Alternative technique of the right atrial anastomosis (cavo-atrial) in orthotopic heart transplantation.

An alternative technique of the right atrial anastomosis in heart transplantation, which allows a more anatomical reconstruction of the right atrium and is easier in handling than bi-caval anastomoses is described.

Rat cytomegalovirus and Listeria monocytogenes infection enhance chronic rejection after allogenic rat lung transplantation.

The role of infection in the pathomechanism of obliterative bronchiolitis (OB) after human lung transplantation is controversial. In a rat lung transplantation model, we analyzed the effect of viral [rat cytomegalovirus (RCMV)] and bacterial infection [Listeria monocytogenes (LM)] on the development of chronic allograft rejection. Fisher rats underwent single left lung transplantation with allografts from Lewis rats.

Midterm follow-up after minimally invasive direct coronary artery bypass grafting versus percutaneous coronary intervention techniques.

Background: Revascularization of the left anterior descending coronary artery can be performed by minimally invasive direct coronary artery bypass grafting (MIDCAB) or percutaneous coronary intervention techniques (PCI). The study compared the midterm results of both techniques.

Methods: The outcome of 206 consecutive MIDCAB and 256 PCI patients treated from 1998 until 2001 was retrospectively analyzed.

Sevoflurane but not propofol preserves myocardial function during minimally invasive direct coronary artery bypass surgery.

Volatile anesthetics exert cardioprotective properties in experimental and clinical studies. We designed this study to investigate the effects of sevoflurane on left ventricular (LV) performance during minimally invasive direct coronary artery bypass grafting (MIDCAB) without cardiopulmonary bypass. Fifty-two patients scheduled for MIDCAB surgery were randomly assigned to a propofol or a sevoflurane group.

Coronary artery bypass surgery in diabetic patients.

Background: Cardiovascular disease is a major cause of morbidity and mortality in patients with diabetes. This study examines the impact of diabetes on mortality and morbidity following coronary artery bypass surgery.

Methods: We retrospectively analyzed 590 consecutive patients after coronary artery bypass grafting in 1998.

Early and medium-term results after on-pump and off-pump coronary artery surgery: a propensity score analysis.

Background: Comparative publications on beating-heart off-pump coronary artery bypass grafting (OPCAB) surgery versus conventional coronary artery bypass grafting (CCAB) surgery frequently do not offer conclusive information because of investigator bias.

Methods: Trying to eliminate this problem, a propensity score analysis of the data of all CCAB patients (n = 517) and OPCAB patients (n = 133) operated on by the same surgeons during the same time period (1998 to 2001) was applied. After matching patients with similar propensity score values, 97 CCAB patients and 72 OPCAB patients entered the final analysis.

[Minimally invasive coronary surgery].

Regardless the general acceptance of cardiac operations by physicians and patients as routine procedures since the early seventies conventional cardiac surgery is still associated with a significant surgical trauma and exceptional invasiveness in part effected by the extracorporeal circulation. In parallel to the common interest of nearly all surgical fields to minimize the invasiveness of surgery the intentions in cardiac surgery aim at minimizing surgical access on the one hand and avoidance of extracorporeal circulation on the other hand. Subsequently a broad variety in applying minimal surgical access including total endoscopic procedures as well as beating heart surgery without extracorporeal circulation with modified cannulation and clamping technology was investigated.

Antero-axillary access for hypoplastic aortic arch repair.

A 16-year-old adolescent presented with systemic hypertension due to a hypoplasia of the aortic arch resulting in a significant stenosis. In childhood, he underwent surgery for aortic coarctation through a left posterolateral thoracotomy. We present the successful repair of the complete aortic arch that could be achieved applying a patch plasty of bovine pericardium through an anteroaxillary thoracotomy.