Results of tricuspid valve replacement for nonrheumatic and noninfective disease.

Because of the rarity of isolated, nonrheumatic, noninfective tricuspid valvular disease, the long-term results of treatment by tricuspid valve replacement are uncertain. From June 1967 to April 1986, we implanted 23 biological or mechanical tricuspid valve prostheses in 20 patients for nonrheumatic, noninfective endocarditis. All cases were followed from 1 to 20 years after the procedure, for a total of 215.

Isolated coarctation of the aorta: surgical treatment and late results. Eighteen years' experience.

From March 1967 to February 1985, ninety one patients aged from eleven months to 53 years underwent surgical treatment of isolated coarctation of the aorta. On reviewing the long term results it was found that persistence of hypertension was related to the age when the operation was performed. Dividing the patients into three age groups; group I: 0-5 years, group II: 6-15 years and group III: over 15 years, it was found that there was no late hypertension in group I while hypertension persisted in 11% in group II and 25% in group III.

Surgical treatment of isolated coarctation of the aorta: 18 years' experience.

From March 1967 to February 1985 91 patients aged from 11 months to 53 years underwent surgical treatment of isolated coarctation of the aorta. The surgical procedures in descending order of frequency, were: resection with end to end anastomosis, resection with replacement by a tube graft, patch aortoplasty, and bypass graft. Resection with end to end anastomosis was achieved mainly in younger patients.

Ebstein's anomaly: sixteen years' experience with valve replacement without plication of the right ventricle.

From June 1967 to February 1983 10 patients aged from 13 to 51 years underwent surgery for Ebstein's anomaly. Nine patients were in class III according to the New York Heart Association (NYHA) classification and one was in class IV. The interatrial communication was closed in all patients; the tricuspid valve was repaired in one patient and replaced in the other nine patients.

Incidence and prognostic importance of jaundice after cardiopulmonary bypass surgery.

In a prospective study of 248 consecutive patients undergoing cardiopulmonary bypass surgery, early postoperative "post-pump" jaundice (PPJ) developed in 49 (20%). Development of PPJ was strongly associated with a bad outcome; 25% of jaundiced patients and 1% of non-jaundiced patients died in the postoperative period. The jaundice was a conjugated hyperbilirubinaemia, and was detectable in 48 out of 49 patients by postoperative day 2.

Acute subclavian steal syndrome following blunt thoracic trauma.

A rare case of acute subclavian steal syndrome following blunt thoracic trauma is described. By aortography, obstruction of the origin of the left subclavian artery was found and the reversed flow through the vertebral artery was demonstrated. This injury was successfully treated by an aortosubclavian bypass Dacron prosthesis using a left posterolateral thoracotomy approach.

Complications of cannulation of the ascending aorta for open heart surgery.

In a series of 420 ascending aortic cannulations for cardiopulmonary bypass, major complications occurred in three patients. Aortic dissection occurred in one patient believed to be due to aortic cross-clamping. Avoidance of this manœuvre is suggested when the aorta is grossly atheromatous.

Pulmonary sequestration. A report of an unusual case and a review of the literature.

A case of extralobar sequestration with findings indicating a pulmonary origin is reported. The literature has been reviewed and evidence presented that intra- and extralobar sequestration are variants of the same abnormality and that the systemic artery is an associated anomaly. From the evidence available at present the pathogenesis of this anomaly is best explained as an abnormality of bronchial and foregut budding resulting from failure of normal embryonic organizer control.