BACKGROUND AND AIM OF THE STUDY: The study aim was to characterize changes in mitral valve area and flow, and left ventricular (LV) size and function, following edge-to-edge (E-E) repair for severe functional mitral regurgitation (MR). The possibility that preoperative dobutamine stress echocardiography (DSE) might be used to predict post-repair ...

Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathies. The possible correction of mitral regurgitation is now being accepted as an alternative to cardiac transplantation in a special subset of patients. We proposed a new surgical approach that consisted of implantation of a mitral prosthesis smaller ...

BACKGROUND: Rheumatic mitral regurgitation (MR) causes heart failure by volume overload and an increase in atrial natriuretic peptide (ANP) levels by atrial stretching. Symptoms of heart failure improve with ANP treatment. Angiotensin-converting enzyme inhibitors (ACEI) and ANP have similar effects, such as vasodilation, natriuresis and diuresis. OBJECTIVE: To determine ANP ...

BACKGROUND AND AIMS OF THE STUDY: Quality of life (QoL) is of increasing interest in major surgical procedures. Mitral valve reconstruction (MRr) is assumed to be better tolerated than mitral valve replacement (MVR). The study aim was to assess mid-term QoL in patients undergoing isolated mitral valve surgery. METHODS: QoL ...

BACKGROUND: Septoexclusion is a technique described by Guilmet in the mid 1980s. Its indications and midterm results are evaluated and compared to those obtained with the Dor operation. METHODS: From January 1998 to April 2001, 79 patients had an exclusion of scars following myocardial infarction in left anterior descending artery ...

BACKGROUND: Mitral valve repair is the treatment of choice in patients with mitral insufficiency. Mechanical valves, even when functioning perfectly, are less efficient hemodynamically than a native mitral valve and also have attendant morbidity from thrombolism, anticoagulant-related hemorrhage, and endocarditis. Long-term data have confirmed the durability of mitral repair. METHODS: ...

Balloon mitral valvuloplasty has been reported to give equal or less positive results after previous commissurotomy than after a first procedure. Percutaneous mechanical mitral commissurotomy (PMMC) is a new technique that has not yet been evaluated in this subset of patients. Of 1,175 PMMC procedures (1,175 patients), 173 patients (14.7%) ...

BACKGROUND: The outcome of significant functional tricuspid regurgitation (TR) associated with mitral stenosis (MS) after percutaneous mitral valvuloplasty (PMV) remains to be clarified. METHODS: From 265 patients who underwent PMV at our institution from 1995 to 2000 and who were regularly observed, we selected 71 patients (55 women, mean age ...

BACKGROUND: The results of the maze procedure are known to be less satisfactory in rheumatic mitral disease than in nonrheumatic mitral valve disease. The aim of this study was to determine whether the etiology of mitral valve disease affected surgical outcome. METHODS: From July 1997 to January 2001, 129 consecutive ...

BACKGROUND AND AIM: The authors present a retrospective analysis of 14 patients treated for spinal cord hemangioblastoma (SCH). This study was conducted to evaluate and compare the difference of functional outcomes associated with the extent of surgical removal of the tumor. METHODS: Eleven patients were male and three were female, ...

Perioperative tachycardia is common in patients undergoing surgery. In patients with mitral valve stenosis, the tachycardia can precipitate congestive heart failure and pulmonary oedema. Efficacy of atenolol premedication (0.5 mg/kg) for haemodynamic stability was assessed in 37 patients undergoing closed mitral commissurotomy (Group I) and compared with 43 patients who ...

A 59-year-old man underwent closed mitral commissurotomy for mitral stenosis at the age of 19 years, and mitral valve replacement (MVR) with a Hancock standard bioprosthesis and tricuspid annuloplasty at the age of 40 years. Two years after the second operation, the patient developed human T-lymphotropic virus type-1 infection, manifesting ...

BACKGROUND: We studied the predictors and natural history of moderate mitral regurgitation following valvuloplasty using Inoue balloon since it has not been well documented in a large series. METHODS: Balloon mitral valvuloplasty was performed in 590 consecutive patients with severe mitral stenosis with mitral regurgitation of mild or lesser grade. ...

INTRODUCTION: Proximal hypospadias poses major problems in surgical correction owing to the complexity and severity of the abnormalities, leading to the use of staged repairs to correct this condition. However, with precise definition of the components of this deformity a single-stage operation can be developed and applied successfully for surgical ...

OBJECTIVES: To compare the outcome of the onlay technique in cases with an untouched urethral plate (group 1) and patients who had undergone previous hypospadias repairs (group 2). METHODS: The records of the 50 patients undergoing onlay island flap urethroplasty in the past 10 years were reviewed. The frequency of ...

The Inoue balloon technique for mitral commissurotomy is well established and carried out worldwide. Metallic commissurotomy is reported to be a cheaper and effective alternative to balloon mitral commissurotomy. One hundred patients were randomized into 2 groups to undergo percutaneous transmitral commissurotomy (PTMC) by means of the Inoue balloon technique ...

The purpose of this study was to clarify whether or not a change in the clinical characteristics of cardiac myxoma has occurred during the past 2 decades. The clinical records of 57 patients (22 men, 35 women; age, 52+/-14 years) with myxoma that had been surgically treated between May 1978 ...

BACKGROUND: Biventricular pacing is becoming more and more popular as a therapeutic strategy for patients with severe congestive heart failure refractory to medical treatment. The aim of our study was to evaluate the outcome of resynchronization therapy on the clinical and echocardiographic statuses, to determine whether any factors were predictive ...

PURPOSE: A urethral mobilization and advancement technique for repairing glanular, subglanular and midshaft hypospadias with or without chordee was developed, and has been used for more than 6 years. A brief description of the procedure and the results are presented. MATERIALS AND METHODS: From 1995 to 2001, 73 boys 4 ...

OBJECTIVES: Tricuspid regurgitation (TR) is common after heart transplantation (OHT), but its clinical relevance is undetermined. This study documents the clinical progress of patients with TR after OHT in relation to the severity of TR. METHODS: We studied 238 transplant recipients who had survived for at least 12 months after ...

OBJECTIVE: To determine the feasibility of surgically correcting pectus excavatum and carinatum deformities in adult patients. SUMMARY BACKGROUND DATA: Although pectus chest deformities are common, many patients progress to adulthood without surgical repair and experience increasing symptoms. There are sparse published data regarding repair of pectus deformities in adults. METHODS: ...

INTRODUCTION: The transseptal Inoue (IN) and to a lesser extend retrograde non-transseptal (RNT) techniques are established procedures for percutaneous mitral balloon valvuloplasty (PBMV) in patients with mitral stenosis. However, a head to head comparison of these two techniques, especially from a single center, has not yet been reported. METHODS: Seventy-two ...

BACKGROUND: The results of mitral valve replacement (MVR) with Sorin mechanical valves in patients who had tight mitral stenosis with high pulmonary artery pressure were reviewed. METHODS: During a period of two years, from August 1998 to May 2000, a mitral valve replacement with a Sorin Bicarbon mechanical valve was ...

OBJECTIVES: The goal of this study was to determine the presentation and outcome of the unoperated adult with congenitally corrected transposition of the great arteries. BACKGROUND: The presentation of this disorder and the outcome in unoperated adults have not been well defined. METHODS: All unoperated patients > or =18 years ...

BACKGROUND AND AIMS OF THE STUDY: The outcome of percutaneous balloon mitral commissurotomy (BMC) has been reported as poor in patients with prior surgical commissurotomy. The study aim was to evaluate immediate and long-term follow up results of BMC in patients with restenosis after surgical commissurotomy compared to patients with ...

BACKGROUND: The double switch operation is emerging as the procedure of choice for congenitally corrected transposition of the great arteries. However, rhythm disturbances in the postoperative period are rarely discussed. METHODS AND RESULTS: Eighteen survivors who underwent corrective surgery for congenitally corrected transposition of the great arteries were followed up. ...

BACKGROUND AND AIMS OF THE STUDY: Recent studies evaluating the severity of valvular insufficiencies have focused on the effective regurgitant orifice area (EROA), which corresponds hydrodynamically to the cross-sectional area of the vena contracta (VC). The study aim was to quantify aortic regurgitation (AR) by using color Doppler imaging of ...

BACKGROUND: Non randomized studies suggest that mitral valve repair for rheumatic disease is technically more difficult than repair for degenerative disease, and that operative and late results are worse. New surgical techniques have been developed in our and other institutes during the last 5 years, and this moved us to ...

Doxorubicin is an anthracycline antibiotic with a broad spectrum of antineoplastic activity. Cardiotoxicity is a serious long-term complication of the drug. Simultaneous administration of carnitine has been proposed to prevent cardiotoxicity. We aimed to monitor the serum carnitine levels during the treatment of doxorubicin and to determine a relationship between ...

From 1997 to 2000, 221 patients underwent mitral valve surgery through a mini-thoracotomy, using a port-access endovascular cardiopulmonary bypass system in 38 and a transthoracic clamp in 183. In 120 patients, exposure of the mitral valve was facilitated by an endoscope attached to a voice-controlled robotic arm (AESOP 3000). The ...

BACKGROUND: Native valve endocarditis is frequently managed with antibiotics alone, but prosthetic valve endocarditis usually requires an early operation. What is the best treatment of endocarditis after mitral valve repair? METHODS: From 1986 to 2000, 22 patients were treated for endocarditis affecting a previously repaired mitral valve. Causes of mitral ...

This study examines the incidence, predictors, and evolution of postoperative atrioventricular block (AVB) after mitral valve repair (MVR) in 115 consecutive patients using Carpentier's technique (between November 1996 and April 1997). Postoperative AVB occurred in 27 patients (23%). Third-degree AVB was found in 7 patients (6%) in the immediate postoperative ...

BACKGROUND: In this study, the authors' experience in adaptation of the Snodgrass technique for primary hypospadias repair, with an alternative way to create a barrier layer of dartos flap for neourethral covering, is presented. METHODS: Between March 2000 and January 2001, Snodgrass urethroplasty was consecutively done on 24 boys aged ...

Percutaneous transvenous mitral commissurotomy has emerged as an effective nonsurgical technique for the treatment of patients with symptomatic mitral stenosis. This report highlights the immediate and long-term follow-up results of this procedure in an unselected cohort of patients with rheumatic mitral stenosis from a single center. It was performed in ...

AIMS: This study is the first prospective randomized trial evaluating the efficacy of an antiarrhythmic surgical procedure in patients with chronic atrial fibrillation undergoing mitral valve replacement. METHODS AND RESULTS: Thirty consecutive patients with chronic atrial fibrillation undergoing mitral valve replacement were randomized for an additional modified MAZE-operation using intra-operatively ...

BACKGROUND: Percutaneous mitral balloon valvuloplasty (PMV) results in good immediate results, particularly in patients with echocardiographic scores (Echo-Sc) < or =8. However, which variables relate to long-term outcome is unclear. METHODS AND RESULTS: We report the immediate and long-term clinical follow-up (mean, 4.2+/-3.7 years; range, 0.5 to 15) of 879 ...

BACKGROUND AND AIM OF THE STUDY: Few long-term results exist of mitral valve replacement (MVR) in patients with chronic mitral regurgitation (MR) and severely enlarged left ventricle. Hence, the present study was conducted to provide additional data in this respect. METHODS: Between April 1988 and September 2000, 45 patients (28 ...

BACKGROUND AND AIM OF THE STUDY: The study aim was to assess the feasibility and follow up data of extensive decalcification for mitral valve repair in patients with severely calcified mitral annulus, in order to avoid mitral replacement. METHODS: Between 1993 and 1998, among 2,318 patients who underwent mitral valve ...

OBJECTIVES: Aortic valve leaflet extension using glutaraldehyde-fixed autopericardium in aortic regurgitation (AR) is technically demanding, and it is not a popular procedure among surgeons. This study evaluates the effectiveness and clinical feasibility of the leaflet extension technique as a treatment modality for AR. MATERIALS AND METHODS: From March 1995 to ...

BACKGROUND: Facing young foreign polyvalvular rheumatic patients, for which long-term anticoagulation is not available, we have chosen to attempt triple valve repair procedures in order to avoid prosthetic implantation in this particular population suffering from triple valve disease. METHODS: Twenty-one young rheumatic patients (mean age:11+/-4 years) underwent triple valve repair ...

PURPOSE: The aim of this study is to review the new technical modifications and results of 303 patients who have had pectus excavatum repair utilizing the minimally invasive technique. METHODS: A retrospective chart review was conducted of 303 patients undergoing minimally invasive pectus repair from 1987 through August 2000. Since ...

BACKGROUND AND AIMS OF THE STUDY: The study aims were to evaluate early and mid-term survival and freedom from reoperation in patients with isolated mitral valve (MV) congenital malformation (MVCM) or in association with other cardiac defects, and to identify predictors for poor early and late outcome. METHODS: Between January ...

OBJECTIVES: To report further experience of hypospadias repair using the tubularized-incised urethral plate (TIP) technique and to evaluate the role of postoperative neourethral dilatation as a method of preventing complications. PATIENTS AND METHODS: The study included 64 patients (aged 2-18 years) who underwent TIP repair of hypospadias; 47 required a ...

AIMS: To evaluate the safety and efficacy of a new approach for transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). METHODS: One hundred and two patients with rheumatic mitral stenosis were randomized into two groups. In the study group (RA approach), an imaginary horizontal line was drawn from ...

Eighty patients with tight and pliable mitral stenosis were randomized in a prospective trial comparing percutaneous balloon valvuloplasty and open commissurotomy. Mitral valve area increased significantly in both groups immediately after the procedures. However, a decrease in mitral valve area occurred in both groups at 6, 12 and 24 months ...

BACKGROUND: A variety of techniques have been described to reduce surgical access in mitral valve surgery: Mini-sternotomy (Gundry) involves partial division of the sternum while the right anterior mini-thoracotomy approaches described involve either Port Accesstradmark; (Heartport, Redwood City, CA), indirect endoscopic techniques (Chitwood) and more recently, robotic techniques (Intuitive Surgicaltradmark;). ...

BACKGROUND AND AIM OF THE STUDY: Mitral valve repair offers a survival benefit compared with valve replacement in surgery for non-infectious mitral regurgitation. It is unclear whether repair offers an advantage for patients undergoing mitral valve surgery for active endocarditis. Morbidity and mortality (early and late) and event-free survival were ...

Biventricular pacing substantially improves LV systolic function and symptom status in some patients with dilated cardiomyopathy. To assess whether the long-term benefit could be predicted from the echocardiographic parameters. Sixteen patients with dilated cardiomyopathy who underwent atrio-biventricular pacemaker implantation were analyzed in two groups: the responders (n=11) were those with ...

OBJECTIVES: There are an increasing number of reports concerning mitral valve repair by reconstruction of the chordae tendinae with the use of expanded polytetrafluoroethylene (PTFE) sutures. However, little information is available about the extended application or results of this technique for extended prolapse of bilateral mitral leaflets, which is considered ...

PURPOSE: We examine the results of a reoperative Snodgrass procedure for complex hypospadias. MATERIALS AND METHODS: A total of 25 patients with hypospadias in whom repair had failed underwent a reoperative Snodgrass procedure. Mean patient age and number of prior repairs were 11.4 years and 2.5, respectively. Before this treatment ...