The Freestyle valve in the pulmonary position in a congenital population is associated with low medium-term incidences of SVD and reintervention. It performs equally well to the homograft when a conduit is required and can be considered a valid alternative to stented bioprostheses when PVR alone is required.

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We report on 19 patients from Western Australia of pleural empyema with Klebsiella oxytoca, an organism never before reported in association with this condition. Median age was 65 years, 14/17 (83%) had been in hospital within 30 days prior to diagnosis, 12/18 (67%) had active cancer, 9/17 (53%) had been in intensive care and 7/17 (41%) had prior surgery. Nine patients died at the time of censure, five within 90 days of infection.

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Objective: Cardiac surgery is being performed on older and sicker patients with excellent outcomes. Percutaneous coronary intervention may be used in preference for high-risk patients with IHD, who would otherwise benefit from CABG. This renewed our interest in the outcomes for octogenarians undergoing surgical revascularisation. Methods: A retrospective analysis was performed, of 96 patients aged 80-89 years, undergoing CABG, from 2010-2016, at three Western Australian hospitals. Outcomes measured were 30-day mortality, stroke and duration of ICU and hospital stay, new renal failure and arrhythmia. Results: The mean age was 82.4 years with a 73% male preponderance. There was pre-existing congestive cardiac failure (CCF) in 9.3%, 11.4% had a prior cerebrovascular accident (CVA) and 18.7% had chronic obstructive pulmonary disease (COPD). Forty-six per cent underwent CABG alone and an equal number had concomitant aortic valve replacement (AVR). An IABP was placed for 3 people preoperatively, and another one to facilitate wean from bypass. The mean ICU stay was 3 days and the mean total hospital stay was 13.8 days. Further rehabilitation was needed post acute episode of care, for 31 patients. One patient had a CVA and 36.2% developed a new arrhythmia. There were 3 sternal wound infections requiring further intervention and 4 leg wound infections. The 30-day mortality was 3.1%. No patient required nursing home placement. Two patients required further PCI at mean follow-up of 24 months. Conclusion: The provision of CABG for octogenarians can be achieved with success and an acceptable risk profile, with increased requirement for allied health's rehabilitation services.

All patients had total arterial revascularisation (BIMA 58.1%; mean grafts number 2.9) and a conventional longitudinal carotid endoarterectomy with patch angioplasty. Results: One perioperative stroke (3.2%) and two deaths within 30 days (6.5%) were observed. No perioperative MI were recorded; the mean length of stay was 9 days. One patient died on postoperative day 2 of gut ischaemia after waking up with ipsilater upper limb weakness due to carotid patch thrombosis. The other death occurred on postoperative day 27 after discharge from hospital. Both were urgent referrals for recent NSTEMI and had EuroSCORE > 10%. Conclusion: Synchronous anaortic-OPCAB and CEA is a safe and effective option for patients requiring combined revascularisation.