Long-term results of the REV (réparation à l'ètage ventriculaire) operation.

Objective: Despite its innovative features, the réparation à l'ètage ventriculaire (REV) procedure has not gained large popularity in the treatment of transposition of the great arteries, ventricular septal defect, pulmonary stenosis, and related anomalies, and thus the Rastelli operation remains the preferred type of repair. We try to obviate the alleged lack of long-term results that has been suggested to explain this reluctance to change.

Methods: We reviewed a series of 205 patients who underwent the REV procedure between 1980 and 2003.

Surgery for malposition of the great arteries: the REV procedure.

The REV procedure was introduced in 1980 to treat transposition of the great arteries with ventricular septal defect (VSD) and pulmonary stenosis and malpositions similar to transposition of the great arteries (TGA). It aims at overcoming the drawbacks and limitations of the classic Rastelli operation, such as subaortic stenosis, late ventricular deterioration, arrhythmias and sudden death. In particular, the resection of the infundibular septum allows for the placement of a straighter, smaller ventricular patch, bulging much less in the right ventricular cavity.

[Manual thrombus aspiration with the Export catheter during primary and rescue angioplasty. Predictors of failed myocardial reperfusion].

Background: Manual thrombus aspiration seems to improve myocardial reperfusion after coronary angioplasty in patients with ST-elevation acute coronary syndrome. We sought to assess the independent variables of complete myocardial reperfusion after primary and rescue coronary angioplasty with use of the Export manual thrombus aspiration catheter.

Methods: Myocardial reperfusion were judged complete if ST-segment resolution were >70% at 60 min post-procedure ECG.

A cosmetic access for minimally invasive aortic valve replacement without sternotomy in women.

Background: Different methods of replacing the aortic valve via a minimally invasive access have been reported in the recent literature. Although these strategies have clear advantages in terms of reduced surgical trauma, no further refinements in terms of cosmetic results have been made for women.

Methods: Aortic valve replacement was performed in 4 women via a right anterior submammary minithoracotomy without rib resection.

Coronary ostial stenosis after aortic valve replacement.

Coronary ostial stenosis is a life-threatening complication of aortic valve replacement. We describe the case of a patient who developed symptoms and signs related to coronary insufficiency 4 months after aortic valve replacement. In view of a coronary angiogram revealing a 99% left main stem stenosis, an urgent revascularization procedure was performed.