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Digitale Medien

Long-Term Effectiveness of Operative Procedures for Stanford Type A Aortic Dissections (2004)

Driever, Rudolf ; Botsios, Spiridon ; Schmitz, E. ; [weitere]

350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc

Journal of cardiac surgery 19 (2004), S. 0

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ISSN: 1540-8191

Quelle: Blackwell Publishing Journal Backfiles 1879-2005

Thema: Medizin

Notizen: Abstract Background: The object was to evaluate the long-term effectiveness of strategies for managing the aortic root and distal aorta in type A dissections. Methods: From 1990 to 1999, 50 patients (32 men (64.07%); 18 women, (36.0%); mean age 57.4 ± 11.1 years) underwent operation for ascending aortic dissection. Surgical strategies included aortic root replacement with a composite graft (21/50; 42.0%), valve replacement with supracoronary ascending aortic graft (3/50, 6%), and valve preservation or repair (26/50; 52.0%). Results: Overall hospital mortality rate was 18.0%. Follow-up was completed for 47 patients (94.0%) and ranged from 1 month to 10.5 years (mean 28.8 months). Actuarial survival for patients discharged from the hospital was 84% at 1 year, 75% at 5 years, and 66% at 10 years. There was no significant difference between the various procedures regarding mortality, neurological complications, long-term survival, and proximal reoperations. The ascending aorta alone was replaced in 8 of 50 patients (16%), ascending and hemiarch in 30 of 50 patients (60%), and arch and proximal descending aorta in 12 of 50 patients (24%). Hospital mortality (11.5%, 20.0%, and 16.7%, respectively; p 〉 0.05) and 5- and 10-year survival (p 〉 0.05) were not statistically dependent on the extension of the resection distally. Residual distal dissection was not associated with a decrease in late survival. With regard to emergency surgery (36/50) there was no significant difference in hospital mortality (p 〉 0.05) and 5-year survival (p 〉 0.05) between those who had undergone coronary angiography (19/36; 52.8%) on the day of surgery with those who had not (17/36; 47.2%). Conclusions: Preservation or repair of the aortic valve can be recommended in the majority of patients with type A dissection. Distal extension of the resection does not increase surgical risk. Residual distal dissection does not decrease late survival. Preoperative coronary angiography may not affect survival in patients undergoing emergency surgery. (J Card Surg 2004;19:240-245)

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1111/j.0886-0440.2004.04062.x

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Digitale Medien

The Edwards MIRA™ Heart Valve Prosthesis: (2004)

Driever, Rudolf ; Fuchs, Stefan ; Meissner, Markus ; [weitere]

350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . : Blackwell Science Inc

Journal of cardiac surgery 19 (2004), S. 0

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ISSN: 1540-8191

Quelle: Blackwell Publishing Journal Backfiles 1879-2005

Thema: Medizin

Notizen: Abstract Background: The Edwards MIRA™ mechanical heart valve is designed to optimize hemodynamics, reduce thrombogenicity, and avoid mechanical failure with a special hinge mechanism. The purpose of the study was to investigate the clinical performance and postoperative hemodynamic results of the first European patients receiving Edwards MIRA™ mechanical heart valves. Methods: From March 1998 to March 1999 a total of 54 Edwards MIRA™ valves model numbers 3600 (aortic, n = 44) and 9600 (mitral, n = 10) were implanted in 52 (36 male, 16 female; mean age 61 ± 10.1 years) consecutive patients undergoing mechanical valve replacement in a prospective study. Follow-up of the patients including physical examination, ECG, blood tests, and Doppler were performed prior to discharge, at 6 months, at 1 year, and at least 2 years postoperatively. Results: Through October 2001 a total of 172 follow-up examinations were completed (51 patients at discharge, 46 patients at 6 months, 43 patients at 12 months, 32 patients at 2 years or beyond). All patients were in NYHA class I and II at the 6-month and 2+-year follow-up. All the patients stated an improved quality of life. Hospital mortality was 1.9%. There were no complications related to anticoagulation. Mean international normalized ratio at 6 months was 3.2 (range 1.9 to 4.3); lactate dehydrogenase was slightly increased with 264 ± 103 U/L on average (normal value 80 to 240 U/L). No signs of valvular dysfunction or paravalvular leakage were observed. Mean pressure gradients were related to valve diameter: after mitral valve replacement (size 27, 29, 31 mm: 4.8, 3.2, 2.1 mmHg); after aortic valve replacement (size 19, 21, 23, 25 mm: 12.1, 13.1, 9.3, 8.2 mmHg). Conclusions: These preliminary data suggest good hemodynamic function and a low rate of valve-related complications of the Edwards-MIRA™ mechanical prosthesis. (J Card Surg 2004;19:226-231)

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1111/j.0886-0440.2004.04060.x

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Digitale Medien

Pacemaker Therapy in Isolated Congenital Complete Atrioventricular Block (2002)

BREUR, JOHANNES M.P.J. ; UDINK Ten Cate, FLORIS E.A. ; KAPUSTA, LIVIA ; [weitere]

Oxford, UK : Blackwell Futura Publishing, Inc.

Pacing and clinical electrophysiology 25 (2002), S. 0

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ISSN: 1540-8159

Quelle: Blackwell Publishing Journal Backfiles 1879-2005

Thema: Medizin

Notizen: BREUR, J.M.P.J., et al.: Pacemaker Therapy in Isolated Congenital Complete Atrioventricular Block. The aim of this study was to evaluate the effect of pacemaker (PM) therapy in patients with isolated congenital complete atrioventricular block (CCAVB). Patients with CCAVB eventually qualify for PM implantation, however, timing remains controversial. Retrospective evaluation of left ventricular end-diastolic diameter (LVEDD), shortening fraction (SF), and cardiothoracic ratio (CTR) in 149 CCAVB patients, before, at, and after PM implantation was carried out. LVEDD shows an average increase of 0.48%/month in non-PM patients, and an average decrease of 0.88%/month in PM patients. SF shows an average increase of 0.10%/month in non-PM, and an average decrease of 0.32%/month in PM patients. CTR shows an average increase of 0.02%/month in non-PM, and an average decrease of 0.19%/month in PM patients. The difference between the non-PM and PM groups is significant (P = 0.05) for all variables. Symptomatic patients show no significant change in LVEDD after PM therapy (from 66.5% before to 68.5% after PM therapy). Asymptomatic patients do show a significant (P 〈 0.001) decrease in LVEDD after PM therapy (from 78.4% before to 73.3% after PM therapy). CTR does not differ significantly between symptomatic and asymptomatic patients before PM therapy (58% and 57%, respectively). CTR does differ significantly (P 〈 0.001) between symptomatic and asymptomatic patients after PM therapy (52% and 48%, respectively). Heart size and SF are increased in most patients with isolated CCAVB. PM implantation is associated with a decrease in heart size and normalization of SF in most patients. Indications for PM therapy in children may require reevaluation in asymptomatic patients with increased cardiac size and decreased cardiac function.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1046/j.1460-9592.2002.01685.x

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X-ray topographic dislocation contrast visible in reflections orthogonal to the Burgers vectors of axial screw dislocations in hexagonal silicon carbide (2001)

Vetter, W. M. ; Dudley, M.

Copenhagen : International Union of Crystallography (IUCr)

Applied crystallography online 34 (2001), S. 20-26

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ISSN: 1600-5767

Quelle: Crystallography Journals Online : IUCR Backfile Archive 1948-2001

Thema: Geologie und Paläontologie , Physik

Notizen: Contrast is associated with micropipes in X-ray topographs of SiC crystals obtained with prismatic reflections, representing an apparent violation of the g·b = 0 invisibility criterion. This is explained as a population of basal-plane dislocations with Burgers vectors of the set b = {\textstyle{1 \over 3}}〈11{\bar{2}}0〉 that occur in a high density within a few micrometers of the micropipes, below the resolution of X-ray topography. These basal-plane dislocations could be observed under an electron microscope. The presence of the surfaces of the micropipes influences the dislocation images in the topographs taken with prismatic reflections, often resulting in a band of light contrast along the axes of the micropipes.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1107/S0021889800017027

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