ABSTRACT
Personal experience acquired in the course of 177 mitral valve replacements with a Lillehei-Kaster prosthesis up to June 1977 is discussed. Intraoperative mortality was 8.5%. Postoperative mortality (as at 31-12-1976) was 5.3%. The clinical, radiological, and ergometric findings were fully satisfactory. Haemodynamic examination at rest and during effort revealed improved pressure and heart capacity values. The mean transprosthetic gradient at rest was 5.61 and rose to 13.53 (after uncalibrated effort). Thromboembolism was noted in 5 patients (3.1%), as in the literature. The haemodynamic features and low thrombogenicity of the Lillehei-Kaster prosthesis would thus appear to make it a sound replacement for the mitral valve.
Subject(s)
Heart Valve Prosthesis , Mitral Valve Insufficiency/surgery , Mitral Valve Stenosis/surgery , Adolescent , Adult , Blood Coagulation Tests , Female , Follow-Up Studies , Hemodynamics , Humans , Male , Middle Aged , Physical Exertion , Postoperative Complications , Prognosis , Thromboembolism/etiologyABSTRACT
After examining the modalities of sternal perfusion and the techniques of median sternotomy, with special regard to closure techniques, personal experience of 1000 sternotomies is reviewed. Complications may be major or minor, incidence was 1,8% and total mortality two cases. After reviewing the various causes of sternal dehiscence, reported and personal experience of the various techniques for preventing and treating the complication is discussed.
Subject(s)
Sternum/surgery , Adolescent , Adult , Aspergillosis/etiology , Bacterial Infections/etiology , Female , Humans , Male , Mediastinitis/etiology , Middle Aged , Osteomyelitis/etiology , Postoperative Complications/mortality , Sepsis/etiology , Surgical Wound Dehiscence , Surgical Wound InfectionABSTRACT
The AA. examine their experience concerning 23 patients operated on for a discrete subaortic stenosis since 1969. Immediate results are satisfactory, even if there have been postoperative complications in 26% of the patients. Late results are less satisfactory, above all because of the progression of aortic insufficiency far from the operation. Date of literature are nor allowing valuable indications about the natural history of the patient after surgical treatment, because of the scarcity of postoperative hemodynamic controls and, especially, of serial examinations. The AA. believe, on the ground of considered data and personal experience, that it is prudent, awaiting for further critical evaluation of late results, to limit surgical indications, in asymptomatic patients, to cases with left ventricular-aortic gradient superior to 70 mmHg.
Subject(s)
Aortic Stenosis, Subvalvular/congenital , Cardiomyopathy, Hypertrophic/congenital , Adolescent , Adult , Angiocardiography , Aortic Stenosis, Subvalvular/diagnostic imaging , Aortic Stenosis, Subvalvular/surgery , Child , Female , Follow-Up Studies , Humans , MaleABSTRACT
Two cases of patients with discrete subaortic stenosis complicated by aortic regurgitation resulting from the sequelae of bacterial endocarditis and treated by valvular replacement are described. A correct preoperative evaluation was due to echocardiographic data and pressure curves; left ventriculography did not show any evidence of subaortic obstruction in any of the cases. In one patient, bacterial endocarditis involved mitral valve too, which was replaced by an artificial prostheses. Bacterial endocarditis is very rare in patients with discrete subaortic stenosis, but it must be regarded as a factor complicating the natural history of cardiopathy.
