The Thoracic and cardiovascular surgeon
-
Thorac Cardiovasc Surg · Feb 2014
Comparative StudyImpact of smoking status on outcomes after concomitant aortic valve replacement and coronary artery bypass graft surgery.
There is a paucity of data on the impact of smoking status on outcomes after concomitant aortic valve replacement and coronary artery bypass graft (AVR-CABG) surgery. ⋯ Smoking is not associated with adverse outcomes after concomitant AVR-CABG surgery. Smoking status should not, therefore, preclude these patients from undergoing this procedure. Given the adverse effect of smoking on overall cardiovascular morbidity and mortality and late postoperative mortality, patients should be encouraged to quit smoking.
-
Thorac Cardiovasc Surg · Feb 2014
Comparative StudyMinimally invasive versus conventional extracorporeal circulation in minimally invasive cardiac valve surgery.
Minimally invasive extracorporeal circulation (MECC) technology was applied predominantly in coronary surgery. Data regarding the application of MECC in minimally invasive valve surgery are missing largely. ⋯ We were able to prove the feasibility of MECC even in minimally invasive performed mitral and aortic valve procedures. In addition, the use of MECC provides decreased platelet consumption and less hemodilution. The use of MECC in these selected patients lead to a shorter ventilation time and ICU stay.
-
Thorac Cardiovasc Surg · Feb 2014
Case ReportsPulmonary embolism in deceivingly stable patients with high thrombus load-when is stable really safe?
The definitive treatment of hemodynamically stable patients with pulmonary embolism and echocardiographically proven moderate to severe right ventricular dysfunction is unclear. We discuss the cases of a 45-year-old woman and a 62-year-old man that fulfilled the above criteria, but had a high risk for adverse events. Although both patients were treated according to current guidelines, one underwent successful surgical embolectomy the same day and the other was resuscitated a few days later. Surgery is an alternative for carefully selected patients with mild right ventricular dysfunction, but a high risk for adverse events that would otherwise be treated the same way as low- to moderate-risk patients.
-
Thorac Cardiovasc Surg · Feb 2014
Case ReportsUse of extracellular matrix materials in patients with endocarditis.
Tissue replacement is sometimes necessary during surgery for endocarditis. Commonly used materials are Dacron, expanded polytetrafluoroethlyene, or bovine pericardium. Those materials have no potential for bioresorption and cannot restore regional functionality. ⋯ Here we present two cases of patients with endocarditis. CorMatrix ECM (CorMatrix Cardiovascular, Inc., Atlanta, Georgia, United States) was used to repair intracardiac structures with good results in follow-up up to 3 months. CorMatrix ECM may be an adequate alternative to foreign material for patients with endocarditis.
-
Thorac Cardiovasc Surg · Feb 2014
The Mosaic bioprosthesis in the aortic position: 17 years' results.
The Mosaic bioprosthesis (Medtronic Inc., Minneapolis, Minnesota, United States), a stented porcine aortic valve, combines glutaraldehyde fixation with zero-pressure, root-pressure techniques and antimineralization treatment with amino-oleic acid for improved hemodynamics and tissue durability. The first device has been implanted worldwide at the authors' institution in September 1993. The aim of the present study was to collect mid- to long-term data of the prosthesis. ⋯ Performance and late outcome of the Mosaic bioprosthesis was satisfactory during 17 years after clinical introduction. The Mosaic bioprosthesis showed low incidence of SVD or need for reoperation in the long term.