Long-term outcome after the Ross procedure in 173 adults with up to 25 years of follow-up.

Objectives: The potential risk of autograft dilatation and homograft stenosis after the Ross procedure mandates lifelong follow-up. This retrospective cohort study aimed to determine long-term outcome of the Ross procedure, investigating autograft and homograft failure patterns leading to reintervention.

Methods: All adults who underwent the Ross procedure between 1991 and 2018 at the University Hospitals Leuven were included, with follow-up data collected retrospectively.

Integrated Signal Amplification on a Fiber Optic SPR Sensor Using Duplexed Aptamers.

Throughout the past decades, fiber optic surface plasmon resonance (FO-SPR)-based biosensors have proven to be powerful tools for both the characterization of biomolecular interactions and target detection. However, as FO-SPR signals are generally related to the mass that binds to the sensor surface, multistep processes and external reagents are often required to obtain significant signals for low molecular weight targets. This increases the time, cost, and complexity of the respective bioassays and hinders continuous measurements.

The long-term outcome of an isolated vascular ring - A single-center experience.

Background And Objectives: The aim of this study is to document the long-term outcome of patients with a vascular ring.

Methods: A single-center retrospective review of clinical symptoms was conducted in all patients born between 1980 and 2013, diagnosed with a complete vascular ring and at least 2 years of follow-up. Data were extracted from patient files and clinical symptoms were assessed by questionnaires sent to the parents.

Durability of homografts used to treat complex aortic valve endocarditis.

Background: Acute bacterial endocarditis may be extremely destructive for cardiac valves and their periannular structures. It has been suggested that complex reconstruction procedures require the use of homografts because of their versatility and potency to resist repeated infection.

Methods: We studied the long-term results of 69 patients with complex endocarditis who received homografts in the aortic position.

20 years of arterial switch operation for simple TGA.

Background: Arterial switch operation became the golden treatment for simple transposition of the great arteries (sTGA). We describe our experience with the arterial switch operation regarding long-term outcome and the need for re-intervention. Nevertheless, supravalvular pulmonary stenosis (SPS) remains a concern in the long run.

Evolution of the Z-score in size-reduced bicuspid homografts.

Background And Aim Of The Study: Human homografts are frequently used to establish an anatomic continuity between the right ventricular outflow tract (RVOT) and the pulmonary artery. Their limited availability, especially in small sizes, has encouraged the use of alternative strategies, such as size-reduced bicuspid homografts. The study aim was to analyze the follow up of patients who had received a standard tricuspid or size-reduced bicuspid homograft in the RVOT position, and to investigate modifications of the patients' Z-scores over the years.

The Contegra conduit in the right ventricular outflow tract is an independent risk factor for graft replacement.

Objective: A large spectrum of congenital heart diseases requires valved conduits to establish an anatomical continuity between the right ventricle outflow tract (RVOT) and the pulmonary artery. The aim of the present study was to compare the incidence of graft replacement in patients receiving the Contegra conduit (bovine jugular vein graft) with that in patients receiving a homograft implanted in the RVOT.

Methods: We reviewed a total of 347 conduits (Contegra 54; homografts 293) implanted in the RVOT from 1989 to 2003 in 323 patients (median age 12.

Surgery for transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction: European Congenital Heart Surgeons Association multicentre study.

Objectives: Optimal surgical management for patients with transposition of the great arteries (TGA), ventricular septal defect (VSD) and left ventricular outflow obstruction (LVOTO) remains controversial. Although the Rastelli operation has been the most widely performed surgical procedure during the past decades, several studies have shown its suboptimal long-term prognosis. Other operations have been developed to improve results.

Surgery for complications of trans-catheter closure of atrial septal defects: a multi-institutional study from the European Congenital Heart Surgeons Association.

Objective: This study aims to analyse the collective experience of participating European Congenital Heart Surgeons Association centres in the surgical management of complications resulting from trans-catheter closure of atrial septal defects (ASDs).

Methods: The records of all (n=56) patients, aged 3-70 years (median 18 years), who underwent surgery for complications of trans-catheter ASD closure in 19 participating institutions over a 10-year period (1997-2007) were retrospectively reviewed. Risk factors for surgical complications were sought.

European Contegra multicentre study: 7-year results after 165 valved bovine jugular vein graft implantations.

Objective: The valved bovine conduit "Contegra" for RVOT reconstruction became available for clinical use within a 100 % source data monitored and echo core lab controlled prospective European Multicentre Study, carried out from 1999 to 2006. We present the results of this study.

Methods: A total of 165 Contegras were implanted in 8 centres.

Long-term results with a stentless porcine aortic valve: the Edwards PRIMA model 2500.

Background And Aim Of The Study: The study aim was to evaluate the very long-term patient survival, clinical and hemodynamic status after aortic valve replacement (AVR) with the Edwards PRIMA model 2500 stentless porcine aortic valve.

Methods: A cohort of 50 patients was prospectively followed between September 1991 and November 2006, with clinical evaluation and echocardiography. The mean patient age at implantation was 72.

Behaviour of polyester grafts in adult patients with repaired coarctation of the aorta.

Aims: Whatever the technique used for surgical or endovascular repair of a coarctation of the aorta (CA), long-term complications might occur. Aneurysm formation after patch angioplasty is not uncommon and may lead to a life-threatening condition. Therefore, we were interested in the long-term results of different types of tube grafts, from which a lower degree of dilatation is expected.

Homograft survival after tetralogy of Fallot repair: determinants of accelerated homograft degeneration.

Aims: Homografts are frequently implanted in patients with tetralogy of Fallot (TOF). However, the lifespan of homografts is shorter than that of graft recipients, thus making surgical re-intervention unavoidable. Therefore, to determine variables that could influence their survival, we retrospectively studied the survival pattern of homografts used to treat TOF.

Endovascular stenting of juvenile vessels: consequence of surgical stent removal on vessel architecture.

Aims: To investigate the effect of stenting and later surgical removal on the architecture and therefore growth potential of juvenile vessels.

Methods And Results: Stents were implanted in the carotid artery and jugular vein of six 6-week-old lambs. Ten weeks later, stents were excised and the vessels closed without the use of patch material.

Vertical vascular ring around right mainstem bronchus.

An 18-year-old male patient was referred with an atypical form of vascular ring consisting of a right aortic arch, a right descending aorta, a persistent right ligamentum arteriosum, and a dilated right pulmonary artery in the setting of discontinuous pulmonary arteries with a single functional right lung. The initial presentation was that of pneumonia of the right lung and later evaluation revealed the right mainstem bronchus was squeezed between the descending aorta and the dilated right pulmonary artery. Surgical exploration disclosed the right-sided ligamentum arteriosum was running under the right mainstem bronchus and hereby was completing a vertical vascular ring.

Risk of surgery for congenital heart disease in the adult: a multicentered European study.

Background: Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population.

Imminent fetal cardiac tamponade by right atrial hemangioma.

A fetus presented with a large pericardial effusion caused by a right atrial transmural tumor. Correct prenatal diagnosis by use of targeted fetal echocardiography indicated that treatment was not required until the gestational age of 36 weeks. At that time, cesarean section was performed because early signs of imminent cardiac tamponade developed ("swinging heart").

The arterial switch operation in Europe for transposition of the great arteries: a multi-institutional study from the European Congenital Heart Surgeons Association.

Objectives: This study analyzes the results of the arterial switch operation for transposition of the great arteries in member institutions of the European Congenital Heart Surgeons Association.

Methods: The records of 613 patients who underwent primary arterial switch operations in each of 19 participating institutions in the period from January 1998 through December 2000 were reviewed retrospectively.

Results: A ventricular septal defect was present in 186 (30%) patients.

Epicardial pacing: a single-centre study on 321 leads in 138 patients.

Objective: This study presents the long-term outcome of 321 epicardial leads in 138 patients.

Methods And Results: All leads were Medtronic CapsureEpi model 4965 steroid eluting leads. The 1-, 3-, and 5-year patient survival was 91%, 83% and 77%, respectively.

Implementation of an intervention plan designed to optimize donor referral in a donor hospital network.

Context: The shortage of donor organs remains the most important factor of waiting list mortality in organ transplantation worldwide. Donor detection is influenced by the legal system, family refusal, and underreporting caused by erroneous knowledge of donation criteria and lack of familiarity with the procedure.

Objective: To identify possible key factors of donor referral patterns within an existing cooperation with donor hospitals and donor units across the Dutch-speaking part of Belgium, an area of approximately 3 million inhabitants.

Stenting of hypoplastic aortic segments with mild pressure gradients and arterial hypertension.

Objective: To determine the safety, feasibility and effectiveness of stent expansion of hypoplastic aortic segments with pressure gradients in patients with arterial hypertension.

Design: Non-randomised prospective clinical trial.

Setting: Tertiary referral centre, congenital cardiac unit.

Anaesthesia management for pulmonary endarterectomy.

Purpose Of Review: Options for the surgical treatment of chronic thromboembolic pulmonary hypertension are either lung transplantation or pulmonary endarterectomy. Pulmonary endarterectomy is considered permanently curative and the treatment of choice. The procedure dramatically improves functional status and provides an excellent immediate and long-term survival, much better than transplantation.

Repair for partial and complete atrioventricular septal defect: single centre experience and long-term results.

Background: The number of adult patients with surgical repaired congenital heart defects increases continuously. We were interested to compare late outcome after partial and complete atrioventricular defect repair (pAVSD and cAVSD, respectively) and to determine the most important reason for re-intervention.

Methods: All patients older than 16 years, who underwent partial or complete atrioventricular defect repair, were selected from the database.

[Surgical aspects of (cardio) pulmonary transplantation].

Unlabelled: INTRODUCTION AND STATE OF THE ART: Both short and long-term outcomes following lung transplantation have improved substantially in recent years as a result of advances in the selection and management of donors, organ preservation, immunosuppressive therapy, and the treatment of infectious and malignant complications. In addition surgical techniques have evolved over time and have contributed to this increase in success rates.

Perspectives And Conclusions: This review outlines surgical aspects of lung transplantation including a historical note, techniques of lung harvesting, some anaesthetic considerations, the different transplant types and incisions, as well as anastomotic techniques and their pitfalls.