Comparison between homografts and Freestyle® bioprosthesis for right ventricular outflow tract replacement in Ross procedures.

Objectives: Although data from large series indicate the satisfactory performance of bioprosthetic valves in the right ventricular outflow tract (RVOT), replacement of the pulmonary valve in adult patients undergoing the Ross procedure is usually performed with pulmonary allografts. We evaluated the outcomes of homografts vs. bioprosthetic RVOT replacement after the Ross procedure in adults.

Secondary repair of incompetent pulmonary valves.

Background: Secondary repair of the pulmonary valve after right ventricular outflow tract (RVOT) reconstruction is infrequently reported. This article describes possible techniques of secondary pulmonary valve repair and reports follow-up results.

Methods: Secondary pulmonary valve repairs in 7 patients (5 children and 2 adults) in our institution were reviewed.

Long-term follow-up of supra-annular pulmonary autograft aortic root replacement in patients with bicuspid aortic valve.

Objective: The performance of the Ross procedure in the case of geometric mismatch between pulmonary autograft and a bicuspid aortic root has not yet been fully evaluated. To prevent geometrically caused autograft dysfunction, a modification of the surgical technique is necessary.

Methods: Between January 1996 and January 2007, 50 patients (33 male, 17 female; mean age 50+/-14 years; range 13-63 years) underwent replacement of a diseased bicuspid aortic valve (stenosis in 14 cases; insufficiency in 21; combined disease in 15) with a Ross procedure.

Autograft regurgitation and aortic root dimensions after the Ross procedure: the German Ross Registry experience.

Background: Autograft regurgitation and root dilatation after the Ross procedure is of major concern. We reviewed data from the German Ross Registry to document the development of autograft regurgitation and root dilatation with time and also to compare 2 different techniques of autograft implantation.

Methods And Results: Between 1990 and 2006 1014 patients (786 men, 228 women; mean age 41.

Evolution of surgical techniques for atrial septal defect repair in adults: a 10-year single-institution experience.

Objective: We retrospectively analyzed our experience in atrial septal defect repair with varied minimally invasive surgical approaches.

Methods: From 1997 to 2006, 64 patients underwent surgical repair of atrial septal defects in our center. Patients were grouped into four groups according to the approach used; group 1 (n = 16), partial lower sternotomy; group 2 (n = 20), right anterior small thoracotomy with transthoracic clamping; group 3 (n = 4), right anterior small thoracotomy with endoaortic balloon clamping; and group 4 (n = 24), totally endoscopic approach with the use of the da Vinci surgical system (Intuitive Surgical, Mountain View, Calif).

The use of minimized extracorporeal circulation system has a beneficial effect on hemostasis--a randomized clinical study.

Background: Conventional cardiopulmonary bypass (CPB) is associated with increased coagulation and fibrinolytic activity. A closed miniaturized bypass circuit (CorX) features a significantly reduced tubing set, an integrated pump, and an air removal system without a cardiotomy reservoir. In a prospective randomized trial, the effects on hemostasis were investigated while comparing CorX with conventional CPB in patients undergoing coronary artery bypass grafting.

Closure of atrial and ventricular septal defects should be performed by the surgeon.

Surgeons look back on 57 years of experience in the closure of atrial septal defects (ASDs) and 46 years in the closure of ventricular septal defects (VSDs). The transcatheter approaches to repair ASDs started first in the 1980s and for VSDs 8 years later. This study sought to reveal the surgical features only given by the surgical therapy and the limitation of interventional ASD and VSD closure.

Initial experience with a minimized extracorporeal bypass system: is there a clinical benefit?

Background: Drawbacks of conventional cardiopulmonary bypass (CPB) are increased inflammatory response, deteriorated coagulation and systemic organ dysfunction. A closed extracorporeal circuit (CorX) features reduced foreign surface area and priming volume. Potential benefits were studied in comparing the CorX system with conventional CPB in arrested heart coronary artery bypass grafting (CABG).