A continuous suture technique for aortic valve replacement was developed early in our experience. This technique has proved to be simple, quick, effective, and to have several advantages over alternative techniques.

Bioprosthesis↗

PubMedDate not supplied

Viability and histopathology of eleven fresh, antibiotic-treated allografts removed three weeks to three years after implantation.

Changes in metabolic activity of removed heart valve allografts have been measured. The fresh heart valves were sterilized and stored in antibiotic solution before implantation in patients. Viability was determined before insertion and after removal from patients by two methods: 1) tissue culture, and 2) autoradiography, using tritiated thymidine. The length of storage in the Hank's antibiotic or nutrient-antibiotic medium before insertion did not seem to influence the final metabolic activity nor the structural integrity of the allografts when they were removed. Results from the present study show that the most severe degenerative changes occur in valves stored in Hank's solution and then implanted in the mitral position. The viability percentage declined progressively during the time that a valve treated in this manner was functioning in a patient.

Adolescent↗

PubMedDate not supplied

Isolated aortic valve replacement. A six-year follow-up.

A selected group of 259 patients who underwent aortic valve replacement was analyzed retrospectively for early and late mortality and late valve failures up to six years following operation. In this group, 100 patients received aortic valve homografts, 100 pulmonary valve autografts and 59 Starr-Edwards prosthetic valves. The two tissue valve groups, composed of younger, healthier individuals, had a lower early mortality rate than did the group receiving prostheses; mortality decreased even further with additional surgical experience. The homograft group also showed a lower long-term mortality and complication rate. The incidence and significance of the appearance of a diastolic murmur in the tissue valve group were also studied and seemed to play a major prognostic role for these patients.

Adolescent↗

PubMedDate not supplied

Left ventricular fibroma: echocardiographic diagnosis and successful surgical excision in three cases.

The management of three patients with left ventricular fibromas is outlined. All were asymptomatic children. Routine chest radiography suggested cardiac masses. M-mode and two-dimensional echocardiography were valuable adjuncts to conventional angiography in assessing these children. Electrocardiographic changes, present in all cases, were shown to regress postoperatively. We stress the importance of these noninvasive aids in the initial investigation and outline our operative methods of reconstruction.

Child↗

PubMedDate not supplied

Double outlet left ventricle: how should we repair it?

Two patients with D.O.L.V., V.S.D. and P.S. have been successfully corrected surgically. They represent the seventh and the eighth successful repairs of D.O.L.V. reported so far in the literature. Surgical correction was accomplished by an "extraventricular" type of repair, closing the V.S.D., interrupting the connection between left ventricle and pulmonary artery and creating a conduit between right ventricle and pulmonary artery. The conduit used was a fresh aortic homograft. An "intraventricular" type of repair of this rare congenital malformation has been also reported, but the authors believe that it is not applicable to all cases of D.O.L.V. and it is possibly more likely to incur complications, while the "extraventricular" one doesn't seem to have any contraindication. Preoperative diagnosis can be only achieved with careful angiographic study, including left ventriculography.

Adult↗

PubMedDate not supplied

Homograft replacement of the aortic valve.

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Aortic Valve↗

PubMedDate not supplied

Successful surgical repair of solitus, dextrocardia, atrioventricular discordance, and double outlet right ventricle with l-malposition of the aorta.

The authors report a rare case of situs solitus of viscera and atria, dextrocardia, atrioventricular discordance, atrial and ventricular septal defects, origin of both great arteries from the morphologic right ventricle, pulmonary valvar and subvalvar stenosis and l-malposition of the aorta which has been correctly diagnosed and succesfully operated on. The repair was accomplished by closing the ventricular septal defect through a ventriculotomy in the systemic venous ventricle (morphologic left), and placing a conduit between this ventricle and the pulmonary artery which had been ligated proximally. The conduit was a fresh segment of homograft valved ascending aorta fixed on a Dacron woven tube. The authors discuss: firstly the reasons for performing this type of repair instead of the intraventricular one recommended by the Mayo Clinic group in the past and secondly the peculiar location of the conducting tissue and the method of avoiding it when approaching the ventricular septal defect.

Aorta↗