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  • 1
    Electronic Resource
    Electronic Resource
    Aortic Valve Replacement with Biological Substitute (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 13 (1998), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract In the quest for an ideal aortic valve substitute, homografts and autografts are well-established options. We reviewed our results with homografts and autografts for aortic valve replacement during the last 5 years. From March 1992 through July 1997,189 patients (138 male and 51 female), age 8 months to 68 years (mean 31.0 2 4.2 years), underwent aortic valve replacement with a human biological substitute. Of these, 93 patients received a cryopreserved or antibiotic-preserved aortic/pulmonary homograft, whereas 96 patients underwent a Ross procedure. Etiology was rheumatic in 143 (75.6%) patients, bicuspid aortic valve in 40 (21.2%, Marfan's disease in 5 (2.6%), and myxomatous aortitis in 1 (0.5%). Among the homograft group, a scalloped subcoronary implantation technique was used in 54 patients, whereas 32 patients underwent root replacement. Five patients required aortic root and ascending aortia replacement for annuloaortic ectasia. In all patients undergoing the Ross procedure, a root replacement technique was used. Operative mortality was 7.4% (14 patients). Late mortality was 5.3% (10 patients). Follow-up ranged from 1 to 46 months postoperatively. In patients with homograft aortic valve replacement, 76 patients (91.5%) had trivial to mild aortic regurgitation, while 7 patients (8.4%) had important aortic regurgitation. In patients with the Ross procedure, 78 patients (89.6%) had trivial to mild regurgitation. Moderate to severe aortic regurgitation was present in 9 patients (10.3%). all of whom had rheumatic heart disease and were young (〈 30 years at surgery). We conclude that homografts and autografts provide an excellent substitute for the diseased aortic valve. Young age (〈 30 years) with rheumatic etiology is a major risk factor for early progressive aortic regurgitation in patients undergoing the Ross procedure.(J Card Surg 1998;13:1–8)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1998.tb01045.x
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  • 2
    Electronic Resource
    Electronic Resource
    Sinus of Valsalva Aneurysms: 20 Years’ Experience (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 12 (1997), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Background: Aneurysms of sinus of Valsalva are rare. Here, we analyze retrospectively patients operated on at our center during the last 20 years. Patients and Methods: One hundred four cases of congential aneurysm of sinus of Valsalva were operated upon between January 1977 and April 1996. Only 12 aneurysms were unruptured. The majority (76.9%) arose from the right coronary sinus. The right ventricle was the most common chamber of rupture (58.6%). Ventricular septal defect was associated in 46 patients (44.2%), of which 28 (60.9%) were supracristal. Ventricular septal defect was more common in aneurysms arising from the right coronary sinus (91.3%). Aortic incompetence was found in 45 patients (43.3%). The defect was closed through the aortic root alone in 24 patients (23.1%) and through both the aortic root and the chamber of rupture in the remaining 80 patients. Six patients underwent aortic valve repair, and 21 an aortic valve replacement. Results: There were two hospital deaths (1.92%). Morbidities were few. Follow-up ranged from 1 to 20 years (mean 8.2 ± 1.1). There was one late noncardiac death, and in the majority, the long-term follow-up was uneventful. Conclusion: Surgery for aneurysm of sinus of Valsalva yields gratifying results, and it should be undertaken as soon as the condition is diagnosed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1997.tb00143.x
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  • 3
    Electronic Resource
    Electronic Resource
    Redo Mitral Valve Surgery—A Long-Term Experience (2004)
    350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc
    Journal of cardiac surgery 19 (2004), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background: Our experience with reoperative mitral valve (MV) surgery over a 27-year period is presented here. Methods: From January 1975 to June 2002, 11,908 operations were performed for MV disease. Out of these 744 were reoperations. The mean age at primary operation was 23.6 ± 10.1 years (range 2 to 53 years) and at reoperation was 36.0 ± 11.0 years (range 6 to 65 years) with a mean interval of 11.5 ± 2.5 years. Mitral valve replacement (MVR) was performed following previous closed mitral valvotomy (CMV) in 408 patients, open mitral commissurotomy (OMC) in 21 patients, and MV repair in 58 patients, MVR in 80 patients, homograft mitral valve replacement (HMVR) in 11 patients. The reasons for reoperation were mainly progression of lesions. Valve thrombosis and endocarditis were indications for reoperation following MVR. Twenty-eight patients underwent redo CMV, 53 patients underwent OMC, and 14 patients underwent MV Repair. Results: Early mortality was 5.64% (n = 42). Hemorrhage and low cardiac output were the major causes. Follow-up was 124.8 ± 30.5 months (2 to 300 months). Follow-up was 88%. There were no late deaths in the valve repair group. There were three episodes of thromboembolism in this group (0.3% per patient-year). In the valve replacement group there were six late deaths; three due to valve thrombosis, one due to infective endocarditis, and two due to anticoagulant-related hemorrhage. There were 13 episodes of thromboembolism in this group (0.6% per patient-year). Conclusion: Redo MV surgery is safe and can be undertaken with acceptable mortality and morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0886-0440.2004.4054_11.x
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