Ruptured Papillary Muscles After Chordae-Preserving Bioprosthetic Mitral Valve Replacement.

Bioprosthetic valve-associated masses in the perioperative period are rare. This report describes the case of a 68-year-old man with perivalvular masses that were initially discovered on a routine postoperative transthoracic echocardiogram 7 days after chordae-preserving mitral valve replacement and coronary artery bypass grafting. An intraoperative transesophageal echocardiogram demonstrated ruptured papillary muscles.

Prolonged central venous desaturation measured by continuous oximetry is associated with adverse outcomes in pediatric cardiac surgery.

Background: The role of continuous central venous oxygen saturation (ScvO₂) oximetry during pediatric cardiac surgery for predicting adverse outcomes is not known. Using a recently available continuous ScvO₂ oximetry catheter, we examined the association between venous oxygen desaturations and patient outcomes. We hypothesized that central venous oxygen desaturations are associated with adverse clinical outcomes.

Perventricular closure of a large ventricular septal defect in congenitally corrected transposition of the great arteries.

We report the case of a 30 year-old male with congenitally corrected transposition of the great arteries, atrial, and ventricular septal defects (VSD), and pulmonary stenosis. He previously underwent three palliative surgical procedures before undergoing intracardiac repair at age 20 with a left ventricular to pulmonary artery (LV-PA) conduit, VSD closure, and replacement of the systemic atrioventricular valve. A residual VSD was noted postoperatively.

Inhaled nitric oxide in the preoperative evaluation of pulmonary hypertension in heart transplant candidates.

Objective: The goal of this study was to evaluate the efficacy of 100% oxygen and inhaled nitric oxide (iNO) in decreasing pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG) in dilated cardiomyopathy patients being evaluated for orthotopic heart transplantation (OHT); who, despite maximal intravenous (IV) dilator therapy, had persistent moderate-to-severe pulmonary hypertension.

Design: A prospective nonrandomized clinical study.

Setting: University hospital, major transplant center.

Pulse contour analysis for cardiac output monitoring in cardiac surgery for congenital heart disease.

Unlabelled: Conventional methods of cardiac output monitoring using pulmonary artery catheters may not be feasible in patients with congenital heart disease because of patients' small size or aberrant anatomy. We studied the accuracy of a new device, which uses pulse contour analysis to measure continuous cardiac output, in children and adults undergoing congenital heart surgery. Sixteen patients, median ages 7 yr old, were included in this prospective study.

Short-term bridge to heart transplant using the BVS 5000 external ventricular assist device.

From January 1995 to April 2001, 71 patients with cardiogenic shock using the BVS 5000 were treated or accepted in transfer. Of the 24 transplanted, nine had dilated cardiomyopathy, ischemic cardiomyopathy, acute myocardial infarction, giant cell myocarditis and previous Fontan procedure (group I, n = 13). The others had postcardiotomy shock (group II, n = 11); seven were transferred to our center after device implantation.