No abstract

In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.

Esophageal mucosa! biopsies of I 'i pam:ncs with normal squamous epithelium, 11 with inflamed s4uamou~ epithelium and 23 with Barrete\ columnar !med esophagus were assayed for alkali ne phosphara~ and d1sao.:handase aLtivicy. Seven of the patients w1rh Barrett's esophagus had alkaline phosphacase activity greater : ,an three stanc.larJ deviations a hove the mean of the 15 patients with normal Syuamous epithelium. Five of these seven also had disaccharidase activity three standard deviations or greater above normal. One parienc with esophagitis, but without columnar epithelium, had a small increase in alkali ne phosphatase and Jisaccharidasc activity. The production of biochemical markers of small intestinal struuure may he another indicator of the plur iporential nature of Barrett's epithelium. Can J G a stroenterol 1988; 2(1): 15-17

No abstract