[Assisted circulation II--systems for intermediate and long-term mechanical circulatory support].

The concept of artificial circulatory support has been established almost 200 years ago. It has only been within the last four decades that physicians and engineers have developed mechanical assist devices that can temporarily support the circulation until the native heart recovers from a reversible injury. In patients who do not regain native heart function, long-term circulatory support or permanent replace (biologically--heart transplant or permanent mechanical circulatory support) is indicated.

[The internal thoracic artery in myocardial revascularization in patients with severely depressed left ventricular function].

Introduction: In most prospective, randomized studies, severely depressed left ventricular function is found to be the independent predictor of increased morbidity and mortality after myocardial revascularization [3]. Surgical treatment in this particular group of patients results in superior long-term results [1, 2]. Internal thoracic artery (ITA) is considered to be superior compared to venous grafts in myocardial revascularization for the majority of patients with ischaemic heart disease.

[Use of the internal thoracic artery in repeat myocardial revascularization surgery].

The incidence of redo myocardial revascularization is increasing lately. These procedures are accompanied by the higher operative risk, and the use of internal thoracic artery graft may have additional negative impact on early-rization. Mortality and morbidity in this group did not differ significantly compared to a group where only venous grafts were used.

[Myocardial revascularization using the internal thoracic artery: pro and con].

Internal thoracic artery (ITA) has superior histological, physiological and pharmacological properties over the venous grafts, and it is considered to be the graft of choice for myocardial revascularization. It has low incidence of late atherosclerotic lesions, and excellent long-term patency. Usage of ITA yields improved clinical results in all subgroups of patients with coronary artery disease, including patients with poor left ventricular function (EF%), left main stenosis, diffuse coronary artery disease and octogenarians.

[Occlusion of a calcified ascending aorta with a Foley catheter in aortocoronary bypass--case report].

Heavily calcified ascending aorta predisposes to aortic injury and distal embolization during total or partial cross-clamping, during the performance of open-heart procedures. Placement of the arterial cannula may be particularly difficult, occasionally virtually impossible using the standard technique, while placing the clamp on such aorta may be extremely risky. We present a case where we have used a Foley-balloon catheter to occlude the densely calcified ascending aorta, during a aorta-coronary bypass procedure, thus completely avoiding the use of the total aortic clamp.