Our data demonstrate that a partial upper sternotomy is a safe and effective technique for AVR. Postoperative morbidity is not significantly reduced in patients undergoing AVR by this approach. Further studies in a larger patient population are necessary to assess whether postoperative morbidity is significantly reduced.

We showed that the increase of IL-6 after artery bypass grafting was similar between patients operated with CPB or without CPB. We conclude that the main inductor of IL-6 release is linked to surgical trauma rather than a reaction to CPB. Since it is known that gp130 inhibits IL-6-biological activities, we suggest that the decrease of sgp130 sera levels could further enhance the inflammatory effects of IL-6 in cardiac surgery.

No abstract

From January 1975 to September 1983, 615 patients underwent valve replacement using 698 bioprosthetic valves for selected indications. This group represents the third of all patients having valve replacement during the same period. Children younger than 15 years were excluded. The mean pre-operative functional class was 2.9. The early mortality rate was less than 5% and the follow-up range 3 months to 9 years (3.2 yrs). The symptomatic improvement was attested by a mean post-operative functional class of 1.4. In a linear study the following rates of valve related complications were noted: thromboembolism 4.6%, endocarditis 2.5%, primary tissue valve degeneration 1.1%, paraprosthetic leak 2.5%. In an actuarial study, at 8 years, 83% of patients were free from any valve failure. The probability rates of complications were the following: thromboembolic events 8%, endocarditis 5%, degeneration 3%, reoperation 7%. The probability of survival at 8 yrs was 69% and the probability rates of late mortality were noted as follow: cardiac related mortality 27%, valve-related mortality 4%. Despite an expected increasing rate of degeneration, the results warrant the use of bioprostheses in a selected group of patients.