The heart surgery forum
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The heart surgery forum · Jan 2006
Controlled Clinical TrialAortic valve-sparing operations: early and midterm results.
Aortic valve-sparing operations have provided very good clinical outcomes. However, there is still a debate about valve durability because of the absence of the Valsalva sinuses, and various techniques have been proposed to reproduce the native anatomy of the aortic root. We reviewed our total experience with aortic valve-sparing operations to determine early and midterm outcomes. ⋯ Aortic valve-sparing operations showed excellent results in patients electively operated on for aortic root ectasia, and the results in acute aortic dissection were very disappointing. The Gelweave Valsalva prosthesis demonstrated ease of implantability and good reproduction of the pseuodosinuses. Long-term follow-up is necessary to determine if this graft will enhance the function and increase the durability of the aortic valve.
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The heart surgery forum · Jan 2006
Case ReportsRobotic-assisted left atrial ligation for stroke reduction in chronic atrial fibrillation: a case report.
Patients with atrial fibrillation are at significant risk for sustaining a thromboembolic stroke. More than 90% of thromboemboli form in the left atrial appendage. ⋯ We report a case of port-access robotic-assisted left atrial ligation as a stand-alone procedure in a patient with chronic atrial fibrillation in whom anticoagulation was a contraindication. To our knowledge, this is the first reported case of stand-alone robotic-assisted left atrial ligation in the literature.
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The heart surgery forum · Jan 2006
Clinical TrialThe progress of mitral regurgitation after isolated coronary artery bypass in cases of ischemic mitral regurgitation.
Mitral valve intervention combined with coronary artery bypass surgery is inevitable in the case of severe mitral regurgitation in patients with coronary artery disease because the prognosis is poor without mitral correction. The best treatment protocol for patients with a moderate degree of mitral regurgitation is under debate. To clarify the optimal management for these patients, we evaluated the progress of mitral regurgitation after isolated coronary artery bypass surgery in cases of ischemic mitral regurgitation. METHODS; The study was conducted between March 2001 and April 2003. Forty-seven patients (70% men, with a mean age of 61 years, a mean ejection fraction of 43.7%, and a mean New York Heart Association class of 2.53) with preoperative diagnoses of moderate degree ischemic mitral regurgitation (Grade 3 mitral regurgitation on a scale of 0 to 4) and coronary artery disease, without leaflet pathology, underwent isolated coronary artery bypass surgery. Patients were followed-up at a mean of 22 months and an echocardiographic evaluation was done to determine the progress of the mitral disease. ⋯ Patients with moderate ischemic mitral regurgitation and coronary artery disease who underwent coronary artery bypass surgery alone had acceptable results. We are of the opinion that isolated coronary artery bypass surgery might be a good treatment choice for moderate degree ischemic mitral regurgitation.
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The heart surgery forum · Jan 2006
Controlled Clinical TrialAortic valve replacement in true severe aortic stenosis with low gradient and low ejection fraction.
The results of aortic valve replacement are uncertain among patients with severe aortic stenosis, reduced left ventricular ejection fraction, and low mean transvalvular gradient. The aim of the present study was to report on 27 patients who underwent surgery for aortic stenosis with left ventricular ejection fraction
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The heart surgery forum · Jan 2006
Case ReportsProfound hypothermic cardiac arrest treated successfully using minimally invasive cardiopulmonary bypass: a case report.
Hypothermia is defined as a core temperature of less than 35 degrees C. The decision to resuscitate a hypothermic patient can be difficult, as consideration must be given to whether the patient died before the cooling process. The modality for rewarming must also be considered. ⋯ Cardiopulmonary bypass provides excellent circulatory support for profound hypothermia and allows rapid core rewarming. The femoro-femoral approach is the preferred method for this scenario.