We present the case of a 49-year-old patient with aneurysm of the ascending aorta as well as mitral and aortic valvar insufficiency treated surgically. Preoperatively the patient was in NYHA functional class IV. We implanted mitral and aortic valvar prostheses and an intraluminal vascular graft in the ascending aorta above the coronary ostia. The postoperative course was uneventful. Five months after the operation the patient is in functional class II.
The authors present the results of surgical management of patients with mitral valve lesions. In 21 subjects replacement of the mitral valve with calf aortic graft was performed. The heterograft prepared according to O'Brien's technique, and reinforced by a metal-terital ring, was inserted into the mitral ostium. The operative method is described and the enclosed tables show the clinical pre-and postoperative findings based on short term follow-up observations.The absence of any postoperative complications with the inserted heterografts, in contrast to multiple troubles with the use of artificial prostheses, is related to the qualities of biological tissue which seem superior to the plastic grafts. Further observation of the patients and a greater number of cases will enable us to draw more precise conclusions concerning the long term fate of heterografts.
Severe complications prolonged the original hospital stay to over 2 months. After 5 months intermittent fever lead to readmission, but no cause could be found. After 7 months severe fever and heart failure developed. Initially valve endocarditis was suspected. After a blood culture had revealed Candida sp. antimycotic therapy was carried out. The reoperation showed surprisingly no valve endocarditis, but a mycotic lesion of the aortic suture.
Angeborene solitäre oder multiple arterio-venöse Kurzschlüsse mit Umgehung der Lungenkapillaren weisen hämodynamische Symptome eines extrakardialen Rechts-Links-Shunt mit allen seinen Folgen auf. Es ist nicht möglich, ohne röntgenologische Untersuchung diese mit Zyanose einhergehenden arterio-venösen Verbindungen in der Lunge von Herzfehlern mit einem Rechts-Links-Shunt zu unterscheiden. Bis 1961 wurden in der Weltliteratur 389 Fälle von arterio-venösen Kurzschlüssen der Lungengefäße zusammengestellt. Dieser Zahl fügen wir 9 eigene Beobachtungen hinzu. Von diesen 9 Kranken wurde bei 2 Patienten eine Lungenlappenresektion durchgeführt, 2 Kranke verweigerten ihre Einwilligung für den vorgeschlagenen chirurgischen Eingriff, 5 weitere sind in Beobachtung. Das wichtigste Problem bei diesem Leiden ist die Lokalisation, die Zahl und Größe der Veränderungen und das nach der Fickschen Regel bestimmte Shuntvolumen. Davon hängt
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