Weaning from ventilator after cardiac operation using the Ciaglia percutaneous tracheostomy.

Objective: To determine the predictors of weaning from mechanical ventilation after cardiac operation with the Ciaglia percutaneous dilatational tracheostomy (PDT) in our preliminary experience in the use of this technique.

Methods: We prospectively analysed 33 consecutive patients (mean age 70.9+/-12.

Mitral valve surgery for mitral regurgitation in patients with advanced dilated cardiomyopathy.

Background: Unfortunately, mitral valve surgery for mitral regurgitation (MR) in patients with advanced dilated cardiomyopathy is generally associated with a high operative risk and a poor outcome. Some authors believe that only heart transplantation is the really effective surgical treatment. We analyzed our clinical and echocardiographic results after mitral repair or replacement in this difficult subset of patients.

The edge-to-edge technique as a trick to rescue an imperfect mitral valve repair.

Objective: The edge-to-edge (E-to-E) technique in mitral valve repair (MVR) is promising especially to correct mitral insufficiency (MI) caused by complex mitral valve lesions. We tested this technique to improve residual MI straight after conventional MVR.

Methods: From September 1998 to January 2002, 108 consecutive patients underwent MVR with current techniques for pure MI.

Predictors of postoperative complications in high-risk octogenarians undergoing cardiac operations.

Background: Cardiac operations in octogenarians are currently reserved for selected patients with severe symptoms and low extracardiac comorbidity; early and midterm results are satisfactory. We evaluated the outcome of high-risk octogenarians undergoing cardiac operations and investigated the predictors of postoperative complications.

Methods: Between June 1998 and March 2001, 73 consecutive octogenarians (mean age = 83.

Biomolecular and biochemical response of myocardial cell to ischemia and reperfusion in the course of heart surgery.

Background: Previous studies have shown that biomolecular and biochemical adaptive changes antagonize oxidative damage due to hypoxia and ischemia in myocardial cells. The aim of our study was to verify in human ischemic and reperfused cardiac tissue the relationship between mitochondrial enzyme activities and the activation of HSP70 and c-fos syntheses in the context of a cytoprotective mechanism. Nitric oxide (NO) modulating effects on mitochondrial respiratory chain enzyme activities in ischemic and reperfused tissue were investigated (preliminary report).