ABSTRACT
Apicoaortic conduit implantation is easier and safer with cardiopulmonary bypass. We present an analysis of two cases in which the operation was successfully concluded without the bypass. The first patient had a simultaneous correction of aortic coarctation and tunnelliform subaortic stenosis 8 years ago and is asymptomatic at present. The second patient suffered from hyperlipoproteinemia, calcification of the ascending aorta and femoral arteries and severe aortic stenosis. One month after surgery be suffered cardiac arrhythmia and died. Although this experience is limited, we believe that information about this alternative method may be useful in some cases.
Subject(s)
Aortic Valve Stenosis/surgery , Blood Vessel Prosthesis , Cardiopulmonary Bypass , Ventricular Outflow Obstruction/surgery , Child , Female , Humans , Male , Middle Aged , Prostheses and ImplantsABSTRACT
Optimal treatment of prosthetic valve endocarditis due to Brucella melitensis is unknown. The presence of ring abscess makes extensive surgical débridement and valve replacement essential steps of management. Antimicrobial therapy with tetracycline hydrochloride plus streptomycin sulfate or sulfamethoxazole and trimethoprim can achieve the sterilization of infected cardiac tissue. Late bland periprosthetic leaks occur frequently. Reoperation can be safely performed after a period of antimicrobial therapy. Prolonged treatment with doxycycline hyclate seems advisable.