[Biatrial vs. isolated left atrial cryoablation for the treatment of long-lasting permanent atrial fibrillation. Midterm recurrence rate].

Unlabelled: The long-term results of cryomaze in patients with longstanding persistent atrial fibrillation during concomitant surgical procedures are still uncertain.

Methods: Between 2006 and 2011, 150 consecutive patients with associated long-lasting permanent atrial fibrillation and associated heart disease underwent heart surgery were treated by biatrial Cox-Maze (63 patients) or by isolated endocardial or epicardial left atrial cryoablation (83 patients) concomitantly. The results at 3 years in these groups were compared with clinical monitoring, electrocardiography, 24-hour Holter, and echocardiography with measurement of the transmitral A wave at 1, 6 and 12 months and annually thereafter in all patients.

Efficacy of Oral Anticoagulation in Stroke Prevention among Sinus-Rhythm Patients Who Lack Left Atrial Mechanical Contraction after Cryoablation.

The customary recommendation is that oral anticoagulation be withdrawn a few months after cryoablation for atrial fibrillation, independently of left atrial mechanical contraction in patients in sinus rhythm. Recently, a 5-fold increase in stroke has been described in sinus-rhythm patients who lack atrial mechanical contraction. One aim of this study was to evaluate the efficacy of oral anticoagulation in preventing postoperative stroke in such patients.

Mitral stenosis after IMR ETlogix ring annuloplasty for ischemic regurgitation.

Objectives: Ring annuloplasty combined with coronary artery bypass grafting is the standard approach for treatment of patients with ischemic mitral regurgitation. We evaluated mitral valve hemodynamic performance and recurrence of mitral regurgitation after ring annuloplasty.

Patients And Methods: 40 consecutive patients (mean age, 70±8 years) with chronic ischemic mitral regurgitation grade ≥2+ received annuloplasty with an IMR ETlogix ring.

Placement of a rigid tricuspid annuloplasty ring over a flexible ring for the treatment of recurrent tricuspid regurgitation.

We describe a technique that implants a rigid tricuspid annuloplasty ring over a previously inserted flexible ring for the treatment of recurrent tricuspid regurgitation. This technique avoids the trauma associated with the excision of a flexible ring in patients with friable annular tissue.

Early thrombosis of a tricuspid annuloplasty ring and mild hyperhomocysteinemia.

Tricuspid annuloplasty ring thrombosis is an extremely infrequent pathology, and no evidence-based antithrombotic management has been described. We present the case of a 40-year-old female with isolated mild hyperhomocysteinemia and early ring thrombus formation after surgical primary closure of an atrial septal defect and ring tricuspid annuloplasty. Clinical management, antithrombotic treatment, and hyperhomocysteinemia implications are discussed.

Mitral valve prosthesis implanted in atrial wall over huge calcified annulus.

We describe an alternative technique for mitral valve replacement in patients with severe mitral annular calcification, in whom conventional techniques are not feasible. A new annulus that allows supra-annular prosthetic implantation is created.

Cryoablation of atrial fibrillation in cardiac surgery: outcomes and myocardial injury biomarkers.

Objective: Elevations of myocardial injury biomarkers after cardiac surgery without ablation of atrial fibrillation (AF) are related to perioperative myocardial ischemia and associated with an increased risk of mortality and cardiac events. However, there have not been any studies that examined the release of cardiac biomarkers after AF cryoablation procedures with concomitant cardiac surgery. The authors determined the levels of these biomarkers for 2 different procedures involving cryoablation and assessed their clinical implications.

Surgical treatment of giant intramural left ventricular fibroma in an adult patient with refractory ventricular tachycardia.

Cardiac fibromas are rare benign tumors predominantly diagnosed in children and teenagers. We report a 57-year-old male patient with class II dyspnea and angina. During electrocardiographic assessment, recurrent ventricular tachycardia was present and magnetic resonance imaging revealed a giant (12.

Giant left main coronary artery to right atrium fistula.

Aneurysmal arterial origin of coronary fistulae is an extremely rare combination. We report a case of a giant left main coronary artery to right atrium fistula in a 48-year-old male. We describe the clinical course and management options.

Emergent surgery for ruptured aortic arch aneurysm in an octogenarian patient: quo vadis?

Aortic arch aneurysms induce great morbidity and mortality especially when clinical signs of rupture are present. Surgical indications for repair in the high-risk octogenarian population are controversial. We present the case of an 87-year-old man with a ruptured aortic arch aneurysm with a good surgical outcome.

Mitroflow bioprosthesis stent deformation: a rare cause of early prosthetic stenosis.

We report the case of a severe prosthetic aortic stenosis in a 61-year-old male patient with an aortic Mitroflow LF bioprosthesis (Sorin Group) at early (6 months) postoperative echocardiographic follow-up. At reintervention, we found significant stent deformation, asymmetric orientation of the posts, and subsequent central kinking and prolapse of one leaflet. Maldistribution of pledgeted mattress sutures over the flexible stent was found to be the origin of its permanent deformation.

Statins and postoperative risk of atrial fibrillation following coronary artery bypass grafting.

Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting. Atrial remodeling has been observed in AF and has been associated with the development of this arrhythmia. Because 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have been demonstrated to modify remodeling, we hypothesized a protective role of statins against postoperative AF.

Preoperative statin therapy and troponin T predict early complications of coronary artery surgery.

Background: Pretreatment with statins reduces early ischemic events after percutaneous coronary interventions, primarily in patients with a high level of inflammation markers. We sought to examine the association between preoperative statin therapy, systemic inflammation, and myocardial ischemia with the occurrence of early cardiac complications after coronary artery bypass grafting surgery.

Methods: One hundred forty-one consecutive patients who underwent coronary artery bypass grafting surgery from two university tertiary hospitals were stratified according to their preoperative status of statin therapy (87 treated and 54 nontreated).

Optimal location for temporary epicardial pacing leads following open heart surgery.

Temporary epicardial pacing wires are routinely placed in patients undergoing cardiac surgery. Eighteen suitable patients undergoing elective surgery were prospectively studied. Their sensing and stimulating characteristics were studied at various locations.

Nine-year follow up of the omnicarbon prosthesis in the aortic position.

Background And Aim Of The Study: Clinical experience with the Omnicarbon mechanical valve implanted in the aortic position is reported in this retrospective survey.

Methods: A total of 110 patients (mean age 56 years) undergoing isolated aortic valve replacement with Omnicarbon mechanical prostheses at the authors' institution between November 1991 and October 2000 was included. Follow was available in 94.

[A comparative study of the follow-up and hemodynamics in vivo of 21 mm Carpentier-Edwards supra-annular and perimount bioprostheses].

Introduction And Objectives: Analysis and comparison of the clinical performance and hemodynamics in vivo of 21 mm Carpentier-Edwards supra-annular (CESA) and Perimount (CEPM) aortic bioprostheses.

Methods: A follow-up study was made of 40 patients implanted a 21 mm CESA (n = 21) or CEPM (n = 19) prosthesis between October 1992 and September 1997. All eligible survivors (14 CESA, 12 CEPM) were assessed echocardiographically.