Background: Few data exist about the efficacy of radiofrequency (RF) maze procedures in elderly patients with atrial fibrillation (AF) undergoing surgery for mitral valve disease. The aim of the present investigation was to evaluate the effects of AF ablation associated with mitral valve surgery on the recovery and long-term maintenance of sinus rhythm in elderly patients aged > 75 years. Moreover, we evaluated the effects on survival.
View Article and Find Full Text PDFFin whales in the Gulf of California constitute a resident population genetically isolated from the rest of the North Pacific Ocean. Its small population size and the scarce information available about its dynamics in a semi-enclosed sea underline the importance of conducting studies about its reproduction. Given the monsoonal regime that dominates the oceanographic habitat of this region, we hypothesized seasonality in the population's reproductive activity.
View Article and Find Full Text PDFBackground: The usefulness of radiofrequency (RF) ablation in restoring sinus rhythm in patients with permanent atrial fibrillation (AF) undergoing surgery for mitral valve has been demonstrated. But whether sinus rhythm recovery affects long-term survival is less clear.
Methods: This study included 301 consecutive patients (126 men and 175 women, age 69±6 years) undergoing radiofrequency ablation of persistent atrial fibrillation along with mitral valve surgery.
Background: Although mitral valve repair is at present the technique of choice in mitral regurgitation (MR) due to degenerative valve disease, long term results in patients with active mitral infective endocarditis (IE) are still under evaluation.
Methods: In the study were included 34 consecutive patients (22 males; mean age, 60 years; range 32-84 years) referred to our institution between January 1, 2005 to December 31, 2011 who were treated with valve repair for mitral valve (MV) active infective endocarditis. Eighteen patients underwent isolated MV repair.
Introduction: Postoperative atrial fibrillation after isolated coronary revascularization has been associated with increased morbidity and mortality. Aim of present investigation was to evaluate incidence of postoperative atrial fibrillation and its prognostic role in patients undergoing isolated coronary artery by-pass and disclose possible differences between off-pump and cardiopulmonary assisted revascularization.
Methods: Prospective cohort study of 229 patients undergoing isolated coronary artery by-pass at a tertiary heart surgery Centre.
Objectives: At present, limited experience exists on the treatment of atrial fibrillation (AF) in patients undergoing mitral valve repair (MVR) for Barlow disease. The aim of this investigation was to prospectively evaluate the radiofrequency ablation of AF in patients undergoing MVR for severe regurgitation due to Barlow disease.
Methods: From January 1, 2007 to December 31, 2010, out of 85 consecutive patients with Barlow disease, 27 with AF underwent RF ablation associated with MVR.
Background. Aim of present investigation was to analyze survival and recurrence rate in patients with active endocarditis referred to our centre for surgical treatment. Methods.
View Article and Find Full Text PDFThe availability of living donors allows transplant teams to indicate living donor liver transplantation (LDLT) early in the course of liver disease before the occurrence of life-threatening complications. Late referral to transplant centers is still a problem and can compromise the success of the procedure. The aim of this study was to examine the perioperative factors associated with patient and graft survival for 430 consecutive pediatric LDLT procedures at Sirio-Libanes Hospital/A.
View Article and Find Full Text PDFThe increasing number of transplants performed each year has led to the identification of unusual diseases in liver grafts from asymptomatic donors that were unrecognized before liver transplantation. Here we report our experience with patients who received liver grafts infected with schistosomiasis. From September 1991 to August 2010, 482 pediatric liver transplants were performed at A.
View Article and Find Full Text PDFPortal vein thrombosis is a complication that occurs anytime after liver transplantation and can compromise the patient and graft survival. We describe a combined technique for PV recanalization in cases of PV obstruction after liver transplantation. Four children (1%), of 367 subjected to liver transplantation from June 1991 to December 2008, underwent PV recanalization through a combined approach (transhepatic and minilaparotomy).
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2010
Objective: To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization.
Design: A prospective observational study.
Methods: Patients who underwent cardiac surgery from January 1, 2007 to December 31, 2007.
The Pediatric End-Stage Liver Disease (PELD) scoring system is a formula developed to provide a continuous numerical assessment of the risk of death in order to allocate livers to children in need of transplantation. The PELD scoring system was introduced in Brazil in July 2006. An important change was made in the system: the final number for listing patients less than 12 years old for transplantation was the calculated PELD score multiplied by 3.
View Article and Find Full Text PDFBackground: During left lateral segmentectomy for live-donor liver transplant, the vascular inflow to segment IV can be compromised. An area of ischemia can be seen intraoperatively and further segment IV resection may be needed to prevent necrosis and abscess formation.
Methods: From July 1995 to February 2007, 324 consecutive living donor liver transplantations were performed at Hospital A.
Infants with end-stage liver disease represent a treatment challenge. Living donor liver transplantation (LDLT) is the only option for timely liver transplantation in many areas of the world, adding to the technical difficulties of the procedure. Factors that affect morbidity and mortality can now be determined, which opens a new era for improvement.
View Article and Find Full Text PDFA case of asymptomatic aortic valve fibroelastoma was diagnosed by transthoracic and transesophageal echocardiography in a 77-year-old man. A 2nd tumor was found at surgery. Both fibroelastomas were removed surgically without aortic valve replacement.
View Article and Find Full Text PDFPurpose: Surgical treatment of the thoracic aorta may become challenging when a rapid switch from left heart bypass (LHB) to cardiopulmonary bypass (CPB) is required.
Description: We designed a BICIRCUIT system using a centrifugal pump, a heparinized CPB circuit with a hollow fiber oxygenator, two 3/8 x 3/8 x 3/8 connectors (one placed at the bell inlet draining blood from the left atrium or the venous reservoir and the second placed at the bell outlet directing blood to the oxygenator or femoral artery). Our priming volume was 1100 mL; when switching from LHB to CPB, no additional priming volume was required.
Objectives: The technique of choice for myocardial revascularization in elderly patients remains a debated issue. We evaluated the potential advantages of the use of left internal thoracic artery-radial artery composite grafts compared with conventional coronary artery bypass grafts in elderly patients.
Methods: We prospectively enrolled 160 patients aged more than 70 years scheduled to undergo isolated myocardial revascularization.
OBJECTIVES: To present the experience with the first 12 living related liver transplants performed at Hospital Sírio-Libanês in São Paulo. METHODS: The donors were the fathers (6) and the mothers (6) with age ranging from 30 to 48 years. All candidates for donation were submitted to a full informed consent form, clinical and radiological evaluation and had blood withdrawn for autotransfusion.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
February 2001
Background: With the progressive aging of Western populations, cardiac surgeons are faced with treating an increasing number of elderly patients. Controversy exists as to whether the expenditure of health care resources on the growing elderly populations represents a cost-effective approach to resource management. The potential to avoid surgery in patients with little chance of survival and poor quality of life would spare unnecessary suffering, reduce operative mortality, and enhance the use of scarce resources.
View Article and Find Full Text PDFExtracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on the kidneys and the surrounding tissues are increasingly recognized.
View Article and Find Full Text PDFAnn Thorac Surg
November 1999
Intramural hematoma of the aorta is a condition increasingly observed in clinical practice. Uncertainty exists whether such lesions represent a different pathology or simply the precursors of classic dissecting aneurysm. The patient was a 76-year-old woman with intramural hematoma of the ascending aorta.
View Article and Find Full Text PDFAnn Thorac Surg
August 1999
Acute cardiac failure during descending thoracic aorta operations, although rare, may have catastrophic consequences. Under these circumstances, the use of partial veno arterial bypass is advantageous, allowing an assisted perfusion of both proximal and distal circulation districts. Traditionally, the ascending aorta or the aortic arch are the preferred sites of cannulation for proximal arterial reinfusion, but some limitations, such as extensive calcifications or extreme fragility of these segments, may hamper or at least delay this action.
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