Custodiol versus Plegisol: A phase 3 multicentre myocardial protection study.

Background: While considered simple and effective, crystalloid antegrade cardioplegia solutions have had few prospective multicentre comparison trials.

Methods: A commercial intracellular-type histidine-tryptophan-ketoglutarate (HTK) cardioplegia solution (Custodiol HTK; Köhler Chemie GmbH, Germany) designed for 4 h of protection after a single administration was compared with a standard extracellular multidose product (Plegisol [PL]; Hospira Inc, USA) in an open-label, randomized, prospective seven-institution trial. A total of 136 isolated coronary bypass patients were randomly assigned into two groups and stratified by ejection fraction into categories of 40% or greater (n=118) and 20% to 39% (n=18).

Chordae tendinae tumor as the cause of cardioembolic stroke.

We describe the case of a chordae tendinae papillary fibroelastoma with patent foramen ovale and interatrial septal aneurysm in a healthy young woman who suffered from acute ischemic right middle cerebral artery infarction.

Risk-stratified evaluation of amiodarone to prevent atrial fibrillation after cardiac surgery.

Background: Amiodarone prophylaxis (AMP) reduces the prevalence of postoperative atrial fibrillation (POAF) after cardiac surgery. We investigated the impact of AMP on the frequency and duration of POAF, the intensive care unit and hospital length of stay, and its cost-effectiveness in a risk-stratified cohort.

Methods: A retrospective, observational analysis of 509 patients who underwent cardiac surgery in 2003 was performed.

Hemolytic anemia produced by regurgitation through transposed chordae tendineae.

Hemolytic anemia after mitral repair and annuloplasty ring placement is very uncommon, and rarely described. The case is presented of a 53-year-old woman who developed severe mitral regurgitation and transfusion-dependent hemolytic anemia following mitral valve repair with a Carpentier-Edwards annuloplasty ring, which included transposition of chordae tendineae from the posterior leaflet to the anterior leaflet. Transesophageal echocardiography suggested that the transposed chordae tethered the anterior leaflet, causing malcoaptation of the leaflets.

Tricuspid annuloplasty significantly reduces early tricuspid regurgitation after biatrial heart transplantation.

Background: The incidence of tricuspid annuloplasty (TR) observed early after cardiac biatrial implantation is unpredictable and in our experience not infrequently problematic. Although the bicaval method of implant may reduce the incidence of TR, its benefit has not been conclusively documented.

Methods: In an attempt to reduce the incidence of TR observed early after cardiac transplantation, 25 consecutive patients undergoing cardiac transplantation received donor heart tricuspid annuloplasty (TA) with either a DeVega or Ring technique.