Resection of the chordopapillary apparatus during mitral valve replacement has been associated with a negative impact on survival. Mitral valve replacement with the preservation of the mitral valve apparatus has been associated with better outcomes, but surgeons remain refractory to its use. To determine if there is any real difference in preservation vs non-preservation of mitral valve apparat...

Fifty consecutive patients, 25 undergoing aortic valve replacement and 25 mitral valve replacement, were studied by serial electrocardiography, preoperative and postoperative technetium-99m pyrophosphate radionuclide scanning, and serial measurement of enzymes (creatine kinase, aspartate aminotransferase, urea stable lactic dehydrogenase) and the MB isoenzyme of creatine kinase to define the in...

Gilbert's syndrome (GS) is an autosomal inherited disorder characterized by relative deficiency of glucuronyl transferase and poor uptake of unconjugated bilirubin by hepatocytes. Cardiac surgery on cardiopulmonary bypass (CPB) in these patients triggers further hepatic dysfunction. Transesophageal echocardiography (TEE) and Doppler assessment of hepatic vein help in assessing hepatic blood flo...

global myocardial ischemia and ischemia-reperfusion injury are potential adverse events related with cardioplegic arrest. beating heart surgery has avoided such complications and adapted to valve surgery following successful results published on myocardial revascularization. difficulty in weaning from cardiopulmonary bypass may be lessened by using on-pump beating heart surgery for mitral valve...

BACKGROUND The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of...

OBJECTIVE We analyzed the long-term morbidity and mortality of our experience with combined mitral-aortic surgery, as well as their determinants. METHODS Among 2109 consecutive patients undergoing valve operations, 200 had mitral-aortic valve procedures with at least implantation of a mechanical prosthesis: 163 of 200 (81.5%) patients had double valve replacement and 37 of 200 (18.5%) had mit...

BACKGROUND Mitral valve repair is considered better than mitral valve replacement for degenerative mitral regurgitation. AIM To evaluate late clinical results of mitral valve repair as compared to mitral valve replacement in patients with degenerative mitral regurgitation. PATIENTS AND METHODS All patients subjected to open heart surgery for degenerative mitral regurgitation between 1990 an...

A 69-year-old man with a history of aortic valve disease received an aortic valve replacement in 1996. He was reoperated on 5 occasions for prosthetic valve dysfunction, paravalvular leak, and tamponade. A double thoracotomy was performed for hemothorax and infection (1 side with pleurodesis). He was referred for heart transplantation because of persistent paravalvular leak, aortic failure, and...