factors and evolution of non-severe functional mitral regurgitation in patients with severe aortic stenosis undergoing aortic valve replacement.
In order to improve the prognosis, repair of severe mitral regurgitation should be undertaken at the same time as aortic valve replacement in patients with severe aortic valve stenosis. However, mitral regurgitation may be secondary to pressure overload or ventricular dysfunction and improve after surgery. ⋯ The presence of intermediate degree mitral regurgitation in patients undergoing isolated aortic valve replacement increases morbidity and mortality. However, a high percentage of those who do survive experience disappearance or improvement of the mitral regurgitation.
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Eur J Cardiothorac Surg · Jul 2008
Late reoperations after neonatal arterial switch operation for transposition of the great arteries.
The arterial switch operation has become the treatment of choice for neonates with transposition of the great arteries. Currently, the early mortality rate is low as well as the need for early reoperation because of surgical failures; in our experience with 803 neonates, these risks were 3.8% and 1.5%, respectively. The late outcome in terms of survival and functional status is excellent. ⋯ Whether this will remain the case in the decades to come requires further evaluation. Left ventricular function is maintained in the vast majority of patients. Reoperation may be indicated in some patients for other reasons: mitral valve malformation, tracheo-bronchial compression or pulmonary hypertension.