Multicentre study on late outcomes of biventricular repair of double outlet right ventricle.

Objectives: The goal of this retrospective multicentre study was to present late surgical outcomes of the treatment of children with double outlet right ventricle (DORV) coming from emerging countries.

Methods: The Mécénat Chirurgie Cardiaque brings to France for surgery selected children with simple and complex congenital diseases, including DORV. The patients are operated on in 9 hospitals that specialize in paediatric cardiac surgery.

Surgery for severe congenital heart diseases in children from developing nations.

Background: Children with severe congenital heart disease (CHD) are rarely treated in developing countries and have very little to no chance to survive in their local environment. Mécénat Chirurgie Cardiaque (MCC) flies to France children with CHD from developing countries. This report focuses on the early, mid, and late outcomes of 531 children with severe CHD sent to MCC for surgery from 1996 to 2019.

MIECT: How did it start?

Transiently assuming the functions of both heart and lungs as surgeons repair critical valves and vessel lesions can be achieved by mechanical circulatory support has its origins in cardiopulmonary bypass (CPB). However, CPB technologies induce also some unintended adverse effects. During the 90s, a mayor trend pushed many physicians to reconsider the place of coronary artery bypass grafting (CABG) and challenged the surgical reference treatment by less invasive catheter-based angioplasties.

Surgery of single ventricles in humanitarian practice: surgery for which patients?

Objectives: To analyse the feasibility and effectiveness in humanitarian practice of surgical management of children with single-ventricle heart condition.

Methods: Retrospective study of children with a single ventricle, managed by the association Mécénat-Chirurgie Cardiaque since 1996, with long-term follow-up after their return home.

Results: Of the 138 children in our cohort, 119 had one or more surgeries (180 procedures): palliative surgery alone (systemic-pulmonary anastomosis or banding), 41; partial cavo-pulmonary connection, 47; total cavo-pulmonary connection (mean age 8.

Late management of truncus arteriosus: 20 years of humanitarian experience.

Objectives: Early surgical management of common arterial trunk is well established and has good prognosis. Late diagnosis is less common. We reviewed late-diagnosed common arterial trunk management and prognosis for children in developing countries.

An Unreported Congenital Anomaly: Aneurysm of the Lateral Half of the Mitral Valve.

This case draws our attention to a new type of mitral valve anomaly, which seems to be congenital. A 42-year-old man with symptomatic primary severe mitral regurgitation was admitted to our hospital. Echocardiography revealed an aneurysm of the half of the valve, on the anterolateral commissure side, with significant excess tissue.

Bacterial translocation and plasma cytokines during transcatheter and open-heart aortic valve implantation.

Objective: To determine whether the good safety profile of transarterial aortic valve implantation (TAVI) is related to lower levels of systemic bacterial translocation and systemic inflammation compared with open-heart surgery.

Background: Transcatheter aortic valve implantation via the transfemoral approach is increasingly used in very high-risk patients with aortic stenosis. The outcomes seem similar to those after open-heart aortic valve replacement (OHAVR).

Long-term results of Freestyle stentless bioprosthesis in the aortic position: a single-center prospective cohort of 500 patients.

Objective: Stentless xenograft bioprostheses may be the future valve of choice for aortic valve replacement. The study aim was to investigate the long-term clinical outcome after aortic valve replacement with the Medtronic Freestyle bioprosthesis (Medtronic Inc, Minneapolis, Minn).

Methods: Between April 1997 and November 2004, a total of 500 patients (mean age, 74.

Alternative to the bentall procedure for elderly patients with aortic root aneurysms.

We describe an alternative technique to the Bentall procedure for elderly patients with aortic root aneurysms. It is the subcoronary implantation of a Freestyle (Medtronic, Minneapolis, MN) aortic bioprosthesis with interposition of a graft material between the upper part of the Freestyle bioprosthesis and the distal aorta. The technique described avoids the proximal anastomosis of the graft and avoids the coronary reimplantations of the Bentall procedure which are still a potential risk of bleeding particularly in elderly patients.

A technique of aortic annulus enlargement with a Freestyle stentless bioprosthesis.

We describe our surgical technique to manage a small aortic annulus during aortic valve replacement. Starting with the posterior annular enlargement incision described by Manouguian, a stentless porcine aortic root, with excision of the left and right porcine coronary segments and conservation of the mural wall (Freestyle MS design, Medtronic, Minneapolis, MN ), was used. The Freestyle bioprosthesis enlarges the aortic annulus using a direct suture of the valve on the enlarged annulus, and the aorta is closed by a direct suture of the mural wall of the bioprosthesis.

A comparison of low vs conventional-dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery.

The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high-dose anticoagulation with a low-dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred patients who received 300 IU.

[Large coronary aneurysm diagnosed during an acute coronary syndrome. A case report and review of the literature].

Coronary aneurysm is an uncommon variant of coronary atherosclerosis. It usually involves the right coronary artery and is often associated with significant coronary stenosis. It may be revealed by an acute coronary syndrome (ACS).

Eight-year results of Freestyle stentless bioprosthesis in the aortic position: a single-center study of 500 patients.

Background And Aim Of The Study: Stentless bioprostheses may be the future valve of choice for aortic valve replacement (AVR). The study aim was to investigate mid-term clinical outcome after AVR with the Medtronic Freestyle valve.

Methods: Between April 1997 and November 2004, a total of 500 patients (241 females, 259 males) was implanted with a Freestyle bioprosthesis for AVR, without population selection, by a single surgical team at the authors' institutions.

Comparison of the inflammatory response between miniaturized and standard CPB circuits in aortic valve surgery.

Objective: One of the complications of CPB is the systemic inflammatory response syndrome (SIRS). Recent developments tend to minimize the biological impact of CPB in using miniaturized closed circuit with reduced priming volume and less blood-air interface. The benefit of these miniaturized closed circuits in terms of inflammatory response has been proved in coronary surgery.

[Cardiac surgery without transfusion in 2005].

Purpose: Between January 1991 and October 2003, 200 Jehovah Witnesses adult patients underwent elective cardiac surgery. To asses the impact on continuing progress of blood saving protocols and the increasing operative risk of patients proposed to surgery, we have re-assessed our results in this specific population.

Methodology: Files of the first 100 patients operated upon between 1991 and 1998 were reviewed, and compared to the following 100 ones treated between 1998 to today.

Routine use of bilateral skeletonized internal thoracic artery grafts in middle-aged diabetic patients.

Background: The purpose of this study was to determine whether middle-aged diabetic patients aged less than 70 years could have routine use of bilateral skeletonized internal thoracic artery grafting without an increased surgical risk.

Methods: Between January 1997 and December 2003, 712 consecutive patients aged less than 70 years underwent bilateral internal thoracic artery grafting. Among these, 164 were diabetic and underwent bilateral internal thoracic artery grafting without other preoperative selection than age.

Totally minimized extracorporeal circulation: an important benefit for coronary artery bypass grafting in Jehovah's witnesses.

Background: Jehovah's Witnesses who require cardiac surgery represent a challenge to the physician because of their refusal to accept blood transfusions. Because coronary artery bypass grafting (CABG) is performed by most surgeons under cardiopulmonary bypass (CPB), which has potentially deleterious effects on hemostasis, we used a new concept called minimal extracorporeal circulation (MECC). MECC includes heparin-coated tubing, a centrifugal pump, and an oxygenator.

[Treatment of aorto-coronary saphenous vein bypass lesions: pros and cons of angioplasty].

Heart patients who have undergone a coronary bypass may present with renewed myocardial ischemia, often connected with bypass dysfunction. The saphenous bypass is the most frequently implicated, and palliative revascularization may be envisaged, either by further bypass surgery, or by angioplasty. The latter approach has been developed since the beginning of the 1980s, and since that time there has been considerable technical and pharmacological progress in performing this type of graft.

Reduction of the inflammatory response following coronary bypass grafting with total minimal extracorporeal circulation.

Objective: Cardiopulmonary bypass (CPB) is known to cause part of the systemic inflammatory reaction after cardiac surgery that can be responsible for organ failure. A novel technique based on a minimal extracorporeal circulation (MECC(R)) system has been evaluated with regard to the inflammatory response in a prospective study involving patients undergoing coronary artery bypass grafting.

Methods: Sixty consecutive patients were randomly assigned to either standard normothermic CPB (n=30) or the MECC system, with a reduced priming volume, no aortic venting and no venous reservoir, excluding the blood-air interface (n=30).

[Primary pulmonary myxoid liposarcoma discovered fortuitously].

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic.

Does warm antegrade intermittent blood cardioplegia really protect the heart during coronary surgery?

Objective: Intermittent antegrade blood cardioplegia (IABC) has been standardized as a routine technique for myocardial protection in coronary surgery. However, if the myocardium is known to tolerate short periods of ischemia during hypothermic arrest, it may be less tolerant of warm ischemia, so the optimal cardioplegic temperature of intermittent antegrade blood cardioplegia is still controversial. The aim of this study was to compare the effects of warm intermittent antegrade blood cardioplegia and cold intermittent antegrade blood cardioplegia on myocardial pH and different parameters of the myocardial metabolism.

[Optimal myocardial revascularization by coronary bypass and complementary angioplasty. Study of 100 patients].

One hundred patients underwent early coronary angiography (average 20.5 days) after coronary bypass surgery between 1994 and 1996. The indications in clinically asymptomatic patients were: study of double mammary grafts, non respect of the preoperative plan (grafts not available, technical difficulties), and/or postoperative ECG changes.

A review of myocardial normothermia: its theoretical basis and the potential clinical benefits in cardiac surgery.

Myocardial protection during cardiac surgery aims to preserve myocardial function while providing a bloodless and motionless operating field to make surgery easier. Myocardial protection is achieved by decreasing the oxygen needs using hypothermia and producing electromechanical cardiac arrest using potassium infusion which allows surgery to be performed on a non-beating heart. The deleterious effects of hypothermia include dysfunction of enzymatic systems, development of acidosis, a decrease in tissue oxygen delivery, an increase in blood viscosity and a decrease in erythrocyte deformability.