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J Feijoo

Publications and source records attributed to J Feijoo.

5 recordsLinked to original sources

Long-term clinical performance of Sorin tilting-disc mechanical prostheses in the mitral and aortic position.

OBJECTIVE: Analyzing the long term performance of sorin tilting-disc mechanical prostheses. EXPERIMENTAL DESIGN: Retrospective patient-oriented study. The total follow-up was 460.2 patient-years. Follow-up data was obtained from the patients themselves or from their relatives. SETTING: Department of Cardiovascular Surgery in a general community hospital. PATIENTS: Seventy four patients undergoing valve replacement with Sorin tilting-disc mechanical prostheses between May, 1982 and July 1991. INTERVENTIONS: Thirty one of those patients underwent isolated mitral valve replacement (MVR) and 43 isolated aortic valve replacement (AVR). MEASURES: The incidence of the different complications is expressed as linearized rates. Actuarial analysis was performed with the Kaplan-Meier method. RESULTS: Linearized rates for MVR and AVR for the different complications (events per 100 patient-years) were, respectively: Late mortality: 4.5 +/- 1.6 and 1.8 +/- 0.8; Thromboembolism: 3.4 +/- 1.4 and 1.1 +/- 0.6; Anticoagulant-related hemorrhage: 2.8 +/- 1.3 and 0.3 +/- 0.3; Prosthetic endocarditis: 1.1 +/- 0.8 and 0.7 +/- 0.5; Non-structural dysfunction: 0.5 +/- 0.5 and 1.1 +/- 0.6; Reoperation: 1.1 +/- 0.8 and 0.3 +/- 0.3. Actuarial probabilities of freedom from the different complications were, respectively, at 13 years follow-up for MVR and 12 years follow-up for AVR, the following: Late mortality: 45.7 +/- 12.4% and 70.3 +/- 7.9%; Thromboembolism: 74.6 +/- 10.8% and 90.7 +/- 5.1%; Anticoagulant-related hemorrhage: 79.4 +/- 11.6% and 97.3 +/- 2.7%; Prosthetic endocarditis: 92.7 +/- 4.9% and 91.2 +/- 6.4%; Non-structural dysfunction: 95.6 +/- 4.3% and 88.2 +/- 6.6%; Reoperation: 83.6 +/- 11.8% and 97.3 +/- 2.7%. All valve-related mortality and morbidity: 42.2 +/- 11.0% and 56.7 +/- 8.6%. There was no instances of prosthetic structural failure. CONCLUSIONS: The Sorin mechanical prosthesis presents a good durability and its performance in the long term is comparable to other tilting-disc devices of the same generation.

Actuarial Analysis↗

Arteriosclerotic histologic evaluation of the internal mammary artery in patients undergoing coronary artery bypass grafting.

During 1991, 52 patients undergoing myocardial revascularization had a biopsy of the distal internal left mammary artery (IMA) taken. There were 48 male and 4 female patients with a medium age of 58 years. Arteriosclerotic involvement of the IMA was assessed according to the scale of Kay. Using this index, grade 0 corresponds to a normal artery without atherosclerosis, grade 1 represents minimal disease, grade 2 a narrowing of less than 25% of the lumen, grade 3 narrowing between 25 and 50%, and grade 4 narrowing of 50% or greater of the lumen. Of the 52 IMA examined, the arteries with degree 0, 1, 2, 3, and 4 were: 19 (36.5%), 20 (38.4%), 9 (17.6%), 4 (7.6%) and zero. Thirty-three arteries (63.4%) had some degree of atherosclerosis. Considering the arteries with some atherosclerotic narrowing, 13 (25%) of the whole group had this pathological alteration. The IMA has a low but consistent incidence of arteriosclerosis involvement. Preoperative angiographic investigation of the IMA could be routinely performed.

Adult↗

Total aortic arch replacement by a cryopreserved aortic homograft.

The case is presented of a 60-year-old man with previous surgery on the transverse aorta and a pseudoaneurysm of the aortic arch and hemoptysis. The patient was operated upon with cardiopulmonary bypass and cerebral perfusion. The aortic arch was resected preserving a cuff of the aorta containing the three supra-aortic trunks. A bronchial fistula was closed with a pediculated flap of the native arch. A long segment of cryopreserved human aorta (ascending, arch and upper descending thoracic aorta) was inserted in the orthotopic position. The aortic cuff with the supra-aortic vessels was re-inserted onto the allograft. The patient is asymptomatic 2 months after the operation. Aortic homografts are a good alternative in cases with suspected infection or contamination, like this one. Other conditions, such as infected aneurysms, infected grafts, aorto-esophageal fistula and aorto-gastrointestinal fistula, are potentially good candidates for homografting. We believe that this case is the first report of a complete substitution of the aortic arch with a human cryopreserved homograft.

Aorta, Thoracic↗