Quality of internal thoracic artery grafts after mediastinal irradiation.

Background: With the increase of patients of advanced age requiring coronary artery bypass grafting (CABG), the number of those with previous mastectomy and irradiation of the chest increases proportionally. The question of whether mediastinal irradiation leads to relevant internal thoracic artery (ITA) graft damage remains unclear. The aim of the present study was to proof the quality of ITAs and to evaluate the early clinical outcome after using one or both ITAs in this specific population.

Influence of completely supra-annular placement of bioprostheses on exercise hemodynamics in patients with a small aortic annulus.

Objective: Aortic valve replacement in patients with a small aortic annulus is often associated with increased pressure gradients. For this reason, prostheses for completely supra-annular placement have been developed. To evaluate the potential benefit of this design, the present study compared the effectiveness of 1 intra-supra-annular bioprosthesis and 3 completely supra-annular bioprostheses in patients with an aortic annulus diameter of 23 mm or less.

Investigation of various types of neurocardiogenic response to head-up tilting by extended hemodynamic and neurohumoral monitoring.

Background: The pathophysiology of neurocardiogenic syncope is heterogeneous. This study aim was to analyze whether extended monitoring during tilt-table testing provided additional information on the hemodynamic and vegetative state prior to neurocardiogenic syncope.

Methods: This retrospective analysis is based on data of head-up tilt-table testing of 40 unselected consecutive patients with a history of unexplained syncope.

Determinants of ascending aortic dimensions after aortic valve replacement with a stented bioprosthesis.

Background And Aim Of The Study: Concomitant replacement of the mildly dilated ascending aorta during aortic valve replacement (AVR) is controversial because progress of aortic dilatation is uncertain after elimination of the valvular lesion. The study aim was to determine factors influencing the aortic dimensions, to analyze their clinical impact, and to identify criteria for concomitant surgery on the aorta.

Methods: Between February 1994 and May 1999, 100 patients with tricuspid aortic valve disease received the stented porcine Mosaic prosthesis within a FDA approval study.

Hemodynamic evaluation of the Sorin Soprano bioprosthesis in the completely supra-annular aortic position.

Background And Aim Of The Study: The study aim was to evaluate the clinical and hemodynamic performance of the Sorin Soprano bioprosthesis in the aortic position.

Methods: Rest and stress echocardiography were performed at six months after surgery in 57 patients who underwent aortic valve replacement with the stented Soprano bioprosthesis. The exercise protocol included workloads of 25, 50, 75 and 100 W, each of 2 min duration.

Rest and exercise performance of the Medtronic Advantage bileaflet valve in the aortic position.

Background: The aim of the study was to evaluate rest and exercise performance and left ventricular mass regression of the Medtronic Advantage (Medtronic, Inc, Minneapolis, MN) prosthesis in the aortic position at 1 year at a single center as part of a multicenter, prospective clinical trial.

Methods: Between May 2002 and June 2003, 63 consecutive patients underwent aortic valve replacement with a Medtronic Advantage prosthesis (84.1% male; mean age, 56.

Hemodynamic comparison of bioprostheses for complete supra-annular position in patients with small aortic annulus.

Objectives: The present study evaluates complete supra-annular bioprostheses in patients with an aortic annulus of 18 to 23 mm in diameter.

Background: Aortic valve replacement in patients with small aortic annulus using stented bioprostheses is often associated with unsatisfactory hemodynamic results and high incidence of patient-prosthesis mismatch.

Methods: Between February 2000 and January 2004, 156 patients with aortic valve disease and an aortic annulus of 18 to 23 mm in diameter received the stented bovine Soprano (Sorin Biomedica Cardio, Saluggia, Italy) (n = 18), Perimount (Edwards Lifesciences, Irvine, California) (n = 52), Perimount Magna (Edwards Lifesciences) (n = 42), or the stented porcine Mosaic (Medtronic Inc.

Exercise hemodynamics of bovine versus porcine bioprostheses: a prospective randomized comparison of the mosaic and perimount aortic valves.

Objective: This prospective randomized study compares a porcine with a bovine bioprosthesis in the aortic position with regard to hemodynamic performance during exercise.

Methods: Between August of 2000 and December of 2002, 136 patients underwent aortic valve replacement with the porcine Medtronic Mosaic (n = 66) or the bovine Carpentier-Edwards Perimount (n = 70) bioprosthesis. Transthoracic echocardiography was performed to assess hemodynamic and dimensional data preoperatively and 10 months postoperatively; the latter follow-up included stress echocardiography with treadmill exercise.

The effective orifice area/patient aortic annulus area ratio: a better way to compare different bioprostheses? A prospective randomized comparison of the Mosaic and Perimount bioprostheses in the aortic position.

Background And Aim Of The Study: The aim of this prospective, randomized study was to compare the hemodynamic performance of the Medtronic Mosaic and Edwards Perimount bioprostheses in the aortic position, and to evaluate prosthesis-specific differences in valve sizing and valve-size labeling.

Methods: Between August 2000 and September 2002, 139 patients underwent isolated aortic valve replacement (AVR) with the Mosaic (n = 67) or Perimount (n = 72) bioprosthesis. Intraoperatively, the internal aortic annulus diameter was measured by insertion of a gauge (Hegar dilator), while prosthesis size was determined by using the original sizers.

The Mosaic bioprosthesis in the aortic position: seven years' results.

Background And Aim Of The Study: The Mosaic bioprosthesis is a stented porcine aortic valve, which combines glutaraldehyde fixation with zero-pressure and root-pressure techniques and anti-mineralization treatment with amino-oleic acid for improved hemodynamics and tissue durability. The study aim was to collect intermediate-term data of the Mosaic bioprosthesis in the aortic position, the first device having been implanted in February 1994 at the authors' institution.

Methods: A total of 100 patients (49 females, 51 males) underwent aortic valve replacement with the Mosaic bioprosthesis between February 1994 and May 1999.

European experience with the Mosaic bioprosthesis.

Objective: The purpose of this study was to prospectively evaluate the clinical and hemodynamic performance of the Mosaic bioprosthesis (Medtronic, Inc, Minneapolis, Minn).

Methods: The stented porcine bioprosthesis combines the amino-oleic acid antimineralization treatment and the zero-pressure differential fixation technique for improved tissue durability. From February 1994 to May 1999, a total of 561 patients underwent valve replacement with the Mosaic bioprosthesis at 5 centers in Europe: 461 in the aortic and 100 in the mitral position.

Left ventricular mass regression after aortic valve replacement with the mosaic bioprosthesis.

Background And Aims Of The Study: The study aim was to evaluate the hemodynamic performance and extent of left ventricular (LV) mass regression after aortic valve replacement (AVR) with the Mosaic bioprosthesis within the first postoperative year.

Methods: Between 1994 and 1999, 366 patients (203 males, 163 females) underwent AVR with the Mosaic bioprosthesis at five centers in Europe. Mean age at implant was 71.

In-vivo bacterial adherence to intracardiac prosthetic materials: a new experimental model.

Background And Aim Of The Study: Bacterial colonization of inert artificial materials is a critical variable in the appearance of foreign body-centered infections. Hence, a new experimental endocarditis model was evaluated that enables quantitative in-vivo testing of bacterial adherence to prosthetic materials.

Methods: In 53 rabbits, different patches of either Dacron (DAC; n = 16), glutaraldehyde-fixed pericardium (GAP; n = 18) or cryopreserved allograft (AG; n = 19) were threaded onto a Prolene suture and led through a stitch incision at the left atrium to the ventricle, perforating the mitral valve and leaving the heart at the outside of the left ventricle.