Effects of 'Bristol' on surgical practice in the United Kingdom.

In 1995 a child died following an arterial switch operation for complex transposition of the great arteries. There had been general concern regarding the outcomes for the arterial switch procedure in the unit in Bristol. A review, prompted by parents whose children had died, showed that 29 children had died and four others suffered from cerebral damage postoperatively.

Right ventricular disarticulation. An 18-year single centre experience.

Objective: Right ventricular disarticulation (RVD) is an accepted procedure in the treatment of ventricular tachycardia of right ventricular origin. We set out to review the long-term outcomes with RVD at our institution for patients with arrhythmogenic right ventricular dysplasia (ARVD) or refractory tachycardia. A renewed interest in this operation has come about in patients unable to tolerate implantable cardioverter defibrillators.

Functional status and quality of life in patients surviving 10 years after lung transplantation.

Although many lung allograft recipients achieve long-term survival, there is a lack of published data regarding these patients' functional status and quality of life (QoL). We evaluated all 10-year survivors at our institution and, utilizing the SF-36 questionnaire, compared their QoL to population normative and chronic illness data. Twenty-eight (29%) of 96 patients survived > or =10 years following 11 single, 6 bilateral and 11 heart-lung procedures.

The legacy of Bristol: public disclosure of individual surgeons' results.

Measurement of outcomes from medical or surgical interventions is part of good practice, but publication of individual doctors' results remains controversial. The authors discuss this issue in the context of cardiothoracic surgery

Mediastinitis in heart and lung transplantation: 15 years experience.

Background: Mediastinitis after sternotomy carries a very high mortality, especially in patients receiving immunosuppressive treatment.

Methods: A retrospective analysis of the data for patients who had undergone cardiopulmonary transplantation between May 1985 and December 2000 was undertaken. A total of 776 patients had either a median sternotomy or a transverse sternotomy through a clam-shell incision.

Perfadex for clinical lung procurement: is it an advance?

Background: Extensive laboratory experience suggested that low potassium dextran lung preservation solution (Perfadex; Medisan, Uppsala, Sweden) is superior to Euro-Collins (EC; Frusen, Hamburg, Germany), the clinical standard. The purpose of this study was to evaluate Perfadex in clinical lung transplantation.

Methods: A retrospective analysis of the outcome of 69 consecutive lung allografts retrieved and used for transplantation was made.

Clinical and hemodynamic evaluation of small Perimount aortic valves in patients aged 75 years or older.

Background: There is the potential for iatrogenic aortic stenosis and poor quality of life when small aortic valve bioprostheses are used in elderly patients. The alternative is enlarging the aortic annulus to accommodate larger size prostheses, increasing operative mortality. It was hoped that bovine pericardial valves would improve hemodynamic performance in the smaller valve sizes.

Surgical implications in the current treatment of Wolff-Parkinson-White syndrome.

There are currently two different surgical approaches to the abnormal pathway, Wolff-Parkinson-White (WPW) syndrome-the endocardial (ENDO) and epicardial (EPI) techniques. In recent years, ablation of accessory pathways can be achieved by catheter-induced radiofrequency (RF) current. This study was undertaken to assess our results of surgical treatment for WPW syndrome in the current era of catheter ablation.