Low-dose warfarin with a novel mechanical aortic valve: Interim registry results at 5-year follow-up.

Objectives: To evaluate whether warfarin targeted at an international normalized ratio of 1.8 (range, 1.5-2.

Quality of life in patients with bioprostheses and mechanical prostheses. Evaluation of cohorts of patients aged 51 to 65 years at implantation.

Background: The purpose of this study was 3-fold: to compare the quality of life (QOL) in age- and sex-matched patients who received biological and mechanical prosthetic valves in isolated aortic valve replacement, to compare the QOL of patients with aortic valve replacement with the general population, and to compare patients with biological and mechanical prostheses with certain valve-specific questions and relate these responses to overall QOL.

Methods And Results: Patient-perceived QOL was evaluated in 200 patients who were sampled from a population of 420 patients (age range 51 to 65 years) who underwent isolated aortic valve replacement in the period of 1986 to 1996. One hundred of the sampled patients had a mechanical valve inserted and an equal number had porcine bioprostheses.

Primary cardiac tumors: forty years' experience with 71 patients.

Background: Primary cardiac tumors are infrequent, and few cardiac surgeons have extensive experience in treating them. The majority of the tumors are benign. As noninvasive diagnostic imaging of cardiac masses continues to improve, the number of these tumors that are seen by clinicians will increase.

Blunt cardiac rupture. The Emanuel Trauma Center experience.

Objective: To analyze the factors affecting outcome in patients with blunt cardiac rupture, including anatomical cardiac injury, associated injury, clinical presentation, age, mechanism of injury, diagnostic method, surgical intervention, and presence of vital signs in the field and on arrival.

Design: Retrospective review.

Setting: A community-based level I trauma center.

Extracorporeal cardiopulmonary life support with heparin-bonded circuitry in the resuscitation of massively injured trauma patients.

Background: Patients who have massive but potentially survivable injuries frequently die from complications of hypovolemia, hypoxemia, hypothermia, metabolic acidosis, and coagulopathy. Emergency cardiopulmonary bypass has been unsuccessful in preventing such deaths because it involves systemic anticoagulation that exacerbates coagulopathy.

Patients And Methods: A simplified extracorporeal cardiopulmonary life support (ECLS) system was assembled consisting of a centrifugal pump head, heat exchanger, membranous oxygenator, percutaneous cannulas, and heparin-bonded circuitry.

Traumatic rupture of the tracheobronchial tree in a 2 year old.

Tracheobronchial tree injuries occur in a small number of patients after blunt chest trauma, and their occurrence is even more uncommon in the pediatric trauma population. The authors present the case of a 2-year-old boy who presented with rupture of the trachea and disruption of the right upper lobe bronchus and bronchus intermedius.

'The broken halo sign': a fractured calcified ring as an unusual sign of traumatic rupture of the thoracic aorta.

Two elderly patients, involved in separate motor vehicle accidents, sustained blunt chest injury resulting in rupture of their thoracic aortas. The initial chest radiographs showed the presence of a calcified ring fractured in two places with lateral displacement of a calcified fragment by haematoma. This 'broken halo sign' is a radiographic sign not previously well described in the literature.