Conservative surgical treatment for active infective tricuspid valve endocarditis according to the "clover technique".

Aims: This prospective study was undertaken to analyze the outcomes of conservative surgery with the "clover technique" for active infective tricuspid valve endocarditis.

Methods: Five consecutive patients underwent surgery for active infective tricuspid valve endocarditis. The mean age was 36.

Chordal cutting VIA aortotomy in ischemic mitral regurgitation: surgical and echocardiographic study.

Background: Chordal cutting through atriotomy has been proposed to treat significant resting ischemic mitral regurgitation (MR) due to anterior leaflet tenting. In addition, MR may exacerbate during exercise not only trough exercise-induced ischemia but also through an increase in tenting area. Accordingly, we aimed to perform chordal cutting through aortotomy in patients with exercise-induced ischemic worsening of MR.

Chordal cutting technique through aortotomy to treat chronic ischemic mitral regurgitation: surgical technique.

Objective: To describe original surgical treatment in patients with ischemic mitral valve regurgitation due to tenting phenomenon.

Background: The optimal surgical treatment of ischemic mitral regurgitation (MR) in patients with coronary artery disease is controversial. The standard treatment is revascularization and reduction annuloplasty.

Cardiovascular risk factors as predictors of early and late survival after bioprosthetic valve replacement for aortic stenosis.

Background And Aim Of The Study: Cardiovascular risk factors have been associated with aortic valve stenosis, which is considered as an atherosclerosis-like process. The study aim was to assess the effect of cardiovascular risk factors on early and late outcome after valve replacement with a bioprosthesis for aortic stenosis (AS), and the impact of these factors on the outcome of the bioprosthesis.

Methods: Preoperative clinical, biological and echocardiographic data were recorded in 222 patients (110 males, 112 females; mean age 73 +/- 8 years) who underwent surgery for severe AS between 1989 and 1993.

Extracorporeal membrane oxygenation in severe acute respiratory failure in postpartum woman with rheumatic mitral valve disease: benefit, factors furthering the success of this procedure, and review of the literature.

Pregnancy is a common decompensation factor for women with post-rheumatic mitral disease. However, valvular heart diseases causing severe acute respiratory distress are rare. Use of extracorporeal membrane oxygenation (ECMO) early in the event of cardiorespiratory failure after cardiac surgery may be of benefit.

Beating-heart approach and moderately delayed surgical management of postinfarction ventricular septal rupture: an advisable approach to improve results?

Early repair of postinfarction ventricular septal rupture is usually associated with significant mortality and morbidity. Assessing conditions to moderately delay the surgical intervention and reduce cardioplegic arrest may be an interesting approach to improve hospital results. Results of five non-selected patients in whom surgery was moderately delayed and performed according a policy of reducing the cardioplegic-induced ischemia were reviewed.

Changes in cerebral vascular reactivity occur early during cardiopulmonary bypass in the rat.

Background: Cardiopulmonary bypass (CPB) is known to cause cerebrovascular dysfunction. The etiology of these complications is complex, but disruption of normal cerebral endothelial function as a consequence of inflammatory or hypoperfusion phenomena have been implicated. The aim of this study was to investigate the effect of CPB time on cerebrovascular reactivity and to investigate the correlation of these findings with measured inflammatory markers.

A recovery model of minimally invasive cardiopulmonary bypass in the rat.

This study was undertaken to develop a rodent (rat) model of cardiopulmonary bypass (CPB) that has been designed to mimic functionally the minimally invasive clinical setting. The circuit is similar to the clinical model in terms of its construction, configuration, material surface area to blood volume ratio, and priming volume to blood ratio. The overall priming volume was 10 mL.

Second generation of minimal invasive extracorporeal circuit: pilot study resting heart system.

Cardiopulmonary bypass (CPB) has evolved from a complex multifunctional system to the minimally invasive extracorporeal circuit (MIEC). Concerns currently exist regarding the technically demanding nature of off-pump coronary artery bypass (OPCAB) procedures, the quality of anastomosis associated with it, and the difficulty in achieving "complete revascularization." Recognizing these issues, the so-called mini-CPB concept has evolved in an effort to offer the perceived benefits of OPCAB with the technical advantages of CPB and at the same time minimize the adverse effects of full-scale CPB.

Massive pulmonary valve insufficiency associated with double pulmonary artery and ascending aorta aneurysm.

A case is reported of aneurysm of both the ascending aorta and pulmonary artery, associated with massive pulmonary valve insufficiency. Pulmonary artery aneurysm is a rare condition of unknown natural history; therapeutic management has not yet been established. Pulmonary valve insufficiency is also rare, with reported etiologies comprising mainly pulmonary valve anomalies.

Consequences of delayed surgical closure of patent ductus arteriosus in very premature infants.

Background: Surgical closure of ductus arteriosus is commonly indicated in premature newborns. The aim of this study was to assess short-term and mid-term effects of delayed surgical closure of the ductus arteriosus on respiratory and digestive outcome in extremely preterm infants.

Methods: We retrospectively studied 58 infants less than 28 weeks gestational age who underwent surgical closure of ductus arteriosus between January 1997 and December 2002.

Endocardial radiofrequency ablation during mitral valve surgery: effect on cardiac rhythm, atrial size, and function.

Background: Restoration of sinus rhythm is thought to lead to a reduction in left atrial size and to recovery of atrial contraction. We aimed to investigate changes in atrial size and function in patients undergoing radiofrequency ablation for atrial fibrillation during mitral valve surgery.

Methods: In a prospective study, 70 patients (64 +/- 10 years) with mitral valve disease and atrial fibrillation underwent mitral surgery and left atrial endocardial radiofrequency ablation.

Modelling a regional reorganization of cardiovascular surgery provision.

The Nord-Pas-de-Calais region of France is under-served in terms of access to cardiovascular surgery services, as illustrated by relatively high levels of waiting list mortality. This prompted the decision to create a new surgical unit in the region's densely populated, former industrial heartland called the "Mining Basin". Geographical and epidemiological modelling was used prospectively to estimate the likely future level of activity of the existing public sector cardiovascular surgery units.

Pulmonary vascular effects of sildenafil on the development of chronic pulmonary hypertension in the ovine fetus.

We investigated the pulmonary vascular effects of prophylactic use of sildenafil, a specific phosphodiesterase-5 inhibitor, in late-gestation fetal lambs with chronic pulmonary hypertension. Fetal lambs were operated on at 129 +/- 1 days gestation (term = 147 days). Ductus arteriosus (DA) was compressed for 8 days to cause chronic pulmonary hypertension.

Right ventricular assist device thrombosis during biventricular heart assistance.

We report a case of total thrombosis of a right ventricular assist device in a patient during biventricular assistance. The thrombosis occurred 18 days following implantation and the right ventricular device was immediately removed without any complications. The patient was successfully transplanted after 3 months of left ventricular assistance.

[The long term (15 years) evolution after valvular replacement with mechanical prosthesis or bioprosthesis between the age of 60 and 70 years].

Objective: the aim of this study was to document the choice between prosthesis and bioprosthesis in cases of valvular replacement during the seventh decade of life.

Methods: a retrospective and cooperative study linking eleven cardiac surgical teams and five medical cardiology teams combined 497 subjects born between 1915 and 1925 (average age 64.4 years) who underwent aortic (313 cases) or mitral (184 cases) valvular replacement with mechanical prosthesis (259 cases) or bioprosthesis (238 cases).

Circumflex artery stenosis induced by intraoperative radiofrequency ablation.

We report a case of circumflex artery stenosis after intraoperative radiofrequency ablation for permanent atrial fibrillation in a patient who had a previous mitral valve replacement. The patient presented with acute pulmonary edema and severe angina 1 year after an uneventful recovery. The patient underwent a diagnostic angiography that showed the presence of stenosis of a long segment of the circumflex artery, adjacent to the radiofrequency ablation site, which was reopened successfully by angioplasty.

Ten-year echocardiographic and clinical follow-up of aortic Carpentier-Edwards pericardial and supraannular prosthesis: a case-match study.

Background: There are little comparative data on Carpentier-Edwards supraannular and pericardial second-generation bioprostheses. The aim of this work was to compare their hemodynamic and clinical outcomes in patients with aortic stenosis.

Methods: We conducted a retrospective study including 150 patients operated on for aortic stenosis between 1989 and 1993.