Type A aortic dissection: management of brain malperfusion through retrograde cerebral perfusion.
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Aortic Dissection↗
Biomedical subjects
C Bassano
Publications and source records attributed to C Bassano.
Doppler echocardiography evaluation of the CarboMedics valve in patients with small aortic anulus and valve prosthesis-body surface area mismatch.
A Doppler echocardiographic study was performed to evaluate the hemodynamic performances of small diameter CarboMedics aortic valves (CarboMedics, Inc., Austin, Tex.) in patients with a mismatch between the prosthetic valve and body surface area. Fourteen patients receiving either a 19 mm (n = 7) or a 21 mm valve (n = 7) prosthesis were studied. Only patients with a body surface area greater than 1.65 m2 were included in the study. Pulsed and continuous wave Doppler echocardiography was performed at rest and 2 minutes after treadmill exercise with the Bruce protocol. Peak and mean gradients across the valve prosthesis were estimated; effective orifice area, performance index, and discharge coefficient of the valve prosthesis were calculated. All patients achieved a significant increase in heart rate, systolic blood pressure, and cardiac output with exercise. Mean gradients +/- standard deviation of the mean at rest and 2 minutes after exercise were 20.1 +/- 7.1 mm Hg and 21.8 +/- 9 mm Hg for the 19 mm prosthesis and 12.3 +/- 3.4 mm Hg and 15.9 +/- 3.9 mm Hg for the 21 mm prosthesis. The 19 mm valve prosthesis significantly increased the effective orifice area with exercise (1.02 +/- 0.2 versus 1.20 +/- 0.3; p < 0.05), whereas it was almost unmodified for the 21 mm valve (1.38 +/- 0.2 versus 1.39 +/- 0.3; p = not significant). Therefore, despite a similar increase in cardiac output with exercise, only the 21 mm valve prosthesis showed a significant increase in peak (25.4 +/- 5.2 versus 34.9 +/- 8.1 mm Hg) and mean gradient (p < 0.01). We conclude that small diameter CarboMedics valves have satisfactory hemodynamic performances even after strenuous exercise in patients with large body surface areas. The hemodynamic performances of the 19 mm valve prosthesis seem to be optimized with exercise.
Aged↗
Enzyme levels in shed blood after cardiac operations.
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Aged↗
Clinical performance of low-profile bioprostheses: results at 10 years.
The purpose of this retrospective study is to evaluate the long-term performance of the Liotta minimally intrusive bioprosthesis (MIB) and to identify its most important risk factors. From January 1980 to March 1982, 73 patients (30 males and 43 females; mean age 45.5 years +/- 11.7 standard deviation; range 11 to 64) underwent operation for heart valve replacement with an MIB. Fifty-two mitral valve replacements (MVR), 16 aortic valve replacements (AVR), 4 mitral and aortic valve replacements (MAVR), and 1 mitral and tricuspid valve replacement (MTVR) have been performed (78 MIBs implanted). Global operative mortality has been 8.2% (6/73): 9.6% (5/52) for MVR and 6.2% (1/16) for AVR. The 10-year follow-up reaches 519 patient-years and 581 valve-years, and is 96.5% and 93.9% complete, respectively. Actuarial freedom from any patient- or valve-related event has been calculated at one time with its hazard function and its incidence normalized per 100 patient- and/or valve-years; statistical significance of difference between curves has been assessed. In this report, overall actuarial survival at 10 years is 79.4% +/- 5.3% SEM (standard error of the mean), including operative deaths (incidence = 2.6% per patient-year). Two patients experienced periprosthetic leakage (PL) at 4 and 9 years, respectively (incidence = 0.4% per valve-year). One patient underwent reoperation because of otherwise untreatable prosthetic valve endocarditis (PVE) at 5 years (0.2% per valve-year).(ABSTRACT TRUNCATED AT 250 WORDS)
Actuarial Analysis↗