Does a pre-left ventricular assist device screening score predict long-term transplantation success? A 2-center analysis.

Background: A risk factor summation score was previously validated to successfully predict survival after insertion of a left ventricular assist device (LVAD). We investigated whether this scoring system also predicts clinical outcomes after eventual heart transplantation in LVAD recipients.

Methods: A retrospective review was performed on 153 consecutive patients who received an LVAD as a bridge to transplantation at 2 large-volume centers from 1996 to 2003.

Surgical ablation of atrial fibrillation: the Columbia Presbyterian experience.

Background: The Maze III procedure is an effective surgical treatment for atrial fibrillation (AF). However, it is not widely applied due to its complexity, increased operative times, and the risk of bleeding. Various energy sources have been introduced to simplify the traditional "cut and sew" approach.

Edge-to-edge mitral valve repair: the Columbia Presbyterian experience.

Background: The edge-to-edge mitral valve repair, first described by Alfieri in 1995 treats mitral regurgitation when standard reparative techniques are difficult, unlikely to succeed, or have failed. This study examines one institution's medium-term experience with this procedure.

Methods: This study involved patients undergoing edge-to-edge mitral valve repair at a single institution from 1997 to 2003.

Minimally invasive surgery for atrial fibrillation: toward a totally endoscopic, beating heart approach.

In the last several years, a number of procedures have been conceived that have attempted to treat atrial fibrillation (AF) by creating a limited set of lesions modeled after those of the Maze operation. These lesions have been created by a variety of means, including the traditional cut-and-sew method, but also by nonincisional techniques. These have included cryoablation as well as several thermal techniques, using radiofrequency, microwave, laser, and focused ultrasound energy.

Robotic techniques improve quality of life in patients undergoing atrial septal defect repair.

Background: Minimally invasive cardiac surgery has emerged as an alternative to conventional, open surgery. Although most studies of robotically assisted cardiac surgery have reported morbidity and mortality, few have addressed outcome measures, such as pain and quality of life, which was the aim of this study.

Methods: Eleven patients with atrial septal defects (ASD), and five patients with patent foramen ovale, underwent repair using the Da Vinci system (Intuitive Surgical, Mountain View, CA).

A double-blind randomized trial: prophylactic vasopressin reduces hypotension after cardiopulmonary bypass.

Background: Inhibition of angiotensin-converting enzyme (ACE) predisposes patients to vasodilatory hypotension after cardiopulmonary bypass (CPB). This hypotension has been correlated with arginine vasopressin deficiency and can be corrected by its replacement. In patients receiving ACE inhibition, we investigated whether initiation of vasopressin before CPB would diminish post-CPB hypotension and catecholamine use by avoiding vasopressin deficiency.

Nontransplant surgical options for congestive heart failure.

A wide array of surgical options are currently available for the treatment of congestive heart failure ranging from traditional coronary artery bypass grafting to total artificial heart implantation. The indications for each procedure depend on the severity of disease and the individual patients desires. Some surgical options are indicated for patients with moderate disease and prevent worsening heart failure, whereas other procedures are limited to patients who will only survive with high-risk surgery.

New surgical treatments for heart failure.

Medical therapy for heart failure is quickly advancing, but long-term survival unfortunately remains poor. New surgical techniques seek to halt and reverse the progression of heart failure. Positron emission tomography has refined patient selection techniques for coronary artery bypass grafting in the failing heart.