Coronary artery bypass graft in porcelain aorta

A 48 years old male, with porcelain ascending aorta, and diffuse and severe stenosis of great vessels who underwent coronary artery bypass graft [CABG], and the challenges surgeons may encounter in relation to these patients are discussed along with the review of corresponding literature on this challenging entity in cardiac surgery

[Comparison of durability of cardiac bioprosthetic valves between pregnant and non pregnant patients]

Since anticoagulant therapy during pregnancy has high fetal and maternal risks, using bioprostheses valve is recommended for young women with cardiac valve disease who hope to have Children. Evaluation of the effect of pregnancy on the rate of deterioration of bioprosthetic valve is the aim of this study. This case - control study was done on 53 women in the reproductive age who underwent cardiac valve replacement using bioprostheses during 1977- 2001. Twenty seven patients [mean age 22. +/- 7.73 yr] at the time of valve replacement had pregnancy [Group A], and 26 patients [mean age 26.8 +/- 10.9] had no pregnancy after valve replacement [group B]. Mean time of structural valve deterioration, and need for redo valve surgery compared between the two groups. In group A 81.48% of patients underwent mitral valve replacement [MVR], 14.81 aortic valve replacement [AVR], and 3.71% tricuspid valve replacement [TVR]. In group B 84.6% underwent MVR, 11.6% AV R, and 3.81% both MVR and AVR. Fifty six pregnancy occurred in group A which 19.6% of them ended with abortion, 76.8% had normal infant birth 94.64% of pregnancies had no complications and 5.3% had valve degeneration during or 2-4 months after delivery. Average time of freedom from structural valve deterioration in the patients who had pregnancy was 16.60 years and it was 16.74 years in patients who had no pregnancy [P=0.91]. 55.5% of patients in group A underwent redo valve replacement [14.46. +/- 5.4yr] after first operation and 50% in group B after [10.61 +/- 5.63 yr] underwent redo valve replacement. Our finding didn't show any differences in structural valve deterioration time or need for redo valve operation between pregnant and non pregnant patients