Impact of a focused review course in cardiovascular and thoracic surgery on test performance.

Background: The Core Curriculum Review Course in Cardiovascular and Thoracic Surgery is a 4-day educational program consisting of 77 didactic lectures that provide a comprehensive review of the material required for surgeons preparing for the American Board of Thoracic Surgery competency written examination. The lectures are supplemented with a written syllabus and interactive audience participation system. We sought to determine whether participation in this course could improve participants' performance on a cardiothoracic subject-based test.

BioGlue: a protective barrier after pericardiotomy.

Background: Repeat operation on the heart composes about 20% of procedures in contemporary practice of cardiac surgery. A sheet of material providing a barrier against cardiac adhesion to the sternum would be desirable.

Methods: Anterior pericardiectomy was performed in rats.

Comparison of standard Maze III and radiofrequency Maze operations for treatment of atrial fibrillation.

Objective: This study compares clinical results of the standard Maze III operation, a highly effective treatment for atrial fibrillation, to less complex variations of the Maze III operation utilizing unipolar and bipolar radiofrequency ablation and pulmonary vein isolation.

Methods: Records were reviewed of 377 patients who had operations for treatment of atrial fibrillation at a single institution over a 10-year period. Standard Maze III was performed in 220 patients, unipolar radiofrequency Maze III in 60, bipolar radiofrequency Maze III in 65, and radiofrequency pulmonary vein isolation in 32.

Left atrial sarcoma: resection and repair by cardiac autotransplant and in situ pericardial patch.

This report demonstrates the method of resection of a left atrial tumor involving the right superior pulmonary vein. The unique features are use of adjacent pericardium as an in situ patch to reconstruct the left atrium when there is no margin of left atrium remaining on the pulmonary veins and cardiac autotransplantation.

Tricuspid valve replacement after cardiac transplantation.

Background: Tricuspid valve insufficiency (TI) is common after orthotopic heart transplantation. However, tricuspid valve replacement or repair (TVR) is rare. The aim of this study is to evaluate our experience with TVR in cardiac transplant recipients.

Surgical treatment of atrial fibrillation.

This article reviews the fundamentals of surgical treatment of atrial fibrillation. The clinical classification, pathophysiology, medical treatment strategy, and catheter-based interventions are also included. The Cox-Maze III procedure was developed over based on experiences of several operations which proceeded it.

Single ventricle palliation: greater risk of complications with the Fontan procedure than with the bidirectional Glenn procedure alone.

Background: This study was performed to evaluate and compare the early, intermediate, and long-term outcomes of the bidirectional Glenn procedure and Fontan procedure in patients who live at moderately high altitude.

Methods: The outcome of each method of palliation for patients with a functionally single ventricle was retrospectively evaluated from a review of medical records.

Results: The bidirectional Glenn procedure was performed in 177 patients from October 1984 to June 2004.

Early postoperative use of unfractionated heparin or enoxaparin is associated with increased surgical re-exploration for bleeding.

Background: A variety of indications (eg, prosthetic heart valves, atrial fibrillation, etc.) exist for the use of unfractionated heparin (UFH) and enoxaparin (ENOX) in the early postoperative period following open-heart surgery. However, the overall postoperative risk for hemorrhage from the use of UFH and ENOX are not known.

Ten-year outcome after aortic valve replacement with the freestyle stentless bioprosthesis.

Background: Stentless aortic bioprostheses offer excellent hemodynamics and potentially improved durability compared with other bioprostheses. The present report describes the clinical and hemodynamic outcomes for the Freestyle aortic root bioprosthesis in a large, multicenter cohort prospectively followed up for 10 years.

Methods: A total of 725 patients at 8 centers in North America (668 [92%] aged more than 60 years) were followed up prospectively after aortic valve replacement with the Freestyle stentless bioprosthesis.

Early failure of a tricuspid valve replacement with a mitral valve homograft in a heart transplant recipient.

A 24-year-old woman experienced severe tricuspid valve regurgitation 6 years after heart transplantation. Tricuspid valve replacement was performed using a cryopreserved mitral valve homograft. Severe tricuspid valve regurgitation recurred within 4 months, associated with an increase in the panel reactive antibody titers from zero to 72%.

Current status of surgery for rheumatic carditis in children.

Background: The incidence of rheumatic heart disease (RHD) has increased recently in the western United States. We reviewed our 18-year surgical experience with RHD in children to examine current surgical techniques and results.

Methods: From 1985 until 2003, 596 children (<21 years) with rheumatic fever were seen at Primary Children's Medical Center.

Eight-year results after aortic valve replacement with the Freestyle stentless bioprosthesis.

Objectives: We sought to describe the hemodynamic and clinical outcomes for the Freestyle aortic root bioprosthesis (Medtronic, Inc, Minneapolis, Minn) in a large multicenter cohort prospectively followed for 8 years.

Methods: A total of 700 patients (651 [93%] >60 years of age) at 8 centers in North America were followed prospectively after aortic valve replacement with the Freestyle stentless bioprosthesis; the implant technique was subcoronary in 500, total root in 162, and root inclusion in 38. Follow-up was 3395 patient-years (4.

Blunt chest trauma: an experimental model for heart and lung contusion.

Background: Blunt chest trauma is an important clinical problem leading to injury of the heart and lungs that may be fatal. Experimental models in large animals have been developed previously. This study was aimed at developing a small-animal (rat) model for the purpose of evaluating blunt chest trauma.

Impact of implant technique following freestyle stentless aortic valve replacement.

Background: Stentless aortic bioprostheses have excellent hemodynamics and clinical outcomes. The purpose of the present study was to determine whether implant technique of the Freestyle aortic root bioprosthesis impacts clinical outcomes or hemodynamic performance.

Methods: The long-term multicenter study of the Freestyle stentless aortic bioprosthesis includes 500 consecutive patients implanted using the subcoronary and 162 using the full root technique.

Repair of transverse sternal nonunions using metal plates and autogenous bone graft.

Transverse sternal nonunion is a complication of sternal fracture or partial sternotomy, and requires surgical treatment. Three patients with repeated failure of standard sternal repair were treated with a technique using metal plates and autogenous bone graft, which resulted in bone union in all patients. Metal plating of the sternum, accompanied by autogenous bone graft, is an effective method of treating transverse sternal nonunion.

Duplication of the tricuspid valve.

Duplication of the atrioventricular (AV) valves is a rare anomaly, more commonly seen in the mitral position. Only 13 cases have been reported in the literature.(1-10) The case described here represents an unusual variant of this anomaly and provides an opportunity to review the pathology and embryologic genesis of duplication deformities of the AV valves.

COMPLETE ATRIOVENTRICULAR CANAL AND COR TRIATRIATUM.

Two patients with complete atrioventricular canal and coexisting cor triatriatum are described. This rare combination of defects probably results from nonrelated embryological events. Successful correction was limited by the major lesion, complete atrioventricular canal, due to inadequate reconstruction of the atrioventricular valve.

ISOLATED ANOMALOUS INFERIOR VENA CAVA CONNECTION TO THE LEFT ATRIUM: REPORT OF A SUCCESSFUL SURGICAL CASE AND REVIEW OF THE LITERATURE.

This report describes a rare case of isolated anomalous connection of the inferior vena cava to the left atrium. Patching of a surgically-created atrial septal defect and rerouting of caval drainage ino the right atrium effected a successful correction. This case brings to 18 the total number of reported cases in the literature in which the inferior vena cava was connected to the left atrium.