Long-term follow-up of mitral valve repair: a single-center experience.

Background: Our aim was to conduct a long-term follow-up of patients after mitral valve repair for incompetence. We identified determinants for mortality and compared mortality with standardized mortality rates of the Dutch population.

Material/methods: We included in this single-center retrospective study 119 patients operated from March 1976 to February 1981.

Primary lung tumor mimicking acute type A aortic dissection.

A 64-year-old man presented with clinical features and echocardiographic diagnosis of an acute type A dissection. He underwent median sternotomy for definitive surgical treatment. On external examination of the aorta, other intrapericardial structures, and the right lung, it was evident that the patient had an advanced lung tumor.

Transmanubrial osteomuscular sparing approach for sulcus superior tumours.

Objective: The authors report their initial experience with the transmanubrial osteomuscular sparing approach for resection of sulcus superior tumours. The feasibility of this technique is evaluated.

Patients: Between February 2000 and March 2002 three patients with sulcus superior tumours were surgically treated using the transmanubrial osteomuscular sparing approach.

Operative risk factors of type A aortic dissection: analysis of 252 consecutive patients.

Objective: We examined operative risk factors for postoperative death after surgery for acute type A aortic dissection.

Methods: Between 1974 and 1999, 252 patients, 163 men and 89 women (mean+/-SD age, 58+/-12 years) underwent surgery for acute type A aortic dissection. Fifty-eight (23.

Venous coronary artery bypass surgery: a more than 20-year follow-up study.

Aims: Atherosclerosis in venous coronary artery bypass grafts begins early and accelerates from the fifth post-operative year. We studied the influence of 18 variables existing at the time of operation, and of 'classical' risk factors present at 1 and 5 years after operation on the long-term outcome of this type of surgery.

Methods And Results: Four hundred twenty-eight consecutive patients who underwent isolated venous coronary bypass surgery between April 1, 1976 and April 1, 1977 were followed prospectively.

Organized thrombus in the ascending aorta originating from the ostium of the right coronary artery.

This case report describes the rare finding of a pedunculate thrombus in the ascending aorta originating from the ostium of the right coronary artery (RCA) detected after an inferior wall myocardial infarction in a young female. The thrombus was removed surgically during an emergency cardiopulmonary bypass procedure

Repeated thromboembolic and bleeding events after mechanical aortic valve replacement.

Background: The choice of a valve substitute in young adults requires a decision balancing the risks of long-term anticoagulation versus reoperation(s). This article analyzes the long-term risk and determinants of thromboembolic (TE) and bleeding (BLE) complications after mechanical aortic valve replacement (AVR).

Methods: From December 1963 to January 1974, 249 patients survived a mechanical AVR at our institution.

Current management of postoperative chylothorax.

Background: This study was performed to review our experience with postoperative chylothorax and describe our current approach. In addition, we wanted to estimate the impact of video-assisted thoracoscopic surgery (VATS) on our current management policy.

Methods: From January 1991 to December 1999, 12 patients developed chylothorax after various thoracic procedures.

A 23-year experience with composite valve graft replacement of the aortic root.

Background: This is a retrospective study of early and long-term results of composite valve graft replacement of the aortic root.

Methods And Results: Between July 1974 and July 1997, 244 patients underwent aortic root replacement with a composite valve graft. Mean age was 54+/-15 years.

Completion pneumonectomy: analysis of operative mortality and survival.

Background: A single-institution experience with completion pneumonectomy was analyzed to assess operative mortality and late outcome.

Methods: A consecutive series of 138 completion pneumonectomies from 1975 to 1995 was reviewed, and compared with single-stage pneumonectomies performed during the same period.

Results: Hospital mortality was 13.

Acute cardiac herniation following intrapericardial pneumonectomy.

Cardiac herniation is a rare but potentially fatal complication of intrapericardial pneumonectomy. It usually occurs within the first 24 hours postoperatively. Symptoms are side-related.

Surgical thromboendarterectomy for chronic thromboembolic pulmonary hypertension using circulatory arrest with selective antegrade cerebral perfusion.

The use of circulatory arrest with selective antegrade cerebral perfusion is described in a 59-year-old man who underwent thrombendarterectomy for chronic thromboembolic pulmonary hypertension. The postoperative course was uneventful. The described surgical technique may prevent the patient from cerebral sequelae especially in more complex cases.

Extended vertical transatrial septal approach for the removal of left atrial myxoma.

Objective: Optimal exposure greatly facilitates left atrial myxomectomy and is mandatory for safe and efficacious tumour removal. The purpose of this study was to evaluate one institutions experience, with an alternative to the classical approach, for the removal of left atrial myxoma.

Methods: In an eight-year period, eight patients underwent surgical removal of left atrial myxoma at our institution using the extended vertical transatrial septal approach, slightly modified compared to the original method of Guiraudon and associates, as the septum was initially incised superiorly instead of through the fossa ovalis.

Transsternal closure of bronchopleural fistula after pneumonectomy.

Background: Bronchopeural fistula after pneumonectomy, with associated empyema, has no standard therapy. The transsternal, transpericardial approach was used in all patients presenting with a large fistula.

Methods: From 1974 through 1995, 55 patients underwent transsternal, transpericardial closure of a bronchopleural fistula.

Closure of a bronchopleural fistula by midsternal approach in three patients with previous aortocoronary bypass grafting.

The feasibility of midsternal approach for closure of bronchopleural fistula is demonstrated in three patients who had previously undergone sternotomy for aortocoronary bypass grafting.

Clinical outcome in venous coronary artery bypass grafting: a 15-year follow-up study.

Objective: We investigated the clinical outcome of venous coronary artery bypass graft surgery.

Methods: A study group consisting of 428 consecutive patients-operated on between 1 April 1976 and 1 April 1977-was followed prospectively. Single or sequential saphenous vein grafts were performed with a mean of 3.

Different clinical outcome in coronary artery bypass with single and sequential vein grafts: a fifteen-year follow-up study.

Objective: In trying to answer the question about the controversial use of sequential grafts, we determined the long-term clinical outcome of patients in whom coronary artery bypass was done with different types of vein grafts.

Methods: A total of 428 consecutive patients who underwent isolated coronary artery bypass with vein grafts between April 1, 1976, and April 1, 1977, were prospectively observed. In these patients three groups could be defined with single grafts only, sequential grafts only, and combined single and sequential grafts.

Pulmonary function and postoperative complications after wedge and flap reconstructions of the main bronchus.

Between 1980 and 1989, 8 wedge and 17 flap main bronchoplasties were done in 24 patients (4 carcinoid tumors, 4 benign lesions, 17 carcinomas). Bronchial anastomotic stenoses, pulmonary function, and survival were evaluated. Preoperative ventilation/perfusion scans with preoperative and postoperative spirometry were done in all patients except two who underwent a wedge bronchoplasty.

Early mortality after surgical repair of postinfarction ventricular septal rupture: importance of rupture location.

Background: The aim of this study was to identify factors influencing early outcome after surgical treatment of postinfarction ventricular septal rupture. We investigated the influence of proximal or distal rupture location.

Methods: Between 1980 and 1992 109 patients were treated surgically for ventricular septal rupture using a standardized technique.

Long-term survival after bronchial sleeve resection: univariate and multivariate analyses.

Background: Long-term results after bronchial sleeve resection remain controversial, especially in relation to nodal involvement. In a previous report, there were no 10-year survivors among patients with N1 or N2 disease.

Methods: From 1960 to 1989, 145 patients underwent bronchial sleeve resection for a bronchogenic tumor.

Lung function and perfusion after bronchial and pulmonary arterial sleeve resection.

Between January 1985 and December 1991, six patients underwent arterial and bronchial sleeve resections of the left upper lobe. Preoperative and postoperative spirometry, preoperative split pulmonary radionuclide ventilation/perfusion (V/Q) scans and postoperative bronchoscopy were obtained in four patients. Postoperative serial digital vascular images (DVI) of the pulmonary artery were obtained in three patients and one patient had a postoperative V/Q scan.

Multivariate risk factor analysis of clinical outcome 15 years after venous coronary artery bypass graft surgery.

Background: Knowledge is still lacking about pre-operative and postoperative factors which predict the long-term prognosis of patients who undergo venous coronary artery bypass graft surgery.

Methods And Results: Four hundred and twenty-eight consecutive patients who underwent isolated venous coronary artery bypass graft surgery with or without left ventricular aneurysm surgery between 1 April 1976 and 1 April 1977, were followed prospectively. Follow-up was 99.

The scimitar syndrome: clinical spectrum and surgical treatment.

We present seven patients with the scimitar syndrome. The clinical and anatomical spectrum is described. Two different types of scimitar vein was recognized.

Concomitant open heart surgery and pulmonary resection for lung cancer.

From 1979 to 1993, 79 patients underwent pulmonary resection for lung cancer and a concomitant cardiac operation using extracorporeal circulation. There were 75 men and 4 women with a mean age of 65 years (range 52-77). Cardiac procedures consisted of coronary artery bypass grafting (CABG) in 69 patients (three redos), aortic valve replacement in 7 (2 combined with CABG), mitral valve repair in 1 (combined with CABG) and other in 2.

Tetraplegia after a tracheal resection procedure.

We describe a 27-year-old patient who was admitted to our hospital for a tracheal stenosis caused by an adenocystic carcinoma. A tracheal resection procedure was performed and the head was fixed to the anterior chest wall by two sutures. Postoperatively he became tetraplegic, from which he completely recovered after the sutures were removed.