Detection of gender differences in incomplete revascularization after coronary artery bypass surgery varies with classification technique.

Background: Incomplete revascularization negatively affects survival after coronary artery bypass surgery (CABG). Since gender and classification technique might impact outcome and reporting, we investigated their effect on revascularization patterns and mortality.

Methods: A cohort of bypass patients (N = 1545, 23% women) was enrolled prospectively.

Heart valve operations in solid organ recipients: an 18-year single-center experience.

Background: We retrospectively analyzed the outcome of heart valve operations in solid organ recipients, who were referred for operation to our institution.

Methods: Over an 18-year period, 23 heart (group 1) and 16 renal (group 2) transplant recipients in New York Heart Association (NYHA) classes III and IV underwent valve operation. The mean interval from the time of transplantation to cardiac surgery was 77.

Myocardial rewarming mirrors intraoperative mammary artery graft function.

Background: The internal mammary artery (IMA) bypass graft provides a satisfactorily long-lasting blood supply to the myocardium. However, its initial flow capacity can be insufficient with subsequent regional myocardial ischemia. We evaluated a method to assess the IMA graft function intraoperatively.

Risk stratification scores for predicting mortality in coronary artery bypass surgery.

Background: Four risk-stratification scores (RSSs - Euro, French, CCS/Higgins, Parsonnet) were tested as predictors of mortality in coronary artery bypass grafting (CABG) surgery.

Methods: From March to April 2000, the perioperative courses of 245 consecutive CABG patients were compared to the predictions according to the RSSs. Sensitivity and specificity were determined with receiver operating characteristics (ROC) curves.

Continuous antegrade blood cardioplegia: cold vs. tepid.

Background: Continuous antegrade blood cardioplegia (CABCP) is used at different temperatures. We investigated the consequences of CABCP at 6 degrees C (COLD) vs. 28 degrees C (TEPID).

Extent of myocardial tissue damage during transmyocardial laser revascularization with the CO2 Heart Laser.

Objective And Background: Transmyocardial laser revascularization (TMR) is the only surgical treatment for patients with severe diffuse coronary artery disease, who are not candidates for bypass grafting or percutaneous angioplasty. However, vaporization of tissue during the creation of channels leads to a certain loss of viable myocardium during every TMR procedure.

Methods: We analyzed serum levels of creatine kinase and creatine kinase MB subtype in 163 patients after sole TMR with a CO2 laser (wave length 10.

Risk scores currently used in German heart surgery.

Background: Risk scores (RS) in heart surgery assess mortality and morbidity and mirror the degree of severity of disease of the patients when presented for surgery. We examined the use and dissemination of RS in Germany.

Material And Methods: Our survey included 79 German heart surgery institutes in Fall 1999 and Winter 2000.

Cold continuous antegrade blood cardioplegia: high versus low hematocrit.

Objective: Cold continuous antegrade blood cardioplegia (CCABCP) is used with different hematocrit values. We investigated the consequences of CCABCP with low hematocrit (LH: 20-25%) versus high hematocrit (HH: 40-45%).

Methods: Anesthetized open chest pigs (25 kg) were placed on cardiopulmonary bypass (CPB).

[Metastasizing malignant germ cell tumor of the testis with infiltration of the thoracic aorta--a case for metastasis surgery].

History And Findings: A 33-year-old man was admitted 7 years after a testicular teratomatous carcinoma had first been diagnosed, treated by a right orchiectomy and two-stage radical retroperitoneal lymphadenectomy. Five years later the first mediastinal metastases were treated with high-dosage chemotherapy and autologous germ-cell transplantation, and remaining paraaortic--mediastinal tumour tissue was resected. Two years later another tumour at that site was only partially resected.

Batista procedure: elliptical modeling against spherical distention.

Objective: Batista's cardio-reduction of mass and diameter changes the geometry of the left ventricle (LV). This in vivo study explores the LV changing from spherical distention to elliptic modeling.

Methods: Nineteen pigs were connected to cardio-pulmonary bypass (CPB), five of them without cardiac alteration (controls).

Hypocalcemia in piglets reduces cardiac and pulmonary vascular disturbance after hypoxemia and reoxygenation during cardiopulmonary bypass.

Background: Placing cyanotic newborns on cardiopulmonary bypass (CPB) and performing abrupt reoxygenation affects myocardial performance. This study tests the hypothesis that hypocalcemia is beneficial in this circumstance of reoxygenation.

Methods: Twenty-one newborn piglets (anesthetized, open-chests) were placed for one hour on CPB.

Restoring the remodeled enlarged left ventricle: experimental benefits of in vivo porcine cardioreduction in the beating open heart.

Conceptual models have been used to assess the efficacy of cardioreduction (i.e., Batista procedure) because in vivo models were not available.

Influence of different routes of flush perfusion on the distribution of lung preservation solutions in parenchyma and airways.

Objective: The present study was performed to investigate the influence of different routes of perfusion on the distribution of the preservation solutions in the lung parenchyma and upper airways.

Methods: Pigs were divided into four groups: control (n = 6), pulmonary artery (PA) (n = 6), simultaneous PA + bronchial artery (BA) (n = 8), and retrograde delivery (n = 6). After preparation and cannulation, cardioplegia solution and Euro-Collins solution (ECS) for lung preservation were given simultaneously.

Endothelial stunning and myocyte recovery after reperfusion of jeopardized muscle: a role of L-arginine blood cardioplegia.

Ischemia and reperfusion may damage myocytes and endothelium in jeopardized hearts. This study tested whether (1) endothelial dysfunction (reduced nitric oxide release) exists despite good contractile performance and (2) supplementation of blood cardioplegic solution with nitric oxide precursor L-arginine augments nitric oxide and restores endothelial function. Among 30 Yorkshire-Duroc pigs, 6 received standard glutamate/aspartate blood cardioplegic solution without global ischemia.

Submitral left ventricular tuberculoma.

A 62-year-old woman suffered from increasing dyspnea and an impaired general condition. Chest roentgenograms and echocardiogram showed a dense mass at the left atrioventricular junction resulting in the preoperative working diagnosis of a myocardial myxoma. Intraoperatively, an isolated tuberculoma was found caudal to the posterior leaflet of the mitral valve.

Distribution of lung preservation solutions in parenchyma and airways: influence of atelectasis and route of delivery.

Background: Bronchial healing remains one of the dominant issues in lung transplantation. Among other factors the quality of airway protection during lung procurement may contribute to improve bronchial healing.

Methods: Thirty-three pigs were divided into four groups: controls (n = 6), those receiving antegrade delivery of Euro-Collins solution with (n = 4) and without prostacyclin (n = 9), and those receiving retrograde delivery of Euro-Collins solution (n = 14).

Circulating endothelin in patients undergoing coronary artery bypass grafting.

Increased synthesis of endothelin, (a powerful physiological vasoconstrictor), is a uniform response to endothelial injury and has been associated with myocardial ischemia and reperfusion. This study tests the hypothesis that coronary artery bypass grafting (CABG) affects endothelin plasma concentrations in various vascular beds. Twenty-four CABG patients were included in this study.

[An isolated tuberculoma in the left ventricle].

In the course of 8 weeks, a 62-year-old woman with chronic bronchitis developed increasing dyspnoea on effort and reduced well-being. The chest radiograph revealed a round focus, 2 x 3 cm, in the region of the left ventricle which, from the results of echocardiography and left-heart catheterization, suggested myxoma. At open-heart surgery under extracorporeal circulation an encapsulated tumour was found on the mural leaflet of the mitral valve, directly caudal of the atrioventricular plane.

Alpha-adrenoceptor mediated facilitation of acetylcholine release in the rat perfused heart.

Rat hearts were isolated with the vagus nerves intact and perfused, and the neuronal acetylcholine stores were pulse labeled with [14C]choline. The overflow of [14C]choline/acetylcholine evoked by extrinsic vagus nerve stimulation (3 Hz and 720 pulses or 10 Hz and 1200 pulses) was determined by liquid scintillation spectrometry and used as a measure for acetylcholine release. The postjunctional changes in atrial contraction and beating frequency were also recorded.