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S El Dsoki

Publications and source records attributed to S El Dsoki.

2 recordsLinked to original sources
PubMed2001

Aortic valve replacement with a stentless bioprosthesis using the full-root technique.

BACKGROUND: In aortic valve replacement stentless bioprostheses results in improved hemodynamic function compared to stented valves. Using the root replacement technique even larger prostheses are implantable. We present our experience with stentless bioprostheses implanted in the "full-root" technique. PATIENTS AND METHODS: Between 01/1997 and 12/2000, 149 patients underwent root replacement with a stentless xenograft (age 70 +/- 9y, women 52 %, ejection-fraction 58 +/- 15 %). Isolated stenosis was present in 34 %, incompetence in 24 %, and mixed disease in 42 % of patients. Bacterial endocarditis was found in 16 %, and 3 patients suffered from acute aortic dissection. RESULTS: Mean bypass time was 118 +/- 45 min, ischemic time 83 +/- 26 min and operating time 201 +/- 62 min. Concomitant procedures were CABG (32 %), replacement of ascending aorta (22 %) and aortic arch (13 %), mitral valve repair (6.7 %), and carotid thrombendarterectomy (1.3 %). Total in-hospital mortality was 6.7 %, with a 1.8 % mortality rate for patients with isolated aortic valve disease. CONCLUSION: Aortic valve replacement using stentless bioprostheses in the root replacement technique is a safe surgical option. In patients with small aortic roots or ring abscesses it guarantees remodelling of the aortic annulus.

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PubMed2001

Complete arterial revascularisation in patients older than 70 years.

BACKGROUND: Coronary artery bypass grafting (CABG) using left internal thoracic artery and vein grafts is standard in patients of advanced age. A number of these patients, however, present without suitable vein grafting material and thus require the use of arterial conduits. In order to investigate the safety and efficacy of complete arterial revascularisation, we have compared the perioperative results of patients older than 70 years with conventional CABG and complete arterial revascularisation. PATIENTS AND METHODS: Group I (n = 172) with conventional CABG in 1999 was compared with 152 patients (group II) with complete arterial CABG between 1996 and July 2000. There were no significant differences regarding age, gender, left ventricular ejection fraction or incidence of three-vessel disease or left main stenosis. The proportion of reoperations was significantly higher in group II (16 %) vs. group I (4 %). RESULTS: A mean of 3.7 +/- 0.7 anastomoses (I) versus 4.0 +/- 0.9 (II) were performed per patient (p = n. s.). Mean operating time (I: 210 +/- 46 min; II: 194 +/- 46 min) and bypass time (I: 87 +/- 25 min; II: 78 +/- 29 min) were significantly lower in group II. Ischemic time (I: 46 +/- 22 min; II: 49 +/- 21 min) was not significantly different. The incidence of sternal dehiscence was 2.9 % (I: n = 5) vs. 1.3 % (II: n = 2). Hospital mortality was 4.6 % in group I vs. 3.9 % (II). CONCLUSION: Complete arterial revascularisation is a safe option in patients aged over 70. It remains to be shown whether it may also have advantage in the long term.

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