Assessment of vacuum-assisted closure therapy on the wound healing process in cardiac surgery.

Postoperative deep sternal wound infection (DSWI) is a serious complication in cardiac surgery (1-5% of patients) with high mortality and morbidity rates. Vacuum-assisted closure (VAC) therapy has shown promising results in terms of wound healing process, postoperative hospital length of stay and lower in-hospital costs. The aim of our retrospective study is to report the outcome of patients with DSWI treated with VAC therapy and to assess the effect of contributory risk factors.

What type of valve is most appropriate for osteogenesis imperfecta patients?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was in osteogenesis imperfecta (OI) patients with valve disease undergoing valve replacement which type of valve (bioprosthetic or mechanical) is most appropriate in terms of safety, complications and survival. Altogether more than 77 papers were found as a result of the reported search, of which 43 represented the best evidence to answer the clinical question.

Coronary Artery Perforation following PCI: An Interesting Finding into the Pericardial Space.

Coronary artery perforation is a known complication of percutaneous coronary intervention and potentially life threatening. Normally, these perforations are small and localized. We report the successful surgical management of a coronary artery perforation following stent insertion with extrusion of an 8-cm endarterectomy length of the circumflex coronary artery with a brief review of the recent literature.

Mini-sternotomy approach for aortic valve replacement in a patient with osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is a heritable disorder of the connective tissue. Cardiovascular involvement is rare, related mainly to aortic valve regurgitation. Open-heart surgery in these patients is associated with increased morbidity and mortality rates as a result of tissue friability and bone brittleness as well as platelet dysfunction.

Late aortic aneurysm after supravalvar aortic stenosis repaired with autologous pericardial patch.

We present a patient with a late aortic root aneurysm subsequent to an autologous pericardial patch repair of congenital supravalvar aortic stenosis (SVAS) performed 20 years earlier. There have been no reports of this complication to date, to our knowledge, and the mechanism of aneurysm formation after use of autologous pericardium is not well known. We presume that nonglutaraldehyde fixation and residual distal aortic arch stenosis contributed to aneurysm formation.

Aortic annulus diameter and valve design each determine the valve size implanted.

Background And Aim Of The Study: The study aim was to compare the sizing characteristics and hemodynamics of the Medtronic Mosaic Ultra porcine and Carpentier-Edwards PERIMOUNT Magna bovine pericardial bioprosthetic stented aortic valves in relation to the patient's true aortic annulus size.

Methods: In this prospective multicenter randomized study, data acquired perioperatively and at six months postoperatively were collected. Following aortic valve excision and debridement, the annulus was measured by blinded sizers prior to the randomization of 141 patients (Ultra, n=72; Magna, n=69).

Simultaneous mitral valve and pectus excavatum repair with a Nuss bar.

We present the successful management of an interesting case of a single-stage combined mitral valve repair plus repair of the pectus excavatum with a Nuss bar.

Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy.

Objective: Prospective randomised study comparing patients with atrial fibrillation (AF) of more than 6 months duration after mitral valve surgery plus biatrial modified radiofrequency Maze procedure using Medtronic Cardioblate System (Cardioblate group, n=24) vs mitral valve surgery plus intensive rhythm control strategy (control group, n=25).

Methods: Patients were blinded to randomisation. Preoperatively, at discharge, and at 3-month and 1-year follow-up, echocardiography, quality of life assessments and ECGs were done.