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1.
Eur J Cardiothorac Surg ; 9(2): 95-8, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7748579

RESUMO

Although the outcome of patients transplanted after univentricular cardiac support is similar to that of conventional patients, death on the device remains a substantial problem. The wearable Novacor left ventricular assist system (LVAS) may offer advantages over console-based systems by improving rehabilitation before transplantation. For these advantages to be realised, however, a smooth perioperative course is necessary. We describe our operative technique, based on minimising blood loss and preserving right ventricular function, and the results in the first three patients to have the wearable Novacor LVAS implanted in this institution.


Assuntos
Cardiopatias/cirurgia , Transplante de Coração , Coração Auxiliar , Procedimentos Cirúrgicos Cardíacos/métodos , Humanos , Resultado do Tratamento
2.
Arch Mal Coeur Vaiss ; 84(12): 1797-802, 1991 Dec.
Artigo em Francês | MEDLINE | ID: mdl-1724365

RESUMO

Aprotinin is a pharmacological agent which, when given in high doses during cardiopulmonary bypass (CPB), seems to reduce postoperative blood loss significantly and thereby reduces the need for blood transfusion. This study was undertaken to confirm these claims and to show that there was also decreased peroperative bleeding and a shorter operation time. The immediate postoperative clinical course was also assessed. The study was a prospective, randomised double-blind trial versus placebo in 60 coronary patients undergoing at least 2 aorto-coronary bypass grafts for the first time within a 3 month period. During surgery after stopping the CPB the blood loss recorded by aspiration was 49 +/- 61 ml in the aprotinin group and 90 +/- 84 ml in the placebo group (p less than 0.05). The quality of haemostasis in the operated area evaluated independently by the anaesthetist was judged to be excellent in 30 patients in the aprotinin group compared with only 19 in the placebo group (p less than 0.001). The time between coming off CPB and skin closure was significantly shorter in the aprotinin group (42 +/- 10 min versus 49 +/- 12 min) and the dose of protamine injected at the end of the operation was 19 +/- 38 mg in the aprotinin group compared to 43 +/- 46 mg in the placebo group (p less than 0.05). The blood loss recorded over 48 hours in the intensive care unit was nearly three times less in the aprotinin group (380 +/- 125 ml) than with placebo (852 +/- 523 ml).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Aprotinina/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Ponte de Artéria Coronária , Circulação Extracorpórea , Adulto , Idoso , Transfusão de Sangue , Método Duplo-Cego , Feminino , Fibrinogênio/análise , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Contagem de Plaquetas , Período Pós-Operatório , Estudos Prospectivos
5.
J Card Surg ; 2(2): 265-74, 1987 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2979976

RESUMO

Bacterial endocarditis of the mitral valve appears to be much less common than bacterial endocarditis of the aortic valve. One of the main etiologic factors is the presence of degenerative lesions of the mitral apparatus, ballooning or mitral floppy valve. The surgical anatomy of the lesions is described: vegetations, perforations, rupture of chordae tendinae, abscess of the mitral ring observed in the isolated mitral endocarditis, mitral-aortic dislocation, abscesses and aneurysms of the mitral-aortic fibrosa and jet lesions on the anterior mitral leaflet. In the isolated primitive mitral infective lesions, all the technical skills are directed toward the prevention of the perivalvular leakage of the prostheses. Special procedures are described for the management of the abscesses of the mitral ring. In patients with mitral-aortic lesions, the main problem is treatment of the dislocation of the annuli or aneurysms of the mitral-aortic fibrosa. Despite technical advances, the surgical prognosis of the mitral endocarditis remains severe. In a personal series, the authors recorded a mortality of 12% in isolated mitral cases and 42% in the combined mitral-aortic patients. Early surgical treatment remains the most significant factor in decreasing the fatality of such lesions.


Assuntos
Endocardite Bacteriana/cirurgia , Valva Mitral/cirurgia , Valva Aórtica/patologia , Valva Aórtica/cirurgia , Endocardite Bacteriana/patologia , Doenças das Valvas Cardíacas/patologia , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas , Humanos , Valva Mitral/patologia
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