Showing papers in "Seminars in Thoracic and Cardiovascular Surgery in 2000"

TL;DR: The Maze-III procedure remains the surgical procedure of choice for the treatment of medically refractory atrial fibrillation and has been used exclusively since April 16, 1992.

TL;DR: The Cox-Maze procedure effectively addressed the major complications of atrial fibrillation and was associated with low perioperative and late morbidity rates.

TL;DR: The experience indicates that ventricular dysfunction is not a contraindication for operation and that restoration of sinus rhythm after the Cox-Maze procedure improves left ventricular ejection fraction in most patients.

TL;DR: Cardiac tumors produce a large variety of symptoms through any of 4 mechanisms, and the most useful diagnostic tool is the echocardiogram, which in almost all cases precisely locates the tumor and defines its extent.

TL;DR: The Maze procedure was developed for the treatment of atrial fibrillation over a period of several years, with the eventual Maze-III procedure that is now in clinical use.

TL;DR: The results of a questionnaire survey show that surgical treatment for atrial fibrillation (AF) has been performed in more than 2,500 patients in Japan and any type of Maze procedure can be used to cure atrial arrhythmia that is caused by macro-reentries alone.

TL;DR: It is clear that only a miniscule percentage of the patients with atrial fibrillation will ever become candidates for the open-heart Maze procedure as it is now performed, so the continuing struggle to relieve the invasive downside of the Maze procedure is warranted.

TL;DR: Experimental and clinical experiences with the Maze procedure indicate that 1 of the most important principles is to interrupt conduction across the posterior-inferior portion of the left atrium.

TL;DR: The results favor broader use of the Maze procedure for symptomatic atrial fibrillation and supportUse of the original Maze-III technique as the procedure of choice.

TL;DR: The creation of postcardiotomy referral centers that offer long-term support or heart transplantation would conserve scarce donor organs, maximize the chance of myocardial recovery, and yield expertise applicable not only to device recipients but also to critically ill heart-failure patients who do not need an implantable pump.

TL;DR: Treatment options vary depending on the presentation, but most often surgical resection is recommended, and patients with malignant neurogenic tumors still have poor long-term survival prospects.

TL;DR: The Thoratec VAD is suitable for a wide range of applications, and efforts are underway to facilitate patient mobility and allow hospital discharge, and an intracorporeal version of the VAD, which is currently under development, will help achieve these goals.

TL;DR: The Maze procedure has proven to be extremely effective in curing medically refractory atrial fibrillation and has the lowest perioperative stroke rate of any major cardiac surgical procedure.

TL;DR: Open Collis gastroplasty is an effective way to manage acquired shortening of the esophagus, and it creates a tension-free intra-abdominal segment of neoesophagus for fundoplication.

TL;DR: Clinical experience with 205 implantable left ventricular assist devices at the Cleveland Clinic between December 1991 and January 2000 is described, along with manufacturers' data submitted to the Food and Drug Administration.

TL;DR: The results of this study indicate that the Maze-III procedure is just as safe and effective in controlling atrial fibrillation associated with valvular heart disease as it is in control of atrialfibrillation not associated withValvularHeart disease.

TL;DR: Recently, short-term outcome studies have reported that minimally invasive approaches to PEH may be associated with less morbidity, shorter hospital stay, faster recovery, and excellent clinical results.

TL;DR: Recognition of familial and syndrome myxomas (eg, Carney's complex) is important in guiding surgical approach, planning follow-up, and predicting recurrence of these unusual neoplasms.

TL;DR: The technique for esophagectomy has evolved from a laparoscopic transhiatal approach to a combined laparoscopy and thoracoscopic approach, and now this approach is offered to the majority of patients with resectable cancers.

TL;DR: Aggressive therapy of late recurrence, including resection of new tumor masses and pleural metastases, has yielded successive disease-free intervals that validate persistent treatment.

TL;DR: Mechanisms of bleeding common to virtually all patients after heart surgery are platelet dysfunction, enhanced fibrinolysis, dilution of all components of the coagulation system, and the presence of heparin and protamine.

TL;DR: Subxiphoid pericardiostomy and drainage is a safe procedure that provides effective and durable symptomatic relief in these terminally ill patients.

TL;DR: A wide array of devices is available to provide increasing levels of circulatory support, and the fact that myocardial function can improve enough with chronic ventricular unloading to allow removal of the device may further broaden the use of this technology.

TL;DR: The CardioWest total artificial heart (TAH), formerly known as the Jarvik-7 and then the Symbion heart, is the only TAH in current clinical use and has proved safe and effective, allowing a 72% survival rate for an average of 24 months.

TL;DR: Conversion from a minimal-access approach to a more traditional incision should be an anticipated possibility that is often undertaken as the next logical step rather than an expression of exasperation.

TL;DR: Staging can be performed with routine imaging studies, surgical intervention is often required to ensure accurate histologic diagnosis of these lymphomas, and therapeutic modalities usually include chemotherapy and/or radiotherapy.

TL;DR: Intracardiac extension of infradiaphragmatic tumors is an uncommon but significant surgical challenge for the treating surgeon, and cardiopulmonary bypass and deep hypothermic circulatory arrest provide the safest and most effective technique for removing these tumors.

TL;DR: Prophylaxis with antiarrhythmic agents such as amiodarone and sotalol and recently with atrial pacing have shown promise in recent randomized trials and Beta blockers are effective agents that keep patients from developing postoperative atrial fibrillation and help maintain ventricular rate control.

TL;DR: Since the first deliberate open heart operation was performed on a patient known to be carrying HIV, much has been learned and the concern that the operators would be exposed to significant risk of acquiring the infection during surgery has proved to be unfounded.