Massive coronary subclavian steal syndrome.

Coronary subclavian steal syndrome is an unusual cause of angina, secondary to decreased or reversed flow in patients with patent "in situ" internal mammary-to-coronary artery graft. The most frequent cause of coronary subclavian steal syndrome is ipsilateral subclavian artery stenosis. We present a 60-year-old man with cerebrovascular and peripheral artery disease and a documented massive coronary subclavian steal syndrome, which impaired cardiopulmonary bypass weaning after multiple coronary artery bypass with double T-mammary artery graft.

Impact of preoperative anemia on cardiac surgery in octogenarians.

Objectives: Preoperative anemia has been related with adverse outcomes in elective valve replacement and CABG surgery. Impact of preoperative anemia on outcome in octogenarians submitted to cardiopulmonary bypass (CPB) has not yet been precisely described.

Methods: We analyzed association between preoperative hemoglobin level, minimum intraoperative and immediate postoperative hematocrit (HCT), and other co-morbidities and occurrence of adverse outcomes in 227 octogenarians who underwent cardiac surgery.

Analysis of inflammatory response and utility of N-terminal pro brain-type natriuretic peptide in cardiac surgery with extracorporeal circulation.

Objectives: Cardiac surgery with cardiopulmonary bypass (CPB) elicits an inflammatory response. During and after cardiac surgery, we examined the pattern of cytokine release of interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-alpha, to investigate inflammatory response. We analyzed N-terminal pro brain-type natriuretic peptide (NT-proBNP) as a marker of ventricular function.

[Cardiac surgery with extracorporeal circulation in cancer patients: influence on surgical morbidity and mortality and on survival].

Introduction And Objectives: Morbimortality related to cardiac surgery may be superior in patients with malignant neoplastic disease. Inflammatory phenomena and immunologic changes secondary to extracorporeal circulation use can also increase tumor recurrence. We evaluate characteristics and results of cardiac surgery in our neoplastic patients.

Plasma troponins as markers of myocardial damage during cardiac surgery with extracorporeal circulation.

All types of cardiac surgery involve considerable injury to the myocardium. However, it is difficult to differentiate, in the immediate post-operative state, between ischemic alterations associated with the cardiac surgery itself and the pathological alterations of a peri-operative myocardial infarction. The diagnosis of damaged myocardium, classically performed with the enzymatic markers creatine kinase (CK) and its muscle fraction (CK-MB), has become more precise with the option of measuring cardiac troponins T and I.

Heart transplantation treatment for a malignant cardiac granular cell tumor: 33 months of survival.

A malignant granular cell tumor is a high-grade sarcoma with a high rate of metastasis, local recurrence and short survival. We describe a patient who underwent orthotopic heart transplantation due to a metastatic unresectable malignant granular cell tumor. At thirty-three months following this procedure she is alive and free of recurrence.

Cognitive decline after cardiac surgery: proposal for easy measurement with a new test.

Objectives: Neuropsychological dysfunction is a recognized complication after cardiac surgery. Attention, concentration, short term memory, and speed of mental processing are commonly involved. We evaluated prospectively the incidence of cognitive impairment in our population using a single test: Paced Auditory Serial Addition Test.

[Myocardial revascularization in the female population].

Objectives: To analyze the factors that influence outcomes of surgical myocardial revascularization in the female population.

Patients And Method: This is a retrospective study in which 128 woman, subjected to GABC[IBM1] from January to September 2004, were enrolled in an univariate and multivariate analysis of risk factors associated with morbidity and mortality.

Results: The mean age was 69.

Clinical and prognostic profile of patients with infective endocarditis who need urgent surgery.

Aims: Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study were to describe the profile of patients with left-sided endocarditis who underwent urgent surgery and to analyse the factors that predicted mortality.

[Cardiac surgery in octogenarians: current situation and future perspectives].

Background And Objective: Increasing life expectancy makes cardiac surgery in octogenarians not very uncommon. We evaluated the characteristics and outcomes of patients aged over 80 undergoing cardiac surgery in our centre.

Patients And Method: We retrospectively analyzed preoperative risk factors, in-hospital morbimortality, and long term survival in 120 patients aged 80 years--mean age (standard deviation): 81.

[Valve replacement with the Omnicarbon valve prosthesis. A 10-year follow-up].

Objective: We retrospectively examined the outcomes of 264 patients who underwent consecutive Omnicarbon valve implantation surgery between April 1985 and May 1995.

Methods: At the time of surgery, patients who received this mechanical prosthesis averaged 57+/-11 years of age. Omnicarbon valves were placed in the aortic position in 36% of the cases, in the mitral position in 44%, and in both positions in 20%.

[Results of isolated and combined surgical coronary revascularization in patients over 75].

Background: Increase in life expectancy is causing an increase of surgical myocardial revascularization procedures in the elderly. We evaluate the evolution of this type of interventions in people older than 75 years, taking into account the risk factors, results and survival.

Patients And Method: Between July 1988 and May 2001, 237 isolated or combined myocardial revascularization procedures were carried out in patients older than 75 years (Group I), while 1177 were performed in younger patients (Group II).