RESUMO
Valve dysfunction, attributed to primary tissue failure several years after implantation of Ionescu-Shiley bioprostheses, has led to re-operation in most cases. We report a rare case of this bioprosthesis showing stenosis and regurgitation after implantation in the mitral position 24 years previously. No cusp tears, but severe calcification and well-grown neointima over the Dacron cloth of the inner surface were observed. This may explain how the valve functioned for such a long period of time. We replaced it with a Carpentier-Edwards pericardial bioprosthesis.
Assuntos
Bioprótese/efeitos adversos , Próteses Valvulares Cardíacas/efeitos adversos , Insuficiência da Valva Mitral/cirurgia , Falha de Prótese , Idoso , Remoção de Dispositivo , Insuficiência Cardíaca/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Masculino , Reoperação , Fatores de TempoRESUMO
OBJECTIVE: We determined whether minimally invasive direct coronary artery bypass (MIDCAB) leads to excellent postoperative pulmonary function, and which contributes more to this--minithoracotomy or avoidance of cardiopulmonary bypass. METHODS: Pulmonary function 1 week before and 2 weeks after surgery was evaluated in 8 patients undergoing MIDCAB (Group M), 10 undergoing off-pump coronary artery bypass (Group O), and 12 undergoing conventional coronary artery bypass grafting (Group C). Parameters were adjusted by their predicted values and postoperative values were expressed as a ratio to preoperative ones. RESULTS: Only Group M maintained postoperative vital capacity and forced expiratory volume in 1 second close to the preoperative level and thus, showed significantly better recovery than Groups O and C. No significant difference was seen between Groups O and C. CONCLUSIONS: MIDCAB provides better recovery of pulmonary function early postoperatively than other procedures thanks to minithoracotomy rather than avoidance of cardiopulmonary bypass.
