A randomized controlled trial to assess the effect of audiotaped consultations on the quality of informed consent in cardiac surgery.

Objective: To evaluate the effect of audiotaping outpatient consultations on informed consent for cardiac surgery.

Design: Randomized controlled trial.

Setting: Tertiary health care center in Scotland.

Health-related quality of life after cardiac transplantation: results of a UK National Survey with Norm-based Comparisons.

Background: Health-related quality of life (HRQOL) is an important measure of outcome that is known to improve after cardiac transplantation, and some studies have suggested that the HRQOL approaches levels found in normal populations. This study presents descriptive analyses of HRQOL and norm-based comparisons after cardiac transplantation in the UK.

Methods: A cross-sectional postal survey of cardiac transplant recipients at their first-, third- or fifth-year anniversary after transplantation was undertaken using the Short Form-36 (SF-36), EuroQol (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) questionnaires.

Post myocardial infarction left ventricular free wall rupture.

Occurrence of left ventricular free wall rupture following myocardial infarction is an unpredictable event associated with very high mortality rate. The most appropriate surgical approach remains controversial. With recent advances in portable echocardiography machines there has been a progressive rise in the number of cases of left ventricular free wall rupture diagnosed and reported.

Informed consent in cardiac surgery: is it truly informed?

Objective: To develop a validated questionnaire to measure how informed patients are when giving consent for elective coronary artery bypass grafting.

Methods: We developed a questionnaire covering the domains described in the consent guidelines published by the General Medical Council. The questionnaire was developed for use in face-to-face interviews as opposed to a self-administered questionnaire.

Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest.

Objectives: The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions.

Design: We conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day.

A randomized, controlled trial of C0- Vs C2-guided therapeutic drug monitoring of cyclosporine in stable heart transplant patients.

Background: Cyclosporine monitoring using 2-hour post-dose samples (C2) is thought to be more efficacious than using pre-dose levels (C0) in managing immunosuppression for transplant patients. We evaluated the effect of C2 monitoring on cyclosporine dose and clinical parameters in stable heart transplant patients.

Methods: 125 stable heart transplant patients were randomized to C0 or C2 monitoring of cyclosporine levels for a period of six months.

Pre-existing renal failure doubles 30-day mortality after heart transplantation.

Background: Survival after cardiac transplantation has not changed over the last 10 years. Our objective was to identify risk factors for 30-day mortality after cardiac transplantation with particular reference to focusing on the impact of pre-existing renal dysfunction.

Methods: We analyzed the data of all 1,180 patients who received a first heart transplant in the 8 adult transplant centers in the United Kingdom between April 1996 and March 2002 using the UK Cardiothoracic Transplant Audit database.

A prospective controlled trial of St. Jude versus Starr Edwards aortic and mitral valve prostheses.

Background: There is a paucity of controlled trials comparing the merits of different heart valve prostheses. In this prospective randomized trial we compared Starr Edwards and St. Jude prostheses in the aortic and mitral positions.

An economic evaluation of lung transplantation.

Objective: This study was undertaken to determine the cost per quality-adjusted life-year gained with lung transplantation relative to medical treatment for end-stage lung disease in the United Kingdom.

Methods: Patients on the transplant waiting list were used to represent medical treatment. Four-year national survival data were extrapolated to 15 years by means of parametric techniques.