Clinical evaluation of new generation oxygenators with integrated arterial line filters for cardiopulmonary bypass.

New generation oxygenators with integrated arterial line filters have been marketed to improve the efficacy of cardiopulmonary bypass (CPB). Differences in designs, materials, coating surfaces, pore size of arterial filter, and static prime exist between the oxygenators. Despite abundant preclinical data, literature lacks clinical studies.

"Polarizing" microplegia improves cardiac cycle efficiency after CABG for unstable angina.

Background: Myocardial protection during coronary artery bypass grafting (CABG) for unstable angina (UA) still represents a major challenge, ought to the risk for further ischemia/reperfusion injury. Few studies investigate the biochemical, hemodynamic and echocardiographic results of microplegia (Mic) in UA.

Methods: Eighty UA-patients undergoing CABG were randomized to Mic (Mic-Group) or standard 4:1 blood Buckberg-cardioplegia (Buck-Group).

How should I wean my next intra-aortic balloon pump? Differences between progressive volume weaning and rate weaning.

Objective: Although the intra-aortic balloon pump is the most used ventricular assist device, no study has ever evaluated the best weaning method. We compared 2 different intra-aortic balloon pump weaning methods.

Methods: Thirty consecutive patients needing an intra-aortic balloon pump because of perioperative low-output cardiac syndrome were randomized to be weaned by ratio (4 consecutive hours of a 1:2 assisting ratio followed by 1 hour of a 1:3 ratio; group R) or by progressive volume deflation (10% of total volume every hour for 5 consecutive hours; 15 patients, group V).

Myocardial protection in heart transplantation using blood cardioplegia: 12-year outcome of a prospective randomized trial.

Background: Blood cardioplegia yields a lower prevalence of right heart failure, arrhythmias, and myocardial ischemia early after heart transplantation (HTx). Because depolarizing (high [K(+)]) cardioplegic solutions may alledgedly cause endothelial damage, the 12-year outcome of a prospective randomized trial was reviewed.

Methods: Between January 1997 and March 1998, 47 consecutive patients received crystalloid (Group 1, n = 27) or blood cardioplegia (Group 2, n = 20).

Impact of donor quality on outcome of heart transplantation.

Objective: Over the last few years, there have been changes in both donor and recipient profiles in heart transplantation. Encouraging clinical outcome of marginal donors in candidates older than 60 years of age led us to allocate suboptimal donors for younger recipients as well. We reviewed our experience retrospectively so as to assess the impact of donor quality on heart transplantation.

A rare case of mitro-aortic intervalvular fibrosa aneurysm evolving in the para-aortic cavity.

The mitro-aortic intervalvular fibrosa (MAIF) connects the anterior mitral leaflet to the posterior portion of the aortic annulus. The aneurysms of MAIF represent a complication of aortic valve endocarditis, but blunt chest trauma, aortic valve replacement and congenital heart disease have also been reported as a cause. We describe a case of an aneurysm of MAIF, whose progression was documented by serial echocardiographic observations.