Intraoperative assessment of mitral regurgitation: role of phenylephrine challenge.

Objectives: We defined the effects of the operative (OP) state and phenylephrine challenge on the assessment of mitral regurgitation (MR) severity.

Methods: In all, 57 patients underwent transesophageal echocardiographic assessment of MR severity pre-OP (PREOP) and intra-OP. MR severity was assessed PREOP under conscious sedation and intra-OP with general anesthesia, before and after hemodynamic manipulation with vasoactive agents, to match intra-OP and PREOP transesophageal echocardiographic mean arterial blood pressures.

Myocardial infarction in a 14-year-old girl, ten years after surgical correction of congenital coronary artery fistula.

Acute myocardial infarction developed in a 14-year-old girl, ten years after surgical repair of a coronary artery fistula. Angiography revealed fresh thrombus in the left anterior descending branch of the left coronary artery. The thrombus probably developed in the residual cul-de-sac of the occluded fistula.

Outcome of isolated coronary artery bypass surgery in octogenarians.

Background: Between 1989 and 1992 100 consecutive patients aged 80 or older underwent isolated coronary artery bypass grafting (CABG) in our institution. Eighty-six percent had angina grade III or IV symptoms.

Methods: Emergency surgery was required in 31, urgent surgery in 30, and elective surgery in 39 patients.