Clinical cardiology
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Clinical cardiology · Oct 1997
Comparative StudyEarly and long-term outcome of aortic valve replacement with homograft versus mechanical prosthesis--8-year follow-up study.
Aortic valve disease is an important and frequent clinical problem with a mortality rate as high as 50-80% in a 5-year natural history of patients with severe aortic valve disease. Biological or mechanical prosthesis implantation is the only way to improve prognosis. ⋯ Early and late mortality as well as estimated probability of survival and hemodynamic improvement at 8-year follow-up after aortic valve replacement are independent of the type of implanted valve. Complication rate does not depend upon the type of preexisting valve pathology, but severe late complications are more common after mechanical valve implantation than after homograft implantation.
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Clinical cardiology · Jul 1997
Case ReportsPost-traumatic ventricular septal defect following coronary bypass surgery.
A 60-year-old patient underwent triple coronary artery bypass grafting following an inferoseptal myocardial infarction and early onset of exertional angina. Four years later he was involved in a car accident during which he sustained an abdominal and thoracic trauma. ⋯ Closure of the septal defect was successfully accomplished through a right atrial approach. Rupture of the ventricular septum following blunt chest trauma in a patient with previous myocardial revascularization has not been previously reported.
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Clinical cardiology · Jun 1997
Clinical TrialRoutine arterial oxygen saturation monitoring is not necessary during transesophageal echocardiography.
Transesophageal echocardiography (TEE) is now an established adjunct to routine echocardiography, its diagnostic impact making it an invaluable first-line diagnostic procedure in many cardiac conditions. However, there is no unanimity in the way the transesophageal procedure is carried out, especially with regard to the need for antibiotic prophylaxis, sedation, and the monitoring of oxygen saturation. ⋯ In patients with no chronic obstructive airway disease who are not in congestive heart failure, routine oxygen saturation monitoring is not deemed necessary during transesophageal examination. The cause of hypoxemia during the procedure is not only related to sedation but also to esophageal intubation.
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Contraction-excitation feedback, that is, electrophysiologic changes that are caused or preceded by mechanical changes of the myocardium, has been extensively studied in the ventricles. The role of contraction-excitation feedback in the atria, and more particularly in the genesis and maintenance of atrial fibrillation, has been less adequately investigated. ⋯ In patients with lone atrial fibrillation, modest increases in atrial pressure may facilitate the induction of atrial fibrillation.
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Clinical cardiology · May 1997
Cannulation of the coronary sinus via the femoral vein--a new technique.
Cannulation of the coronary sinus usually has been accomplished by advancing a catheter through the sub-clavian or internal jugular veins. ⋯ Analysis of the results showed evidence of a learning curve with improvement of time with an increasing number of patients. The method provides a safe and inexpensive solution for catheterization of the coronary sinus, easily accessible to every catheter laboratory.