Early and 8 year results of aortic valve replacement: a clinical study of 232 patients.

The study concerns early and late results of aortic valve replacement (AVR) in 232 patients with aortic valve disease, using the Björk-Shiley tilting-disc prosthesis. Of the 232, 27 patients had some evidence of mitral valve disease with valvulotomy having been undertaken in 7 previously, and in 12 at the time of the aortic valve replacement. Patients who underwent simultaneous mitral valve replacement and/or aorta coronary artery bypass grafting are not included in this analysis.

The postvalvulotomy propranolol test to determine reversibility of the residual gradient in pulmonary stenosis.

We advocate the use of propranolol in very low dosage at the end of operation to determine a prognosis of the long-term results to be expected after valvulotomy in diverse types of pulmonary stenosis.

Surgical correction of unusual double-outlet right ventricle.

This paper presents the case history of an 8-year-old girl who had total situs inversus and double-outlet right ventricle with pulmonary stenosis and severe tricuspid insufficiency in the presence of dextrocardia with ventricular discordance. A successful repair was performed using the Rastelli technique in conjunction with replacement of the tricuspid valve with a Bjork-Shiley prosthesis. The postoperative course was uneventful, and follow-up catheterization revealed a good operative result.

Infections through blood from heart-lung machine.

Of 657 cultures of blood from the heart-lung machine during operations performed with extra-corporeal circulation, 16 (2·4%) proved to be positive. Of these 16 patients, 12 showed no clinical infective symptoms. The case histories of the remaining four patients are presented.