Bilateral remote ischemic conditioning in children: A two-center, double-blind, randomized controlled trial in young children undergoing cardiac surgery.

Objective: The study objective was to determine whether adequately delivered bilateral remote ischemic preconditioning is cardioprotective in young children undergoing surgery for 2 common congenital heart defects with or without cyanosis.

Methods: We performed a prospective, double-blind, randomized controlled trial at 2 centers in the United Kingdom. Children aged 3 to 36 months undergoing tetralogy of Fallot repair or ventricular septal defect closure were randomized 1:1 to receive bilateral preconditioning or sham intervention.

Transapical approach to optimize left ventricular resynchronization in patients with dilated cardiomyopathy.

An alternative to coronary sinus implantation for a left ventricular pacing lead is frequently needed for cardiac resynchronization therapy. We have developed a transapical approach to implant an endocardial pacing lead that will reach the most delayed segment of the left ventricle. This method is easily combined with other transapical heart surgeries.

Transapical approach to optimize left ventricular resynchronization in patients with dilated cardiomyopathy.

An alternative to coronary sinus implantation for a left ventricular pacing lead is frequently needed for cardiac resynchronization therapy. We have developed a transapical approach to implant an endocardial pacing lead that will reach the most delayed segment of the left ventricle. This method is easily combined with other transapical heart surgeries.

Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy.

Purpose: Cardiac resynchronization therapy (CRT) is an established therapeutic option in selected heart failure patients (pts). However, the transvenous left ventricular (LV) lead implantation remains ineffectual in a considerable number of pts. Transapical LV (TALV) lead implantation is an alternative minimally invasive, surgical, endocardial implantation technique.

Alternative techniques for left ventricular pacing in cardiac resynchronization therapy.

Cardiac resynchronization therapy (CRT) is an important treatment modality for a well-defined subgroup of heart failure patients. Coronary sinus (CS) lead placement is the first-line clinical approach but the insertion is unsuccessful in about 5-10% of the patients. In recent years, the number of CRT recipients and the considerable need for left ventricular (LV) lead revisions increased enormously.

Comparison of the efficacy of two surgical alternatives for cardiac resynchronization therapy: trans-apical versus epicardial left ventricular pacing.

Background: Epicardial pacing lead implantation is the currently preferred surgical alternative for left ventricular (LV) lead placement. For endocardial LV pacing, we developed a fundamentally new surgical method. The trans-apical lead implantation is a minimally invasive technique that provides access to any LV segments.

Feasibility of percutaneous implantation of transapical endocardial left ventricular pacing electrode for cardiac resynchronization therapy.

Failure of coronary sinus lead implantation for resynchronization therapy requires alternative approaches. For such events we have developed a transapical implantation technique as a feasible alternative. We report the outcome of this technique and its evolution from a minithoracotomy to a percutaneous approach.

[Heart transplantation after corrective surgery of a congenital heart disease. Surgical technical problems].

Heart transplantation was performed in a 17-year old boy with severe left ventricular failure. Previously a congenital heart disease, tetralogy of Fallot was reconstructed in one and half years old of age. Authors present the different surgical problems complicated this procedure.

[Redo procedures for correction of aortic valve diseases in infants and children. The Bentall-Konno procedure].

On an infant with critical valvular aortic stenosis balloon-valvoplasty, and 3 years later because of the aortic valve regurgitation Ross operation was performed. In the early postoperative period an aortic-root abscess occurred due to an infective endocarditis; the aortic root was corrected by homograft implantation. Due to a relatively small, calcified aortic valve, with aortic valve regurgitation grade III at the age of 12 years, a Bentall-Konno procedure was performed successfully.

[Surgical management of congenital heart defects in adolescent and adult patients, between years 2001-2008].

Unlabelled: The leading interventions due to congenital heart defects performed in adults are: (I) reconstructive operations, including: (a) newly diagnosed malformations, (b) previously adjudged to be inoperable defects, (c) so called "tardive" interventions due to pulmonary hypertension or right ventricle insufficiency. There is a growing number of (II) REDO operations, including: (a) correction of residual defects, (b) replacement of damaged or outgrown homografts, (c) recoarctation (aneurysm, dissection) of the aorta after surgical or catheter interventions, (d) Ross procedure, valve replacements due to previously performed aortic valvulotomy/valvuloplasty or corrections of different malformations (e.g.

A novel approach for endocardial resynchronization therapy: initial experience with transapical implantation of the left ventricular lead.

Background: Coronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a considerable dislocation rate during follow-up. For these patients epicardial pacing lead implantation is the most frequently used alternative. Recent data support endocardial lead implantation through the atrial septum and the mitral valve, because this method provides further hemodynamic advantages.

Alternative method for cardiac resynchronization: transapical lead implantation.

Alternative methods are necessary for cardiac resynchronization therapy when coronary sinus lead implantation fails. We aim to describe a fundamentally new approach using transapical implantation of an active fixation endocardial pacing lead. This technique is based on direct puncture of the left ventricular apex using the standard Seldinger technique.

[Alternative method for cardiac resynchronization: transapical lead implantation].

Coronary sinus lead placement for transvenous left ventricular pacing in cardiac resynchronization has significant failure rate at implant and significant dislocation rate during follow-up. Alternative methods are necessary for these patients. We aim to describe a fundamentally new approach using transapical implantation of an active fixation endocardial pacing lead.

New method for cardiac resynchronization therapy: transapical endocardial lead implantation for left ventricular free wall pacing.

Coronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a significant dislocation rate during follow-up. For these patients, epicardial pacing lead implantation is the most frequently used alternative. The aim of this case report is to describe a fundamentally new approach for the endocardial LV lead implantation.

[Successful cardiac surgical removal of migrated Kirschner wires used for fixation of the surgical neck of the humerus].

Dislocation and migration of two Kirschner wires were found 13 days after fixation of the surgical neck of the humerus. One of the wires was located between the lateral thoracic muscles, while the other one has perforated the apex of the heart, showing a synchronous motion with heart contractions. An anterolateral thoracotomy was performed and the wires were removed successfully.

Chlamydia pneumoniae in coronary bypass grafts of redo patients. The concept of the 'adventitial baseline infection'.

The pathogenic role of Chlamydia pneumoniae in late coronary bypass graft failure has not yet been extensively investigated. We examined failed and new arterial/venous bypass grafts using immunohistochemistry, polymerase chain reaction (PCR), and serology. Thirty-four long-term failed grafts and 28 new grafts were examined in 21 patients undergoing redo coronary artery bypass grafting (CABG).

Immunological and histopathological changes in the atrial tissue during and after cardiopulmonary bypass.

Background: Ischemia and reperfusion injury occur in cardiac operations using cardiopulmonary bypass (CPB). Little is known about the immunological and histopathological changes in the atrial tissue under these conditions.

Objectives: To investigate and compare multiple right atrial biopsy specimens by means of a self-developed pathological and immunohistochemistry panel.

Surgical treatment of cardiac myxomas: a 20-year follow-up.

Clinical experience in the diagnosis and management of 50 cases of cardiac myxoma seen over a 20-year period from 1974 to 1994 has been reviewed. There were 17 men and 33 women of mean age 55.2 (range 16-81) years.

[Long-term results of surgical treatment of cardiac myxomas].

We have reviewed our clinical experience in the diagnosis and management of 50 cases of cardiac myxoma seen over a 20 year period, 1974 to 1994. There were 17 males and 33 females, their ages ranged from 16 to 81 years (mean 55.2 years).

Dissection of the atrial wall after mitral valve replacement.

We describe an unusual sequela of mitral valve replacement in a 50-year-old woman who had undergone a closed mitral commissurotomy in 1975. She was admitted to our hospital because of mitral restenosis in November 1993, at which time her mitral valve was replaced with a mechanical prosthesis. On the 8th postoperative day, the patient developed symptoms of heart failure; transesophageal echocardiography revealed dissection and rupture of the left atrial wall.

Valve repair in infective endocarditis.

From 1985 to 1995, 12 patients with native valve endocarditis underwent valve repair instead of replacement. Mean age was 41.9 years (range from 5 to 79 years).

[Experience with the implantation of the Thermos 01 rate-adaptive pacemaker].

Authors summarise their 16 patient-years experience of eight Thermos 01 rate-adaptive pacemaker systems implanted in the Hungarian Institute of Cardiology. Data collected during regular control of the patients, exercise tests and Holter investigations are presented. Five of the 8 patients had better exercise capacity, but improvement over 25 Watt workload appeared only at two patients.

Total correction of tetralogy of Fallot in adolescents and adults.

From 1976 to 1988, 23 adolescent and adult patients underwent total correction of tetralogy of Fallot. There were 13 males and 10 females, ranging in age from 16 to 47 years (mean 24.3 +/- 8.