Early or late surgery for endocarditis with neurological complications.

Background: The European Society of Cardiology 2015 guidelines advise urgent surgery for endocarditis complicated by cerebral embolism or transient ischemic events (1B evidence). Nevertheless, the timing of surgery remains contentious. This study aimed to review our experience of early versus delayed surgery in a selected cohort.

Right ventricular myxoma causing pulmonary outflow tract obstruction.

A patient presented with shortness of breath, lethargy and weight loss. A computerized tomography and echocardiogram showed a mass in the right ventricle nearly obstructing the pulmonary valve during systole and prolapsing into the main pulmonary artery. The mass was completely excised.

Adequacy of brain and spinal blood supply with antegrade cerebral perfusion in a rat model.

Objective: The purpose of this study was to examine whether different techniques used for antegrade cerebral perfusion could account for variation in the perfusion adequacy of the brain and spinal cord.

Methods: Selected vessels were ligated in 30 rats, recreating a selection of approaches used in aortic arch surgery for patients undergoing circulatory arrest with antegrade cerebral perfusion. Filling of spinal and cerebral vessels was mapped after cannulation and perfusion with E20, gelatin/India ink, or buffered saline/India ink.

Medtronic Mosaic porcine bioprosthesis: assessment of 12-year performance.

Background: The Mosaic porcine bioprosthesis (Medtronic, Inc, Minneapolis, Minn) was approved in 2000 by the US Food and Drug Administration. Clinical performance was evaluated in 6 centers.

Methods: From 1994 to 2000, 797 patients (mean age 69 years) had aortic valve replacement (AVR) and 232 (mean 67 years) had mitral valve replacement (MVR).

The mosaic valve clinical performance at seven years: results from a multicenter prospective clinical trial.

Background And Aim Of The Study: The Mosaic valve is a third-generation stented porcine bioprosthesis built upon the historical durability of the Hancock II valve in an attempt to improve hemodynamic performance and durability.

Methods: This multicenter trial was prospective and non-randomized in design. Between February 1994 and October 1999, six centers following a common study protocol enrolled 797 patients (mean age 70 years: range: 21-88 years) who underwent aortic valve replacement (AVR), and 232 patients (mean age 68 years; range: 17-84 years) who underwent mitral valve replacement (MVR).

Bivalirudin versus heparin and protamine in off-pump coronary artery bypass surgery.

Background: Bivalirudin is a short-acting direct thrombin inhibitor, with advantages over unfractionated heparin for anticoagulation in cardiac surgery. We hypothesized that bivalirudin is not associated with a clinically important increase in blood loss compared with heparin with protamine reversal in patients undergoing off pump coronary artery bypass (OPCAB) surgery. We also assessed flow with angiography at 3 months using a modified Thombolysis in Myocardial Infarction (TIMI) grade in the grafted coronary arteries.