g. ostial encroachment and
previous mitral valve replacement). GDC-0973 purchase The aim of this study was to prove the feasibility and efficacy of this novel innovative off-pump apico-aortic conduit technique.
The bipartite conduit consists of an 18-mm prosthetic tube graft containing a stentless porcine aortic valve as well as a flexible semi-rigid and curved ventricular connector. Via left anterior lateral thoracotomy, the valved conduit is sutured to the descending aorta. The left ventricular connector is implanted with a gun-like applicator into the apex without cardiopulmonary bypass and with minimal blood loss.
Between March and December 2011, 7 patients (5 females/2 males) with a mean age of 82 (79-89 years) were operated on. The mean logistic EuroSCORE I was 36.4 +/- 23.7 (median 36.7%). The mean ejection fraction was 37 (25-65%) CUDC-907 manufacturer and the mean preoperative transaortic gradient was 38 (22-53 mmHg). Three patients had previous mechanical mitral valve replacement, 1 had a porcelain aorta and 3 had unfavourable distances between the aortic annulus and ostia (ostial
encroachment). Implantation was uneventful in all patients, with need for limited cardiopulmonary bypass in only 1 patient. Postoperative mean transaortic gradient was 14 (11-25 mmHg). Approximately 70% of stroke volume was bypassed as measured in postoperative magnetic resonance. One patient died in hospital due to respiratory failure. New York Heart Association class in the other patients diminished from 3.6 to 1.6. No rhythmic disturbances or heart block were encountered.
With this novel conduit, we observed excellent haemodynamic results. We feel that this additional surgical approach to aortic stenosis in elderly, high-risk patients can augment conventional on-pump and interventional treatments of aortic stenosis.”
“Background Gastric perforations are one of the intraoperative
complications of laparoscopic gastric banding (LAGB). Delayed diagnosis can increase the mortality and morbidity rates.
Methods Retrospective analysis of surgery outcome and long-term follow-up of the patients with gastric perforations during primary LAGB and revisional band procedures was performed.
Results BKM120 solubility dmso Twenty-four patients with gastric perforations were identified during 15 years of LAGB surgeries. Half of these had primary LAGB and half had revisional procedures (five emergent and seven elective). Gastric tear was found at surgery in 19 patients; the band was preserved and LAGB was completed in 18 of these. Five patients had delayed diagnosis and underwent re-exploration 24-72 h after surgery. During the surgery, 23 anterior, 8 posterior, 1 esophageal, and 1 small bowel tears were found. Laparoscopic repair was successful in 19 (83 %) cases. The mean surgery time and mean hospital stay were 56.3 min and 7.8 days, respectively. Morbidity and mortality rates were 25 and 4.1 %, respectively.