CABG procedure in the presence of HM enhances LV recovery of function and has a favourable prognosis. Functional benefit of the left ventricle, however, appears to be time-limited, despite remarkable improvement in patient functional capacity. Advanced preoperative heart failure, minimal perioperative improvement of LVEF, and age account for a poor long-term prognosis.
The autologous pericardium seems to be superior to rigid prosthetic rings for annuloplasty in MVR since it provides more favourable mitral annulus dynamics and preserves LV function during stress conditions. Effective and durable annular remodelling with the autologous pericardium is achieved up to 6 years from surgery, with no echocardiographic sign of degeneration in the long term. Further studies are required to compare biological versus flexible prosthetic rings in MVR.
The improved design of the recently introduced third-generation stented bioprosthesis Carpentier-Edwards PERIMOUNT Magna allows implantation of a significantly bigger valve than with the old generation. Furthermore, the improved hemodynamic performance of the Carpentier-Edwards PERIMOUNT Magna compares favorably with both the Carpentier-Edwards PERIMOUNT and the Edwards Prima Plus.
We report our preliminary experience in post-cardiac surgery mediastinitis using a recently introduced silver-releasing dressing claiming prompt antibacterial activity. Acticoat, a silver nanoparticles slow release dressing was used in four patients with documented post-cardiac surgery mediastinitis and persistently positive microbiological cultures despite vacuum-assisted closure (VAC) therapy. In all four patients negative cultures were obtained within a maximum of 72 h and patients were discharged within a maximum of 20 days.
Objective: Atrioventricular (AV) conduction impairment represents an infrequent complication following aortic valve replacement (AVR). Although several conditions have been considered as potential risk factors for such a postoperative event, the role of the surgical technique has not been evaluated. The aim of this study was to investigate if the suture technique for implantation of the prosthetic valve is a potential risk factor need of pacemaker (PM) implantation after AVR. Methods: One hundred twenty‐four patients undergoing AVR were enrolled in this study. A “continuous” suture technique was performed in 72 patients (58%; Group A), whereas an “interrupted” suture technique was used in 52 patients (42%; Group B). The incidence of “major,” requiring PM implantation, as well as “minor,” without PM implantation, impairment of the AV conduction was evaluated and compared in the two groups by means of univariate and multivariate analyses. Results: The patients of the two groups were homogenous for all preoperative parameters except patient age. A longer clamp time was present in the patients of group B than those of group A (73 ± 24 minutes and 60 ± 24 minutes, respectively; p < 0.01). Postoperatively, hospital mortality consisted of four patients (3.2%) with no statistical importance between the two groups. Eleven patients of group A (17.5%) and one patient of group B (2.2%) required PM implantation (p < 0.05). Prolonged P‐R interval was recorded in 15 patients of group A and in 5 patients of group B (p < 0.05). Conclusions: We showed that the continuous suture technique increases the need for postoperative PM implantation after AVR. No major differences have been observed, however, regarding in‐hospital mortality and length of hospital stay, regardless of the type of prosthetic suture technique.
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