OBJECTIVES Destruction of the intervalvular fibrous body, though uncommon, occurs due to paravalvular abscess formation following active infective endocarditis. This warrants a highly complex operation involving radical surgical debridement of the intervalvular fibrous body, followed by double valve (aortic and mitral) replacement with patch reconstruction of the anterior mitral annulus, the le...

Carcinoid heart disease is a rare but important cause of intrinsic right heart valve disorders leading to right heart failure. Occasionally, left-sided heart valves may also be involved. The characteristic cardiac pathological findings of carcinoid heart disease are endocardial thickening as a result of fibrous deposits on the endocardium. Echocardiographic examination and right heart catheteri...

OBJECTIVES This study evaluated the cost-effectiveness of administering prophylactic intravenous (IV) amiodarone therapy to patients undergoing cardiac surgery according to their predicted risk of postoperative atrial fibrillation. BACKGROUND Atrial fibrillation (AF) is a common complication of cardiovascular surgery that is associated with a significant increase in hospitalization costs. Int...

Advanced chronic kidney disease (CKD) is associated with poor outcomes in patients undergoing surgical aortic valve replacement, while its prognostic role transcatheter replacement (TAVR) remains unclear. CKD was defined according to estimated glomerular filtration rate (eGFR): 15–29 mL/min/1.73 m2 (Stage 4—CKD G5), <15 5—CKD and G5D if the patient on hemodialysis. End-stage renal (ESRD) increa...

Mitral regurgitation (MR) is a frequent complication of end-stage heart failure. Historically, these patients were either managed medically or with mitral valve replacement, both associated with poor outcomes. Mitral valve repair via an 'undersized' annuloplasty repair is safe and effectively corrects MR in heart-failure patients. All of the observed changes contribute to reverse remodeling and...

Methods All patients younger than 70 years of age undergoing isolated aortic valve replacement from October 2005 to October 2011 were analyzed. Patient-prosthesis mismatch was defined as the indexed effective orifice area ≤ 0,85cm2/m2. We studied the impact of patient-prosthesis mismatch on mid-term overall mortality, cardiac events and New York Heart Association functional class using an analy...

OBJECTIVES The aim of this paper is to describe the feasibility of a novel transcatheter approach for mitral valve replacement using only venous access. BACKGROUND Failure of mitral valve prostheses necessitating reoperation can represent a high-risk clinical scenario. Although repeat cardiac surgery remains the standard of care for most failed mitral valve operations, nascent transcatheter o...

Background: The majority of prospective cardiac surgical patients in sub Saharan Africa lack access to open heart surgery. We reviewed our midterm results to identify the obstacles to growth and challenges with sustainability. Methods: Records of patients undergoing heart surgery at LASUTH from December 2004 to March 2006 were retrospectively reviewed for clinical and outcome data. Results: Twe...