ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00290.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractOne or more primary chordae tendineae of the anterior leaflet of the mitral valve was replaced with expanded polytetrafluoroethylene (PTFE) sutures in 22 patients as part of mitral valve reconstructive procedure. One patient with flail anterior leaflet of the tricuspid valve also had replacement of chordae tendineae with a PTFE suture. These patients have been followed from 2 to 48 months, mean of 17 months. Valve function has been assessed annually by Doppler echocardiography. The PTFE chordae cannot be visualized by two‐ dimensional echocardiography but they seem to allow the leaflet to move normally during the cardiac cycle. The function of the repaired valve in these 23 patients has remained most satisfactory during the observed interval. We believe that PTFE sutures can be used safely to replace diseased chordae tendineae of the mitral and tricuspid valves when conventional techniques of chordal repair are not possibl

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00291.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractSeventeen consecutive patients with double‐chambered right ventricles underwent intracardiac repair from February, 1985 through March, 1989. Nine patients had an associated ventricular septal defect. A transatrial approach to the repair was utilized in all patients. Early postoperative right ventricular‐to‐left ventricular pressure ratio was a mean of 0.29, range 0.21 to 0.37. There were no hospital or late deaths. We conclude that transatrial repair of a double‐chambered right ventricle can be accomplished routinely with satisfactory

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00292.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe authors present a modification to closure of the sternotomy incision. The procedure consists of detaching the pectoralis muscles on both sides of the edges of the sternum and uniting them presternally.

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00293.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractPredilection of certain sites of the porcine bioprosthetic valve (PBV) leaflets to calcification and tissue disruption has provoked suggestions that design factors and mechanical stresses may be major reasons leading to degeneration. In recent years, computer based numerical models of PBVs have shown a close association between sites of leaflet calcification and disruption and sites of leaflet stress concentration. These numerical models have also provided a means through which methodical design optimization can be carried out. Increasing stent flexibility, for instance, was shown to lead to an overall reduction of mechanical stresses on the PBV leaflets. Reducing the stent height, on the other hand, was accompanied by an undesirable increase of overall leaflet stresses. Despite encouraging work in this field, more research is needed to further elucidate means by which the structural integrity of bioprosthetic valves can be preserved through a minimization of the adverse effects of mechanical stresses.

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00294.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThis article discusses the principles for diagnosis and treatment of infective endocarditis in children. There has generally been a consistent volume of streptococcus endocarditis, the major lesion in pediatric endocarditis, but there has been an increase inStaphylococcus aureusendocarditis as well as neonatal endocarditis. Neonatal endocarditis is a severe form of the disease.

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00295.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractAmong 143 episodes of endocarditis experienced in children over a 38‐year period from 1950 to 1988, 23 patients required surgical intervention, including 11 vatve replacements, 2 valve repairs, 7 mycotic aneurysm resections (most related to coarctation or ductus), and 3 instances of debridement and repair of the ventricular septum. Left‐sided vegetations associated with endocarditis have traditionally been managed surgically only if repeated emboli have occurred. Following the unfavorable outcome In several patients with large mobile vegetations on the mitral valve, we have adopted a more aggressive surgical approach to debride and repair left‐sided valves involved with such vegeta

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00296.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractSurgical treatment of right‐sided endocarditis has in the past been centered on valve resection or resection with valve replacement. From 1981 to 1989, we attempted tricuspid valve repair in 19 patients with right‐sided endocarditis. Fourteen of these were successful. The methods of valve repair and classification of the lesions that allow evaluation for repair are discussed, including the use of transesophageal echo and a hand‐held color Doppler unit for intraoperative asses

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00297.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractInfective endocarditis, both in the native and prosthetic valve, presents a tremendous challenge to the cardiologist and cardiovascular surgeon, as well as the infection specialist. The timing of surgery is critical but it would appear that aggressive surgical intervention is indicated when there is persistent sepsis, continuing congestive heart failure, signs of nonfatal emboli, or in association with certain organisms such as staphylococcus, pseudomonas, or fungal organisms. Cardiac catheterization would not appear to and greatly to the diagnosis except to document the presence of coronary artery disease. The risk of surgery in patients with no annular abscess Is low but the recurrence rate tends to be highly dependent on the organism. Similarly, patients who have annular abscesses tend to provide the greatest challenge for the surgeon and despite the use of newer prosthetic and biological prostheses and an overall more aggressive approach, this pathological entity, particularly in conjunction with prosthetic valve endocarditis, has a high mortality and a high recurrence rate.

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00298.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe experience of the German Heart Center with valve selection and choice of size of prostheses for aortic root endocarditis is hereby reported. This experience includes 37 cases of aortic root endocarditis between 1986 and 1989. Mechanical, bioprosthetic, and homograft valves were used depending on the size, annular pathology, and general conditions related to the patient's medical history. Operative techniques are presented. Regardless of the type of valve replacement device, extensive annular destruction indicates a difficult and complex operation with long‐term early and late results inferior to those in patients without annular absces

ISSN:0886-0440    

DOI:10.1111/j.1540-8191.1989.tb00299.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY