Israel journal of medical sciences
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Experience with isolated mitral and aortic valve replacement at the University of Oregon Medical School since 1965 is presented. Results with non-cloth-covered and cloth-covered valves were analyzed with actuarial techniques and were compared in terms of late survival, thromboembolic complication rate, reoperation rate and the influence of anticoagulation therapy. ⋯ Although anticoagulation therapy is still necessary, a clinical trial is currently in progress to assess the adequacy of antiplatelet drugs. The choice of a cloth-covered or non-cloth-covered valve should be individualized for each patient, based on the different risks and benefits of each prosthesis.
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Deep hypothermia has recently gained popularity as an adjunct to intracardiac surgery for neonates and infants. A number of Japanese investigators played a role in the development and clinical application of both simple surface-induced hypothermia and the combined use of surface and perfusion cooling. The developmental history of both methods is described in detail. ⋯ There has been a notable decrease in operative mortality since the employment of circulatory arrest under deep hypothermia and limited pump-perfusion. This trend is marked in infants with ventricular septal defect and pulmonary hypertension, and in those with total anomalous pulmonary venous connection. The Landé-Edwards membrane oxygenator proved helpful in prevention of postoperative pulmonary complications.