Excessive strut wear allowing ball-poppet embolization in a DeBakey-Surgitool aortic valve prosthesis.

Excessive cage strut wear allowing ball-poppet embolization caused the sudden death of a 47 year old lady in whom a DeBakey-Surgitool aortic prosthesis had been implanted nine years earlier. Patients with this type of prosthesis should have periodic valvular cine fluoroscopy with image intensification to allow visualization of significant strut wear or fracture, and appropriate prosthetic valve replacement.

A rapid, secure method of sternal closure.

In 1977 Robicsek(1) described a method of sternal closure that involved a double wire on each side of the sternum, with appropriate circumferential wires. Shortly thereafter, we modified that procedure, as shown in Figure 1. Only one wire is used on each side of the sternum, and fewer circumferential wires are needed.

Coronary arterial bypass operations without antibiotic coverage.

In this study, six of 693 consecutive patients in 29 months who underwent only myocardial revascularization, without prophylactic systemic therapy with antibiotics, experienced infection of a clean wound. This incidence of infection (0.86 percent) in such patients is the lowest reported in the literature.

Postoperative chest wound infections in patients requiring coronary bypass. A controlled study evaluating prophylactic antibiotics.

A controlled study investigating clean chest wound infections in 904 patients undergoing myocardial revascularization was performed. Four hundred fifty-one patients received systemic antibiotics before and after the operation, and 453 patients received no prophylactic systemic antibiotics. The infection rate was 1.

Bilateral renal vein and inferior vena cava thrombosis with nephrotic syndrome treated by thrombectomy: case report with 3-year followup.

A previously healthy 19-year-old woman taking anovulatory medication presented with symptoms of the nephrotic syndrome and lupus erythematosus. Diagnosis of inferior vena cava and bilateral renal vein thrombosis was made angiographically. The patient was treated successfully by thrombectomy and anticoagulation, and remains well 3 years later.

Complete obstruction of the left main coronary artery associated with congenital pulmonary valvular stenosis.

The surgical treatment of the completely obstructed left main coronary artery is aortocoronary saphenous-vein bypass to the left coronary artery system. Without surgical intervention, this lesion has an exceedingly poor prognosis. This report describes a patient with atherosclerotic obstruction of the left main coronary artery and congenital pulmonary valvular stenosis, an unusual combination of lesions not previously documented together.