Coronary artery disease progression in patients who need repeat surgical revascularisation: the surgeon's point of view.

Objective: The purpose of this study was to evaluate changes in native coronary arteries in patients undergoing repeat myocardial revascularisation late (>3 years) after primary coronary artery bypass grafting (CABG).

Methods: The angiographic images of 30 patients obtained at first and redo CABG were assessed for significant (>75%), short (<1 cm) and long (>1 cm) stenosis or total occlusion in native coronary arteries. Bypass grafts were also evaluated for significant stenosis (>50%) or occlusion.

Surgery for severe aortic stenosis with low transvalvular gradient and poor left ventricular function -- a single centre experience and review of the literature.

Background: A retrospective comparative study was designed to determine whether the transvalvular gradient has a predictive value in the assessment of operative outcome in patients with severe aortic stenosis and poor left ventricular function.

Methods: From a surgical database, a series of 30 consecutive patients, who underwent isolated aortic valve replacement for severe aortic stenosis with depressed left ventricular (LV) function (EF < 40%), were enrolled in the study and divided into two groups according to the mean transvalvular gradient (TVG): LG(low gradient)-Group < 40 mmHg (n = 13), and HG(high gradient)-Group > 40 mmHg (n = 17). Both groups were then comparatively assessed with respect to perioperative organ functions and mortality.