Role of age and comorbidities in mortality of patients with infective endocarditis.

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.

Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.

Surgical rescue after left anterior descending catheter entrapment causing cardiogenic shock.

Entrapment or device loss during percutaneous coronary intervention is a rare but potentially fatal complication. Percutaneous retrieval is possible but surgery can be required on an emergency basis. We present the case of an entrapped balloon catheter in the left anterior descending coronary artery during an elective percutaneous coronary intervention.

An Update on Heart Transplantation in Human Immunodeficiency Virus-Infected Patients.

Cardiovascular diseases have become a significant cause of morbidity in patients with human immunodeficiency virus (HIV) infection. Heart transplantation (HT) is a well-established treatment of end-stage heart failure (ESHF) and is performed in selected HIV-infected patients in developed countries. Few data are available on the prognosis of HIV-infected patients undergoing HT in the era of combined antiretroviral therapy (cART) because current evidence is limited to small retrospective cohorts, case series, and case reports.

[Surgery in the Cardiovascular Surgical Intensive Care Unit].

Background: To analyze the indications, actions and results of the operations performed in the Cardiovascular Surgery Intensive Care Unit.

Methods: Retrospective analysis of consecutive non-selected adult patients operated in the ICU. All operations were included.

Long-term outcome of high-urgency heart transplant patients with and without temporary ventricular assist device support.

Background: The use of short-term ventricular assist devices (VAD) in patients awaiting high-urgency (HU) heart transplantation (HTx) in Spain has steadily increased due to longer waiting times and the new heart allocation system. It is unknown whether the use of short-term VAD support in patients with cardiogenic shock affects HTx outcome. We sought to investigate long-term outcomes of HU transplanted patients with VAD compared with HU transplanted patients without device support.

Durability of the Liotta porcine bioprosthesis beyond two decades.

Porcine valves are generally known to have a limited durability. The case is reported of a 35-year-old male patient who underwent mitral valve replacement with a 28 mm Liotta porcine bioprosthesis. At reoperation 21 years later, the bioprosthesis was replaced (uneventfully) with a second porcine bioprosthesis.

Retrieval of scrap metal from an abdominal aortic aneurysm during the follow-up.

A 75-year-old patient underwent open repair of a rapidly expanded aneurysm after previous multiple endovascular repair (EVAR) attempts by others. Open surgical reconstruction allowed the explants of all metallic components of implanted stent-grafts. This is still an uncommon phenomenon due to the still low late reintervention rate.

Seventeen-year follow-up after ascending-to-infrarenal aorta bypass for recurrent coarctation in an adult.

Anatomic repair of complex aortic coarctation is associated with significant mortality and morbidity, including paraplegia. Extra-anatomic bypass strategies have been developed to reduce these complications and allow the correction of any concomitant conditions during the same operation. We present the case of a woman with uncontrolled hypertension and preductal coarctation of the aorta diagnosed at age 22 who underwent an unsuccessful attempt at primary repair, followed by extra-anatomic bypass from the ascending-to-infrarenal aorta.

Delayed aortic regurgitation caused by a right coronary stent protruding into the aorta.

Aortic valve perforation is an extremely rare complication after percutaneous coronary intervention. The case is presented of a 49-year-old male with aortic valve regurgitation secondary to the intra-aortic protrusion of a right coronary stent. The patient had undergone an apparently successful rescue percutaneous transluminal coronary angioplasty with a drug-eluting stent following failed fibrinolysis, but one month later was readmitted for acute pulmonary edema.

New insights in the management of cardiogenic shock complicating myocardial infarction: role of urgent heart transplantation.

Objective: This study assessed the role of heart transplantation (HTx) in the management of patients with acute myocardial infarction (MI) complicated by refractory cardiogenic shock despite percutaneous coronary intervention (PCI). The primary end-point of the study was mortality at the 1-year follow-up.

Methods: Between January 2001 and December 2005, 74 consecutive patients with acute MI complicated with cardiogenic shock were retrospectively analyzed.

Elective cardiac surgery using Celsior or St. Thomas No. 2 solution: a prospective, single-center, randomized pilot study.

Objective: Celsior is a crystalloid solution specifically designed for solid-organ transplantation. Due to its advanced combination of solutes, we wanted to evaluate its safety, efficacy, and possible benefits when used as blood cardioplegia in elective cardiac surgery in a single-center, randomized, controlled clinical trial, comparing its performance with a well-established cardioplegic solution.

Methods: Patients programmed for aortic valve replacement were randomized to receive either St.

Preoperative risk stratification in infective endocarditis. Does the EuroSCORE model work? Preliminary results.

Objective: There is an important role for risk prediction in cardiac surgery. Prediction models are useful in decision making and quality assurance. Patients with infective endocarditis (IE) have a particularly high risk of mortality.

[Mortality and morbidity in HIV-infected patients undergoing coronary artery bypass surgery: a case control study].

The use of highly active antiretroviral therapy (HAART) in patients with HIV infection has improved survival. This improvement combined with the metabolic effects of treatment has increased cardiovascular risk and the need for cardiac surgery in these patients. We compared morbidity and mortality in HIV-infected patients (cases, n=7) and non-HIV-infected patients (controls, n=21) who underwent isolated coronary artery surgery between 1997 and 2004.

Hemolysis in mechanical bileaflet prostheses: experience with the Bicarbon valve.

Background: Normal functioning mechanical heart valve prostheses are designed to have a certain degree of intrinsic structural regurgitation as a washout mechanism to avoid prosthetic thrombosis. However, intrinsic regurgitation leads to blood cell trauma and hemolysis. Information on hemolysis associated with mechanical bileaflet prostheses is scarce.

[Vancomycin and teicoplanin use as antibiotic prophylaxis in cardiac surgery: pharmacoeconomic study].

Background: To assess the economical impact of vancomycin use versus teicoplanin use as antibiotic prophylaxis for patients undergoing cardiac surgery for valve replacement (VR) and coronary artery by-pass (CABS) procedures.

Patients And Methods: This is an ancillary cost minimization analysis of a double blinded, parallel groups, randomised clinical trial (RCT), with the main objective of comparing the safety and efficacy of these antibiotics. 500 patients were included in the study; 267 in the CABS group and 233 in the VR group.

Cardiovascular tissue banking in the non-cadaveric setting: ten-year experience of a university hospital-based bank with active organ donation program.

Background And Aim Of The Study: Today, transplantation of cardiovascular tissues is common practice, and tissue banking has become routine. Consequently, many institutions exist which carry out high-quality tissue banking.

Methods: The Hospital Clinico of the University of Barcelona established its cardiovascular tissue bank in 1989.

Video-assisted cardioscopy for removal of primary left ventricular myxoma.

Left ventricular myxoma is a rare benign cardiac tumor. Surgical excision is the treatment of choice and completeness of removal is mandatory to avoid late recurrence. A case is presented in which aortic transvalvular video-assisted cardioscopy was used to facilitate removal.

[Postinfarction ventricular septal defect. Surgical approach by right ventriculotomy in 4 patients].

Ventricular septal defect secondary to myocardial infarction still have high mortality. Early and swift surgical repair is needed to obtain adequate results. Surgical exposure of defect through the infarcted left ventricle wall is the usual technique.

Cryopreserved homografts in aortic and mitral prosthetic endocarditis: expanding the use of biological tissues in complex cardiac infections.

The case of a 27-year-old male heroin addict suffering from mitral and aortic prosthetic valve endocarditis is presented. Double valve re-replacement was performed using cryopreserved aortic homografts. Aortic root replacement with coronary re-implantation and intra-atrial valve implantation for mitral valve replacement were the techniques used.

[Mitral endocarditis caused by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin: description of 2 cases with fatal course].

Two patients with infectious endocarditis (IE) by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin (SARMAR) acquired in hospital during the course of an epidemic outbreak of this microorganism in the Hospital Clínic i Provincial of Barcelona. Both patients had undergone surgery of the lower limbs. The entrance of the microorganism was the infection of the surgical wound, with bacteriemia, followed by mitral IE after a short time interval (20 days).

[Aortic valve replacement by a pulmonary homograft].

Minor experience still exists in our country with regard to the use of valve homografts in cardiac surgery. Only a few implantations have been performed in cases of right ventricular outflow tract reconstruction in addition to our own experience in cases of infective endocarditis of the aortic valve. We present a case of aortic valve replacement by using an antibiotic-sterilized fresh pulmonary valve autograft.

[An alternative approach in the surgical treatment of infectious endocarditis. The fresh antibiotic-sterilized aortic valve homograft].

Following the pioneering work of Ross and Barratt-Boyes, there is currently a strong evidence based on long-term follow-up data that valve homografts are the best valve substitutes in the aortic position. Currently there exists a renewed interest in the use of fresh and cryopreserved homografts as we know that homografts show a prolonged durability together with the lack of thromboembolic complications. Here we present the case histories of 3 patients undergoing aortic valve replacement by fresh homografts sterilized in antibiotic solution.