1,720,973 research outputs found
Mitral valve repair versus replacement in the elderly and frail patients aver 75 year or older: Stilo an unsoolved issue.
No full text"Edge-to-edge" repair for anterior mitral leaflet prolapse
No full textThe aim of this study is to report our results in a series of 150 consecutive patients (mean age 53 +/- 15.4 years) in whom mitral regurgitation (MR) due to isolated anterior mitral leaflet (AML) prolapse was corrected using the edge-to-edge (E to E) technique over a period of more than 10 years. At admission, 49 (32.6%) patients were in NYHA class I, 46 (30.6%) in II, 51 (34%) in III and 4 (2.6%) in IV. In the great majority of the cases (111 patients, 74%), degenerative disease was the cause of MR. Hospital mortality was 0.6% (1/150). There were 7 late deaths. The actuarial overall survival and freedom from reoperation at 9 years were 91.6% +/- 3.16% and 96.6% +/- 1.74%, respectively. At follow-up (4.5 +/- 3.21 years, range 2 months-12 years), the mean mitral valve area was 2.7 +/- 0.5 cm(2) and mitral regurgitation was absent or mild in 132 patients (88%). The results of this study demonstrate the effectiveness and durability of the E to E repair in the setting of AML prolapse. In our institution, this technique, in conjunction with annuloplasty, remains the method of choice to correct segmental prolapse of the AML
Surgical treatment of paravalvular abscess: long-term results
No full textObjective: To examine the outcomes of surgery for active infective endocarditis with paravalvular abscess. Methods: Paravalvular abscess was defined as infective necrosis of the valve annulus that required patch reconstruction before implanting a new valve. Of 383 patients with active infective endocarditis who underwent surgical treatment, 135 (35%) had paravalvular abscess. Patients' mean age was 51 ± 16 years and 68% were men. The infected valve was native in 69 patients and prosthetic in 66. The abscess involved the aortic annulus in 73 patients, the mitral annulus in 27, the aortic and mitral annuluses in 33, and the aortic and tricuspid and/or pulmonary annuluses in 2. Surgery consisted of radical resection of the abscess, reconstruction of the annulus with patches and valve replacement. Mean follow-up was 6.2 ± 5.2 years and complete. Results: There were 21 (15.5%) operative deaths. Preoperative shock and abscess in the aortic and mitral annuluses were independent predictors of operative death. There were 34 (25%) late deaths. Survival at 15 years was 43 ± 6% for all patients, 50 ± 8% for native valve endocarditis and 35 ± 9% for prosthetic (p = 0.41). Age by increments of 5 years and recurrent endocarditis were independent predictors of late death. There were 16 episodes of recurrent endocarditis in 15 patients, and the freedom from recurrent endocarditis was 82 ± 4% at 15 years. Fifteen reoperations were performed in 14 patients. Freedom from reoperation was 72 ± 9% at 15 years. Conclusions: Surgery for active endocarditis with paravalvular abscess was associated with high operative mortality, particularly in patients in shock and abscess of both mitral and aortic annuluses. Long-term survival was adversely affected by age and recurrent bouts of endocarditis. © 2007 European Association for Cardio-Thoracic Surgery
Outcomes after surgery for acute type A aortic dissection in “non-Marfan syndrome” patients with long life expectancy: A 24-year follow-up
No full textBackground Long-term survival and risk of reoperation in “non-Marfan syndrome” patients with a long life expectancy who undergo emergency surgery for acute type A aortic dissection (aTAAD) are not well known. Aim To analyse survival, risk of reoperation and quality of life in this population. Methods From 1990 to 2010, all patients aged ≤ 50 years and not affected by Marfan syndrome, who underwent emergency surgery for aTAAD at two institutions, were included in this analysis. Patients were categorized into four groups according to the extension of the aortic replacement: SUPRACORONARY, ROOT, ARCH and EXTENSIVE. Results Sixty-six patients (mean age 45 ± 4 years; range 34–50 years) were considered eligible for this analysis. Overall in-hospital mortality was 24% (16/66 patients); and 25%, 23%, 20.5% and 43% in the SUPRACORONARY, ROOT, ARCH and EXTENSIVE groups, respectively. Mean follow-up among survivors was 10.5 ± 7.2 years (range: 0.1–24.7 years). Overall 10-year survival was 55 ± 6%; and 75 ± 12%, 69 ± 13%, 47 ± 8% and 28 ± 17% in the SUPRACORONARY, ROOT, ARCH and EXTENSIVE groups, respectively. Overall freedom from reoperation on the aorta was 73 ± 7.5%; and 40 ± 20%, 75 ± 21%, 78 ± 8% and 100% in the SUPRACORONARY, ROOT, ARCH and EXTENSIVE groups, respectively. Conclusions In our experience, patients who underwent isolated supracoronary ascending aorta or root replacement showed the most satisfactory late survival. However, because the risk of reoperation is low when the replacement is extended to the root, our data suggest that root replacement could represent a good compromise between operative mortality and long-term survival
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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