European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 1996
Aortic valve replacement after aortic valvuloplasty for calcified aortic stenosis.
This study concerns patients who underwent one or several aortic balloon valvuloplasties at our institution and subsequently required cardiac surgery, either on an emergency basis after aortic valvuloplasty or due to the development of aortic stenosis. ⋯ Both our experience and the literature show that balloon aortic valvuloplasty is followed by an immediate improvement in hemodynamic status with a decrease in valve gradient and an increase in valve area. However, the hemodynamic benefit is typically short-lived with a very high restenosis rate. Balloon aortic valvuloplasty is not an alternative to aortic valve replacement, which remains the best treatment for calcified aortic stenosis; the benefits and long-term results of aortic valve replacement are well established, even in the elderly.
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Gastrointestinal (GI) complications after cardiac surgery with cardiopulmonary bypass (CPB) are uncommon complications with significant morbidity and mortality rates. ⋯ Gastrointestinal complications, although of low incidence, carry a significantly high mortality, and the clinician must be alert to institute early appropriate treatment.
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Eur J Cardiothorac Surg · Jan 1996
Myocardial protection in chronic volume-overload hypertrophy of immature rat hearts.
The benefit of cardioplegic cardiac arrest for protection of the immature myocardium is controversial. We therefore investigated the efficacy of (1) topical hypothermia alone (2) slow cooling by coronary perfusion hypothermia and (3) cardioplegic cardiac arrest plus topical cooling for protection of isolated immature rat hearts (age: 28 days). ⋯ Rapid cooling by topical hypothermia along provides superior protection of hypertrophied- and non-hypertrophied-immature rat hearts to additional slow pre-arrest cooling. Use of St. Thomas' Hospital cardioplegic solution No.2 (STS 2) does not improve protection, and even hinders functional recovery in hypertrophied immature hearts. Endothelial injury caused by cold asanguinous perfusates, including cardioplegia, interferes with the recovery of vascular function, which in turn, may limit mechanical function.
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Eur J Cardiothorac Surg · Jan 1996
Comment Letter Case ReportsExtrapleural haematoma secondary to blunt chest trauma.