Biomedical subjects
Publications and source records attributed to J Mosieri.
We report a case of erosion of an aneurysm of the right sinus of Valsalva into the interventricular septum. The mode of presentation, the preoperative evaluation, and the echocardiographic and nuclear magnetic resonance imaging features are presented, and the cardiac catheterization findings and surgical management of this very rare cardiac pathology are discussed.
Twenty four patients underwent pericardectomy for constrictive pericarditis. There were 2 operative deaths. Tuberculosis was the aetiological factor in 20 patients and a post surgical aetiology was found in 2 patients. The aetiology remained unclear in 2 patients.
Ninety-four patients over the age of 70 years were submitted to 95 operations for aortic valve disease. Seventy-seven patients had isolated aortic valve operations and a further 17 underwent additional procedures. The hospital mortality for the whole group was 15.7%. The actuarial five year survival was 66%. Concomitant coronary revascularization increased the perioperative risk. Myocardial protection by cold crystalloid cardioplegia improved results reducing the perioperative mortality for AVR alone from 21.7 to 11.1%. We believe that these patients should not be denied operative intervention since worthwhile improvement generally ensues. Coronary artery grafting can be hazardous. Bioprostheses inserted with myocardial protection favours surgery over continued medical management which offers little for these elderly symptomatic patients.