Mehmet C. Oz

A ten-year experience with bacterial aortitis***

Twenty-one patients with bacterial aortitis were treated in four institutions over a 10-year period. Clues to the diagnosis were a pulsatile mass; fever; positive blood culture; CT scan revealing aortic nodularity, an aneurysm of irregular configuration, or air in the aortic wall; and angiography revealing a lobulated aneurysm. The most commonly identified organisms were Salmonella and Staphylococcus. Excision with in situ repair was performed in nine patients; 11 patients underwent extraanatomic bypass grafting with aortic ligation. In situ graft repair was performed when the infected aorta could be removed entirely or when the thoracic or suprarenal aorta was involved. Axillofemoral bypass grafting was used when infection was extensive. There were eight disease-related deaths. No graft infections were encountered in patients who survived.

Economic Impact of Less Invasive Cardiac Operations

Cost-containment policies have required a fundamental reexamination of surgical practice. Increasingly government, third-party payers, and the public have expected that surgical treatment will be delivered on an ambulatory or short-term basis. This environment, coupled with the success of laparoscopic interventions in reducing postoperative trauma and shortening the length of stay (LOS) without increased morbidity or mortality, has recently extended to affect the practice of cardiac surgery.

Effects of additives on laser-assisted fibrinogen bonding

In order to produce a solder for Laser-Assisted Tissue Bonding (LATB) with better tactile characteristics and shelf life, plasma-derived fibrinogen concentrate has been augmented with various additives, including anionic polysaccharides, anti-fibrinolytic agents, and preservatives. For comparison of this new, compounded solder with the pure, plasma- derived fibrinogen concentrate an in vivo tissue weld assay was devised. While further analyses must be done to assess more critical healing time periods and characteristics, this study is an affirmation that the plasma-derived, protein concentrates, with or without certain additives, offer effective alternatives to suture repair.