Integrity of mechanical aortic valve prostheses explanted after 27 and 23 years.

We describe 2 cases of mechanical aortic valve endocarditis and the influence on clinical outcome and prostheses material integrity. One patient required extensive reconstruction due to active endocarditis leading to a "rocking valve". The second case was caused by late aortic dissection following endocarditis.

Low-volume, single-shot crystalloid cardioplegia is safe for isolated aortic valve replacement.

We report our experience with a low-volume (100 mL), single-shot crystalloid cardioplegia (Cardioplexol) in 61 consecutive patients undergoing isolated aortic valve replacement (AVR). Cardioplexol resulted in immediate cardiac arrest. Intraoperative courses were uneventful.

Effects of the novel polymer gel LeGoo on human internal thoracic arteries.

Purpose: Established hemostatic devices can injure vessel wall integrity. LeGoo (Pluromed, Woburn, MA), a novel poloxamer gel with reverse thermosensitive properties, is a new device for temporary occlusion of blood vessels. The present study investigated the effects of LeGoo on vascular function and morphology.

Heart failure resulting from giant left atrial synovial sarcoma metastasis.

Synovial sarcoma metastasis affecting the heart and infiltrating the mitral valve is a very rare pathology. We report the case of a 44-year-old male treated with chemotherapy for atypical synovial sarcoma of the oral mucosa who presented to our clinic after cardiac decompensation with a presumptive diagnosis of myxoma of the left atrium. A large necrotic tumour positive for CK 22, EMA, CD 99 and BCL-2 but negative for translocation in COBRA-FISH analysis by break-apart probe could be excised and revealed a very rare subtype of synovial sarcoma metastasis arising from the endocard of the left atrium.

Plicated patch repair for acquired Gerbode defect involving the tricuspid valve.

Gerbode's defect, a left ventricular-to-right atrial communication, with involvement of the tricuspid valve acquired after bacterial endocarditis can be challenging to repair. We report a modified technique for a shunt closure and reconstruction of the tricuspid valve using a plicated bovine pericardial patch. Combining such a repair with a left ventricular patch resulted in a complete defect closure and competent tricuspid valve without regurgitation.

Cryopreservation of vascular tissues.

Cryopreservation of human blood vessels may become an important tool in bypass surgery and peripheral vascular reconstruction. Ideally cryopreservation of a blood vessel should preserve functional characteristics comparable to those of fresh controls. The key advantage of cryopreservation is the fact that storage at deep subzero temperatures allows storage of structurally intact living vascular tissues for virtually infinite time.

Reactive oxygen species mediate functional differences in human radial and internal thoracic arteries from smokers.

Objective: Smoking not only increases the risk that coronary heart disease will develop but also morbidity and mortality in patients with known coronary atherosclerosis and after coronary artery bypass grafting. Excessive generation of reactive oxygen species (ROS) has been implicated as the final common pathway for the development of endothelial dysfunction in various cardiovascular risk factors. This study assessed the influence of smoking on two different human arteries routinely used as coronary artery bypass graft conduits.

[Heart valve substitution: the effect of preoperative findings on long-term outcome].

Background: In a retrospective analysis of 653 consecutive patients who underwent heart valve replacement by one single type of mechanical prosthesis (St. Jude Medical) at three Swiss university medical centers (Basel, Bern, Lausanne), the outcome was judged on the basis of preoperative variables. These variables should facilitate the timing of heart valve replacement.