Prophylactic use of eculizumab during surgery in chronic cold agglutinin disease.

Primary chronic cold agglutinin disease (CAD) is an autoimmune haemolytic anaemia in which a specific bone marrow lymphoproliferative disorder causes production of cold agglutinins (CA). Binding of CA to erythrocyte surface antigens results in a predominantly extravascular haemolysis that is entirely complement dependent. Because of complement activation, exacerbations are common during febrile infections, trauma or major surgery.

Outcome of mitral valve plasty or replacement: atrial fibrillation an effect modifier.

Background: Advances in the understanding of mitral valve pathology have laid to mitral valve plasty (MPL) as the procedure of choice of all the mitral intervention as compared to mitral valve replacement (MVR).

Material And Methods: A cohort of 355 patients with mitral valve disease operated between January 1993 to January 2007 with closing date first of mars 2011. There were 214 MPL and 141 MVR at the Hospital discharge.

Plasma IL-18 and IL-18BP are altered differently in reverse remodeling following aortic valve replacement.

Objectives: Patients with aortic stenosis (AS) develop left ventricular remodeling characterized by changes in extracellular matrix (ECM) and cardiomyocyte-hypertrophy. Aortic valve replacement (AVR) reverses this process (reverse remodeling). We examined plasma levels of interleukin-18 (IL-18) and its binding protein (IL-18BP) before and after AVR for AS since these mediators have been shown experimentally to exert effects on myocardial remodeling.

Traumatic aortic valve rupture after a high-speed motor-vehicle accident: case report.

The case is reported of a 32-year-old male with an aortic valve injury received in a high-speed traffic accident. Several non-cardiac concomitant injuries were present, none of them life-threatening. Cardiac surgery was performed on day 2 due to a grade III aortic valve insufficiency.

Alterations in circulating activin A, GDF-15, TGF-beta3 and MMP-2, -3, and -9 during one year of left ventricular reverse remodelling in patients operated for severe aortic stenosis.

Background: Patients with aortic stenosis (AS) develop left ventricular remodelling with cardiomyocyte hypertrophy and increased fibrosis. Following aortic valve replacement (AVR) reverse remodelling usually takes place.

Aims: To examine circulating levels of members of the transforming growth factor (TGF) beta superfamily and matrix metalloproteinases (MMP), known to have important effects on hypertrophy and extracellular matrix, in patients operated for AS.

Traumatic aortic valve rupture after a high-speed motor vehicle accident.

The case is reported of a 32-year-old male who sustained an aortic valve injury after a high-speed traffic accident. Several non-cardiac concomitant injuries were present, none of which was life-threatening. Cardiac surgery was performed on day 2 due to a grade III aortic valve insufficiency.

Myocardial cooling with ice-slush provides no cardioprotective effects in aortic valve replacement.

Objectives: Topical cooling of the heart with ice-slush has been widely used for myocardial protection. No prospective, randomized study has evaluated the effect of ice-slush on acknowledged markers (CK-MB, troponin-T) of myocardial damage during aortic valve replacement (AVR). This was the first aim of the present study.

Cardiac tamponade caused by acute spontaneous coronary artery rupture.

Acute spontaneous coronary artery rupture is rare and the diagnosis might be missed due to high risk of mors subita. We present three patients hospitalized with signs of cardiac tamponade due to acute spontaneous coronary artery rupture. All the three were successfully operated with evacuation of the pericardial hematoma, identification of the bleeding site, and hemostasis.

The effect of aortic valve replacement on plasma B-type natriuretic peptide in patients with severe aortic stenosis--one year follow-up.

Background: B-type natriuretic peptide (BNP) is synthesized in cardiac tissue in response to increased wall stress and myocardial hypertrophy.

Aims: In patients with severe aortic stenosis (AS) we examined the effect of aortic valve replacement (AVR) on plasma BNP and association between BNP and left ventricular mass index (LVMI) preoperatively and in the reverse-remodeling phase twelve months postoperatively. We also examined the correlation between BNP and NYHA-class and between BNP and age.