Remote Targets for Right Coronary Artery Bypass: Distal Trunk or Posterior Descending Artery Grafting.

Background: Choosing a good anastomotic site is crucial during surgical revascularization of the right coronary artery (RCA) system. In many instances of distal and/or sequential main trunk disease, either the right posterior descending coronary artery (RPDA) or distal part of the right main coronary artery (DRCA) is preferred as the target vessel. In this article, the saphenous vein graft (SVG) patency is compared between these two main targets in the long term.

Evaluation of positive inotropic drug effects on thyroid hormone levels after open heart surgery.

Objective: The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery.

Methods: We analyzed free thyroid hormones (FT3 and FT4) and thyroid-stimulating hormones (TSH) in 200 consecutive patients undergoing open heart surgery. Patients were divided into 5 groups according to the inotropic drug administration as follows: Group A (n = 46) received dopamine alone; Group B (n = 40), dopamine and dobutamine; Group C (n = 36), dopamine, dobutamine, and adrenaline; Group D (n = 32), adrenaline alone; and Group E (n = 46), placebo.

Comparison of neurocognitive functions after beating-heart mitral valve replacement without aorta cross-clamping and after standard mitral valve replacement with cardioplegic arrest.

Background: The aim of this study was to compare the postoperative long-term neurocognitive functions of patients who under-went beating-heart mitral valve replacement on cardiopulmonary bypass (CPB) without aorta cross-clamping with those of patients who underwent mitral valve replacement via the classic method.

Methods: The study group included 25 randomly selected patients who underwent beating-heart mitral valve surgery. During the same period, 25 patients were randomly selected as controls to undergo mitral valve replacement procedures via the standard ascending aorta-cannulation technique.

Implantable cardioverter defibrillator lead endocarditis causing diffuse right atrial abscess and pulmonary artery embolism.

Implantation of electrophysiological cardiac devices such as pacemakers and implantable cardioverter defibrillators has become a widely available and routine procedure in cardiovascular medicine. One of the most feared complications of device implementation is infection. Infection rates for these devices are reported to vary between 0.

Visceral protection during moderately hypothermic selective antegrade cerebral perfusion through right brachial artery.

Objective: This study investigates distal organ protection during moderately hypothermic right brachial artery selective antegrade cerebral perfusion (MHSACP) in patients undergoing aortic arch repair.

Methods: Fifty patients undergoing ascending aorta/aortic arch repair using the MHSACP technique (study group) were compared with another 50 patients randomly selected amongst those undergoing moderately hypothermic open heart procedures (control group). The data from successive clinical examinations and blood samplings were then compared to detect any sign of distal organ damage attributable to the MHSACP technique.

A case of intraventricular septum dissection presenting with aneurysmal dilatation through the outflow track of the left ventricle.

A dissecting aneurysm of the intraventricular septum is an extremely rare entity. Most of these aneurysms originate from the right sinus of Valsalva and are believed to result from rupture of a Valsalva sinus aneurysm. Such cases may present with aortic insufficiency, rhythm disorders, ventriculo-septal ischemia and infectious endocarditis.

Chronic total occlusion of the left main coronary artery.

Total chronic occlusion of the left main coronary artery is a rare angiographic finding in a catheterization laboratory and its treatment rarely is reported. We describe a patient with angiographic findings of chronic total occlusion of the left main coronary artery with left coronary circulation collateralized from the right coronary artery.

Aortic arch aneurysm, pseudocoarctation, and coronary artery disease in a patient with Behçet's syndrome.

Aortic arch aneurysm, pseudocoarctation, and coronary artery stenosis are extremely rare in Behçet's syndrome. We present the case of a 25-year-old man with Behçet's syndrome who underwent coronary artery bypass grafting for severe stenosis in the proximal left anterior descending coronary artery and concomitant surgical correction of a saccular aneurysm that was causing pseudocoarctation of the aortic arch. The surgery was successful.

What to expect after tricuspid valve replacement? Long-term results.

Objective: Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series.

Methods: Forty-two patients (16 male, 26 female; mean age: 33+/-15) underwent tricuspid valve replacement between March 1987 and December 2004.

Cardiac surgery during pregnancy.

Background And Aim Of The Study: Cardiac surgery during pregnancy represents a major challenge as it comprises a single operation for two survivors.

Methods: Between 1988 and 2005, 16 pregnant women underwent cardiac surgery at the authors' institution. Among 14 patients with rheumatic mitral stenosis operated on due to clinical deterioration, closed mitral valvulotomy was performed in 12 cases (three urgently in the third trimester, nine at term concomitantly with cesarean delivery).

Does delayed correction interfere with pulmonary functions and exercise tolerance in patients with tetralogy of fallot?

Study Objectives: To assess exercise tolerance and determine the distinct role of cardiac, respiratory, or peripheral factors on it after delayed surgical repair in patients with tetralogy of Fallot.

Design: The aerobic exercise capacity of 15 adult patients (mean [+/- SD] age, 21 +/- 6; age range, 9 to 30 years) undergoing successful total correction at a mean age of 12 +/- 5 years (patients) was compared to healthy, matched control subjects by using right ventricle echocardiography, resting spirometry, and cardiopulmonary exercise tests at a mean postoperative time of 7.5 +/- 4.

Off-pump, in situ internal thoracic artery grafting: a durable treatment for single-vessel coronary artery disease.

Background: The value of off-pump in situ left internal thoracic artery to left anterior descending coronary artery bypass grafting in single-vessel coronary artery disease was assessed by long-term angiographic and clinical data.

Methods: One-hundred three randomly selected patients (87 male, 16 female; mean age, 57.4 +/- 10.

Off-pump coronary artery bypass grafting: long term angiographic results.

Objective: Although short-term results of off-pump coronary artery bypass grafting are well documented, late postoperative data are still scarce. This report provides an analysis of late postoperative control angiograms.

Methods: 265 patients (231 males, 34 females; mean age: 54 +/- 10) underwent postoperative angiographic control, after an average postoperative period of 4.

Pregnancy after mechanical mitral valve replacement.

Background And Aim Of The Study: Forty-six pregnancies among 32 patients after mitral valve replacement (MVR) were reviewed. Prosthetic valve-related complications, and outcome of pregnancy including feto-maternal mortality and morbidity for different anticoagulation regimens are presented and discussed.

Methods: Among 521 women of fertile age undergoing MVR with a St.

Nitric oxide: implications for vascular and endovascular surgery.

Nitric oxide has a key role in vascular homeostasis. It plays a protective role by suppressing abnormal proliferation of vascular smooth muscle following various pathological situations including atherosclerosis and restenosis after vascular interventions such as balloon angioplasty, stent deployment and bypass grafting. It also has strong antiplatelet and anti-thrombogenic properties.

Approach to sinus of Valsalva aneurysms: a review of 53 cases.

Objective: The reported experience with sinus of Valsalva aneurysms (SVAs) is limited. Our approach to this subset of patients and an algorithm-dependent classification are presented.

Methods: Between 1985 and 2000, 53 patients (mean age: 24+/-12; range 4--60) underwent repair for ruptured (64%) or non-ruptured (36%) SVA.

Closed commissurotomy versus balloon valvuloplasty for rheumatic mitral stenosis.

Background And Aim Of The Study: Closed mitral commissurotomy (CMC) and percutaneous mitral balloon valvuloplasty (PMBV) were compared by their initial results and Doppler echocardiographic data obtained at one week and one year after the procedure.

Methods: Of 580 patients with severe rheumatic mitral stenosis, 280 underwent CMC and 300 PMBV. The mean pre-procedural transmitral gradient (TMG) was 21 +/- 6 mmHg in the CMC group and 20 +/- 5 mmHg in the PMBV group (p = 0.

Comparison of the early results of coronary artery bypass grafting with and without extracorporeal circulation.

To compare the safety and efficacy of coronary artery bypass grafting without using extracorporeal circulation with standard cardiopulmonary bypass technique, based on certain early postoperative criteria, we designed a fully randomized and prospective study on two similar groups of 25 patients (off-pump and on-pump groups). The groups were compared for hemodynamic data (cardiac index, systemic vascular resistance, left- and right-ventricular stroke-work indices, inotropic and mechanical support needs) and enzyme levels (CK-MB and SGOT), as well as mortality, perioperative infarction rate, homologous transfusion requirements, and the symptomatology in the first follow-ups. There was no mortality or perioperative myocardial infarction in either group.