Publications by authors named "Charles Mullany"
Objectives: Adequate nutrition among inmates at correctional facilities may prevent a variety of diseases and conditions. Vitamin D is a nutrient of particular interest to incarcerated populations; however, research in this area is sparse. Therefore, the aim of this study was to assess vitamin D status among inmates in a prison in southern Arizona, a sun-replete region of the United States.
View Article and Find Full Text PDFPurpose: A significant percentage of patients undergoing coronary artery bypass graft (CABG) surgery leave the hospital without appropriate preventive medications. Little is known about this prevention gap and its solutions. We studied the short- and long-term impacts of a quality improvement (QI) project aimed at reducing this prevention gap.
View Article and Find Full Text PDFObjective: Recovery of ventricular function after surgical correction of mitral regurgitation is often incomplete. We studied clinical and echocardiographic factors influencing return of normal left ventricular ejection fraction after mitral valve repair or replacement for mitral regurgitation caused by leaflet prolapse.
Methods: We evaluated 1063 patients who had mitral valve repair or replacement between January 1, 1980, and December 31, 2000.
Background And Purpose: Embolic events have long been thought to occur in patients with cardiac tumors secondary to embolization of tumor fragments; however, there are no large studies examining the epidemiology and occurrence of embolism in this group of patients.
Methods: From 1957 to 2006, 323 consecutive patients with primary cardiac tumors were treated surgically at our institution. Of these, patients who experienced an embolic event included 80 (cerebrovascular accident 31 [9.
Background: Primary cardiac tumors are rare but have the potential to cause significant morbidity if not treated in an appropriate and timely manner. To date, however, there have been no studies examining survival characteristics of patients who undergo surgical resection.
Methods And Results: From 1957 to 2006, 323 consecutive patients underwent surgical resection of primary cardiac tumors; 163 (50%) with myxomas, 83 (26%) with papillary fibroelastomas, 18 (6%) with fibromas, 12 (4%) with lipomas, 28 (9%) with other benign primary cardiac tumors, and 19 (6%) with primary malignant tumors.
Objective: The European System for Cardiac Operative Risk Evaluation has been used to define a particularly high-risk group of patients for aortic valve replacement in whom alternative procedures, such as stent-mounted percutaneous valve procedures, may be appropriate. Our objective was to assess the validity of this risk assessment at a large-volume, tertiary cardiac surgical center.
Methods: From January 1, 2000, to December 30, 2006, a total of 1177 patients underwent isolated aortic valve replacement at the Mayo Clinic.
Objective: We sought to echocardiographically examine the early changes in left ventricular size and function after mitral valve repair or replacement for mitral regurgitation caused by leaflet prolapse.
Methods: Preoperative and early postoperative echocardiograms of 861 patients with mitral regurgitation caused by leaflet prolapse who underwent mitral valve repair or replacement (with or without coronary revascularization) were studied. Among the patients, 625 (73%) were men and 779 (90%) had mitral valve repair.
Background And Aim Of The Study: The long-term benefits of mitral regurgitation (MR) surgery in ischemic cardiomyopathy (ICM) are controversial. Herein are reported the results and trends of this surgical approach over the past 24-year period.
Methods: Patients were identified in refractory heart failure due to ICM with NYHA functional class III/IV symptoms, left ventricular ejection fraction < or =35% and MR who underwent mitral surgery between 1979 and 2002.
Objective: We sought to compare clinical and pathologic characteristics of ventricular tumors and to detect whether differences exist in short- and long-term survival after resection.
Methods: From 1964 to 2005, 323 patients had cardiac surgery for resection of primary cardiac tumors; 53 (16%) patients had primary ventricular tumors. We randomly sampled 53 characteristics of ventricular tumors.
Objective: Improved durability of bioprostheses has led some surgeons to recommend biologic rather than mechanical prostheses for patients younger than 65 years. We compared late results of contemporary bioprostheses and bileaflet mechanical prostheses in patients who underwent aortic valve replacement between 50 and 70 years old.
Methods: In this retrospective study, patients received either St Jude bileaflet valves or Carpentier-Edwards bioprostheses.
Objective: The prevalence of aortic valve stenosis increases with age, and often the diagnosis is made by echocardiography before symptoms develop. To address the controversies in management of asymptomatic patients with severe aortic stenosis, we assessed the early and late outcomes of aortic valve replacement in these patients.
Methods: We analyzed data of 622 patients, aged 72 +/- 11 years, with isolated asymptomatic severe aortic stenosis.
Background: There is considerable interest in atrial fibrillation (AF) ablation during cardiac operations, but there are few studies addressing the impact of preoperative AF on late outcome of surgery. We therefore investigated AF prevalence in nonrheumatic mitral regurgitation and its effect on late survival and morbidity after repair.
Methods: From 1993 through 2002, 36% of 2,821 patients with mitral regurgitation had preexisting AF.
Objective: Extra-anatomic bypass of complex thoracic aortic disease through a median sternotomy has been reported as a safe alternative to thoracotomy. Our objective was to examine intermediate-term outcomes.
Methods: We retrospectively reviewed 50 consecutive patients with congenital aortic coarctation or recurrent coarctation who underwent ascending-descending posterior pericardial aortic bypass between January 1985 and November 2005.
Objective: To determine the role of off-pump coronary artery bypass grafting in the treatment of patients with severe recurrent angina after coronary artery bypass grafting who are not suitable for percutaneous coronary intervention and are considered too high risk for conventional on-pump revascularization.
Patients And Methods: All patients who needed single- or double-vessel revascularization at reoperation with a predicted operative mortality of 10% or higher between March 4, 1994, and December 31, 2002, were studied. Risk stratification was performed using both the Parsonnet risk scoring system and the European System for Cardiac Operative Risk Evaluation.
Background: The seemingly inexorable rise in obesity worldwide is creating a new set of challenges for healthcare providers. Demand for cardiac surgical intervention among patients at extreme levels of obesity (body mass index [BMI] > or = 50) is increasing; however, the risks, benefits, and resources required to meet this need have not been established.
Methods: Between 1993 and 2004, 57 patients with a BMI of 50 or more underwent cardiac surgical procedures at our institution.
Statin therapy has recently been shown to decrease adverse perioperative events in patients undergoing vascular surgery. The potential beneficial effect of lipid-lowering therapy in patients undergoing coronary artery bypass grafting (CABG) is not well known. This was an observational analysis of 4,739 patients who underwent first-time isolated CABG at a single institution from 1995 to 2001.
View Article and Find Full Text PDFBackground: It is not known whether rigorous intraoperative glycemic control reduces death and morbidity in cardiac surgery patients.
Objective: To compare outcomes of intensive insulin therapy during cardiac surgery with those of conventional intraoperative glucose management.
Design: A randomized, open-label, controlled trial with blinded end point assessment.
Cardiac sarcoid is a rare and frequently fatal disease. We report a case of isolated cardiac sarcoid diagnosed during elective cardiac surgery. Although this patient presented with a history that was consistent with sarcoid heart disease, diagnosis is challenging when there is no other organ involvement with sarcoid.
View Article and Find Full Text PDFObjective: The study objective was to describe the independent effect of preoperative atrial fibrillation on the outcome of coronary artery bypass grafting, including the causes of death (cardiac vs noncardiac).
Methods: We analyzed the outcome of patients with preoperative atrial fibrillation who underwent on-pump coronary artery bypass grafting between 1993 and 2002 and compared them with matched controls in sinus rhythm; matching variables were age, gender, ejection fraction, and numbers of diseased coronary arteries and distal anastomoses. Direct patient follow-up focused on late complications and reinterventions, and we investigated causes for all deaths.
Recurrent mitral regurgitation after repair: should the mitral valve be re-repaired?
J Thorac Cardiovasc Surg
December 2006
Objective: We sought to evaluate the clinical and echocardiographic outcomes of reoperation for failed mitral valve repair.
Methods: One hundred forty-five patients with recurrent mitral regurgitation after primary mitral valve repair of degenerative leaflet prolapse underwent mitral valve reoperations between January 1, 1970, and January 1, 2005. The mean age was 66 years, and 102 (70%) were men.
Background: The prognostic significance of preoperative atrial fibrillation (AF) at the time of aortic valve replacement is unknown, as is the potential role for concomitant arrhythmia surgery.
Methods: We performed a cohort comparison of patients with preoperative AF (n = 129) and preoperative sinus rhythm (SR, n = 252) undergoing aortic valve surgery between 1993 and 2002; patients were matched for age, gender, and left ventricular ejection fraction. Follow-up (mean interval, 4.
Background: Factors predicting long-term survival and reoperative risk after mitral valve repair for subsets with prolapse involving the anterior leaflet in the current era are unclear.
Methods: Between January 1, 1980 and December 31, 1999, surgical correction of mitral regurgitation was performed in 2,219 patients. We analyzed a subset of 1,411 patients with isolated mitral regurgitation due to leaflet prolapse undergoing mitral repair or replacement (+/- coronary bypass).