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A number of patients who require an operation for complications of annuloaortic ectasia, such as aortic incompetence or aneurysm of the aortic root (or both), have normal aortic valve leaflets. We have treated these patients by excising the aneurysmal portion of the ascending aorta and sinuses of Valsalva but by leaving the aortic valve leaflets and some(More)
You are contacted by a concerned 34-year-old airline pilot with a leaky bicuspid aortic valve recently diagnosed by an echocardiogram that had been requested by his new employer as part of a routine medical assessment. He claims that he is perfectly healthy but is at risk of losing his job over his condition. He is concerned that his disease is hereditary(More)
OBJECTIVE The optimal diameter at which replacement of the ascending aorta should be performed in patients with bicuspid aortic valve disease is not known. METHODS We reviewed all patients with bicuspid aortic valves undergoing aortic valve replacement at our institution from 1979 through 1993 (n = 201). Patients undergoing concomitant replacement of the(More)
BACKGROUND Deep sternal wound infection (DSWI) is a serious complication of cardiac operations performed by median sternotomy. We attempted to define the predictors of DSWI and to describe the outcomes of two treatment strategies used at our institution. METHODS Retrospective review was performed using prospectively gathered data on 12,267 consecutive(More)
Expanded polytetrafluoroethylene sutures have been used for replacement of diseased chordae tendineae during reconstructive procedures on the mitral valve in 43 patients. There were 28 men and 15 women whose mean age was 55 years, range 21 to 76. Three fourths of the patients were in New York Heart Association class III or IV. Replacement of primary chordae(More)
OBJECTIVE We sought to identify suitable patients for the Ross operation. METHODS A cohort of 212 patients (mean age, 34 + or - 9 years; 66% men; 82% with congenital aortic valve disease) underwent the Ross operation and was prospectively followed with clinical evaluations and echocardiographic analysis for 3.1 to 18 years (mean, 10.1 + or - 4.2 years).(More)
BACKGROUND Surgeons traditionally avoid the use of "small" aortic prostheses because of the potential for residual left ventricular outflow tract obstruction and persistent transvalvular gradients. This study examines the ratio between prosthetic valve size and the body surface area (BSA) of patients undergoing aortic valve replacement (AVR). We sought to(More)
A novel operative technique for postinfarction ventricular septal defect has been used in 44 consecutive patients. The operation consists of excluding rather than excising the infarcted septum and ventricular walls. This is accomplished by performance of a left ventriculotomy through the infarcted muscle and securing a glutaraldehyde-fixed bovine(More)
OBJECTIVE Dilation of pulmonary autograft after the Ross procedure is being recognized with increasing frequency. This study was undertaken to examine the extent of this problem and factors that may be associated with it. METHODS The clinical, operative, and echocardiographic data of 118 patients who underwent the Ross procedure were reviewed. The mean(More)
a S ince the initial publication of ''Guidelines for Reporting Morbidity and Mortality After Cardiac Valvular Operations'' in 1988, 1 followed by a revised version in 1996, 2 valvular heart surgery has evolved to include an enhanced understanding of patient-and disease-related factors affecting outcomes, increased numbers of valve repairs, more operations(More)