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  • 1
    Electronic Resource
    Electronic Resource
    The Use of Glucose and Insulin during Hypothermic and Normothermic CABG (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 793 (1996), S. 0 
    Details
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1749-6632.1996.tb33548.x
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  • 2
    Electronic Resource
    Electronic Resource
    Recombinant BCG approach for development of vaccines: cloning and expression of immunodominant antigens of M. tuberculosis (2000)
    Oxford, UK : Blackwell Publishing Ltd
    FEMS microbiology letters 190 (2000), S. 0 
    Details
    ISSN: 1574-6968
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: In spite of major advances in our understanding of the biology and immunology of tuberculosis, the incidence of the disease has not reduced in most parts of the world. In an attempt to improve the protective efficacy of Mycobacterium bovis bacille Calmette–Guérin (BCG), we have developed a generic vector system, pSD5, for expression of genes at varying levels in mycobacteria. In this study, we have cloned and overexpressed three immunodominant secretory antigens of M. tuberculosis, 85A, 85B and 85C, belonging to the antigen 85 complex. All the genes were cloned under the control of a battery of mycobacterial promoters of varying strength. The expression was analysed in the fast-growing strain M. smegmatis and the slow-growing vaccine strain M. bovis BCG. The recombinant BCG constructs were able to express the antigens at high levels and the majority of the expressed antigens was secreted into the medium. These results show that by using this strategy the recombinant BCG approach can be successfully used for the development of candidate vaccines against infections associated with mycobacteria as well as other pathogens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1574-6968.2000.tb09304.x
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  • 3
    Electronic Resource
    Electronic Resource
    Determinants of Incomplete Left Ventricular Mass Regression Following Aortic Valve Replacement for Aortic Stenosis (2005)
    350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc
    Journal of cardiac surgery 20 (2005), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Objective: Incomplete regression of left ventricular hypertrophy (Abn-LVMI) following AVR for aortic stenosis (AS) may decrease long-term survival. In this prospective study, we identified the predictors of Abn-LVMI. Methods: Between 1990 and 2000, 529 patients undergoing AVR for AS had clinical and hemodynamic data collected prospectively. Preoperative and annual postoperative transthoracic echos were employed to assess left ventricular mass index (LVMI) and hemodynamics. Abn-LVMI was defined as the 75th percentile of the lowest postoperative LVMI (〉128 mg/m2, n = 133). All other patients were included in the normal regression group (N-LVMI). Univariate and multivariable logistic regression analyses were used to determine the predictors of Abn-LVMI. Results: Preoperative hypertension, diabetes, coronary disease, valve size, mean postoperative gradients, effective orifice area, and patient-prosthesis mismatch (PPM, indexed EOA 〈0.60 cm2/m2) did not predict Abn-LVMI. By logistic regression the most important positive predictor of Abn-LVMI was the extent of preoperative LVMI, with an odds ratio of 37.5 (p 〈 0.0001). Survival (93.4 ± 1.8% vs 94.8 ± 2.3%, p = 0.90) and freedom from NYHA III–IV (75.0 ± 3.7% vs 76.6 ± 5.3%, p = 0.60) were similar for both groups at 7 years. Conclusions: Measures of valve hemodynamics were not important predictors of incomplete regression of hypertrophy. The extent of preoperative hypertrophy was the most important predictor, suggesting that earlier surgical intervention may reduce the extent of hypertrophy postoperatively. Furthermore, the significance of LV hypertrophy to long-term survival must be reassessed, in the absence of scientific evidence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.2005.200485.x
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  • 4
    Electronic Resource
    Electronic Resource
    Myocardial Protection in Reoperative Coronary Artery Bypass Grafting: (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  Redo coronary artery bypass grafting (CABG) is associated with higher morbidity and mortality when compared to first-time CABG. Myocardial infarction and dysfunction contribute significantly to the increased risk of redo CABG. Results of reoperative coronary surgery have gradually improved, largely because of improvements in myocardial protection techniques. In the present review we will highlight the principles of myocardial protection in redo CABG patients with an emphasis on retrograde cardioplegia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0886-0440.2004.4052_11.x
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  • 5
    Electronic Resource
    Electronic Resource
    Charting the Future by Examining the Past: (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
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0886-0440.2004.4098_11.x
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  • 6
    Electronic Resource
    Electronic Resource
    Facilitated Insertion of the Hancock II Bioprosthesis (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 17 (2002), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.2002.tb01207.x
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  • 7
    Electronic Resource
    Electronic Resource
    Risk Factors for Stroke Following Coronary Bypass Surgery (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 10 (1995), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Improvements in surgical technique and advances in myocardial protection have resulted in low rates of morbidity and mortality despite a greater incidence of high-risk patients. Noncardiac morbidity prolongs hospital stays and increases the costs of cardiac surgery. This study examines the preoperative predictors of stroke following isolated coronary bypass surgery. The clinical records of 3910 consecutive patients who underwent isolated coronary bypass surgery at the University of Toronto were reviewed. Stepwise logistic regression identified six independent predictors of stroke following CABG (percent in parentheses) and calculated factor adjusted odds ratios (OR) for each risk factor. Triple vessel coronary artery disease was the most important predictor (1.9%, OR 5.71), followed by normothermic systemic perfusion (3.8%, OR 4.85), age 〉 70 years (3.2%, OR 3.88), a previous history of transient ischemic attacks or stroke prior to surgery (6.1 %, OR 3.7), peripheral vascular disease (4.7%, OR 2.77), and diabetes mellitus (2.6%, OR 2.01). The mechanism of stroke is likely different between these high-risk groups and strategies to prevent postoperative stroke should focus on the mechanisms responsible in high-risk patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1995.tb00679.x
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  • 8
    Electronic Resource
    Electronic Resource
    Current Options for Mechanical Heart Technology (2001)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 17 (2001), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Heart transplantation remains the treatment of choice for end-stage heart failure despite limited donor availability and allograft durability. Artificial heart technology was initially developed as a replacement for transplantation but the initial experience with these technologies was disappointing. The quest for a total artificial heart has largely been abandoned in favor of ventricular assist devices (VADs). VADs have gained widespread acceptance as bridge to transplant and bridge to recovery therapy. After more than a decade of clinical use, several FDA approved device designs have proved effective in treating patients with various causes of heart failure. This review describes the current, clinically available ventricular replacement and assist devices and defines the adult patient populations in which they are useful. The next generation of these devices will soon become available and their clinical utility will likely shape the future direction of heart failure therapy. Ultimately the concept of a long-term total artificial heart may be revisited.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.2001.tb01225.x
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  • 9
    Electronic Resource
    Electronic Resource
    Thrombosis of Mechanical Mitral Valve Prosthesis (2005)
    350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc
    Journal of cardiac surgery 20 (2005), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Obstruction of mechanical valve prostheses is a rare but potentially lethal complication following valve replacement surgery. Identifying the etiology and differentiation between thrombus, pannus, and vegetation obstructing the valve prosthesis can pose a diagnostic challenge. We report a patient who had an acute cerebral hemorrhage, developed a progressive mass lesion obstructing his mechanical mitral valve, and discuss contemporary diagnostic and management strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.2005.200474.x
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  • 10
    Electronic Resource
    Electronic Resource
    Changing Trends in Mechanical Circulatory Assistance: (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: The success of long-term implantable ventricular assist devices has led to their increased use in patients previously thought to be unsuitable for mechanical support. As a result, the demographic profile of patients presenting for LVAD support has changed over time. We reviewed our institutional experience to identify emerging risk factors and changing trends in patients who received the HeartMate VE LVAD. Methods: The clinical records were reviewed of 131 consecutive LVAD recipients between 1996 and 2001. All perioperative data were collected prospectively and entered into an institutional database. All patients received a preoperative risk stratification score based upon published criteria. The cohort was arbitrarily divided into early (n = 45), mid (n = 45), and late groups (n = 41). Results: Overall operative mortality was 25% with no difference between groups. The mean risk score increased significantly over time (early 3.5 ± 0.4 vs. late 5.3 ± 0.3, p 〈 0.05). The proportion of patients at high risk for mortality (score 〉5) was significantly higher in the late group (51% vs. 29%, p 〈 0.05). Although ventilation time and ICU stay was similar for all groups, hospital stay was longer in the late group (43 days vs. 23 days, p 〈 0.05). Mean duration of support fell from 90 to 59 days, but this failed to achieve statistical significance. Out-patient therapy decreased from 73% in the early group to 15% in the late group (p 〈 0.001). Multivariate analysis identified right heart failure (odds ratio 4.1, 95% CI 2–11) and risk score (OR 1.4, 95% CI 1.2–1.6) as independent predictors of death. Conclusions: Despite an increasingly high risk patient population, the mortality associated with LVAD therapy has remained constant. Duration of LVAD support has decreased with a trend toward transplantation before hospital discharge. These data continue to support the aggressive institution of mechanical assistance for acute or chronic heart failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0886-0440.2004.4074_11.x
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