The aortic homograft: evolution of indications, techniques, and results in 107 patients.

Background: Homograft aortic valve replacement has been performed in 107 patients during the past 7 years. Two primary methods of implantation were used (intraaortic and root replacement). Results of both methods are presented.

Early experience with homograft aortic root replacement for complex aortic pathology.

Background: Complex aortic valve and root pathology presents a serious operative challenge.

Methods: During the last 45 months 21 cryopreserved homograft root replacements have been performed in 19 patients. The ages of the patients ranged from 28 to 77 years; there were 15 men and four women.

Descending necrotizing mediastinitis: transcervical drainage is not enough.

One of the most lethal forms of mediastinitis is descending necrotizing mediastinitis, in which infection arising from the oropharynx spreads to the mediastinum. Two recently treated patients are reported, and the English-language literature on this disease is reviewed from 1960 to the present. Despite the development of computed tomographic scanning to aid in the early diagnosis of mediastinitis, the mortality for descending necrotizing mediastinitis has not changed over the past 30 years, in large part because of continued dependence on transcervical mediastinal drainage.

The efficacy and timing of operative intervention for spontaneous pneumothorax.

To reassess the role and timing of operative intervention for spontaneous pneumothorax, 119 patients were retrospectively reviewed to compare recurrences, complications, and hospital stay between a nonoperative group (Group 1) and an operative group (Group 2). Total hospital days were greater in Group 2, but excluding the length of preoperative stay, the number of hospital days were similar in both groups. Group 1 patients more than 40 years old had a longer postoperative hospitalization, but not a higher rate of complication.

Evacuation of calcific valvular debris using a standard Ellik evacuator.

A simple but effective technique is described for removing calcific and other debris following aortic and mitral valve replacement. This technique uses an Ellik evacuator , which is readily available in most operating rooms. An 11-year experience is presented, documenting the efficacy of this method in several hospitals.