[Evaluation of the Ionescu-Shiley valve. 7 years' results].
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Biomedical subjects
Publications and source records attributed to F Vermeulen.
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The best management of infected pseudoaneurysms after prosthetic graft replacement of the ascending aorta has not yet been established. The successful surgical treatment of three patients with this complication following replacement of the aortic valve and ascending aorta is reported. Because of the poor preoperative clinical condition of these patients, an effort was made to carry out the operative repair as expeditiously as possible. The prosthetic material was never entirely removed and replaced, but less radical operations were performed in combination with extensive and accurate debridement of the mediastinum and local antiseptic irrigation.
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The combined approach of extracranial arterial lesions in patients undergoing open heart surgery decreases the high cardiac and neurological morbidity and mortality presented by patients operated sequentially. Besides the anatomically sound simultaneous approach of arch lesions and heart surgery, both to be operated by median sternotomy, the authors present their criteria used in the selection of neurologically symptomatic and asymptomatic patients with carotid and vertebral disease to be operated simultaneously. Results in 17 personal cases are presented.
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A series of 295 patients with combined extracranial and coronary revascularization procedures is analyzed. Operations were combined in patients with symptomatic or severe carotid lesions. Hospital mortality was 3.5%; hospital morbidity was mainly neurological with 5% reversible neurological deficits or strokes. The independent risk factors for hospital mortality and morbidity as well as for long-term survival and morbidity were statistically analyzed. The 10-year survival was 47% and predominantly determined by the cardiac 10-year survival (61%).