Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We performed cardiac valve replacement using the Wada-Cutter valve in 124 patients during the 9 years between 1966 and 1974: aortic valve replacement in 48, mitral valve replacement in 56, tricuspid valve replacement in 9, and multiple valve replacement in 11. Sixteen patients died within 30 days after operation, and 34 died in the late postoperative period, with a cumulative mortality rate of 40.3%. Postoperative complications included valve thrombosis in 9 patients, thromboembolism in 4, and mechanical valve failure in 5. The Wada-Cutter valve, first described at the Annual Meeting of The Society of Thoracic Surgeons on January 27, 1967, in a discussion on the paper by Cooley and colleagues on mitral valve replacement with a discoid valve, attracted attention for its unique design. Four of the Wada-Cutter valves were incorporated in Liotia's total artificial heart, which was implanted clinically for the first time in Cooley's second-stage heart transplantation. It may not only claim to be the origin of today's most popular tilting-disc heart valves but also has some original concepts with regard to bileaflet and tricuspid tilting-disc heart valves. However, at that time, cardiac valve replacement with this prosthesis resulted in a high incidence of thrombosis without systemic anticoagulation and in mechanical valve failure due to hinge wear of the Teflon occluder. For these reasons, its clinical use was discontinued in 1974. If Pyrolite carbon had been adopted in construction of the valve when it first became available, the valve design could have been useful even today.
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PMID:Wada-Cutter heart valve: overall experience at the Sapporo Medical College. 277 48

As recently as the 1992 Report of the American Thoracic Society Workshop on Lung Transplantation, no QOL facts were given and no knowledge gaps related to QOL outcomes were cited. Even at the present time, the information in that area is based on a relatively small set of preliminary reports. Current information indicates that successful lung transplantation largely reverses the energy and physical mobility deficits reported by transplant candidates and that those improvements are sustained for at least several years after transplant. Recipients report improved health perceptions, fewer problems, and greater life satisfaction than candidates. The type and amount of QOL benefit appear to differ by underlying lung disorder, and recipients who develop obliterative bronchiolitis syndrome experience declines in QOL. Lung transplantation surgery is an expensive procedure initially, and costs remain high during follow-up. Little information is available on long-term QOL outcomes or cost-effectiveness. There is a compelling rationale for QOL research in lung transplantation. At the present time, some of the most challenging problems in transplantation, such as the selection of optimal timing for transplant and choice of immunosuppression medications, do not appear to have clear-cut survival or clinical benefits. Determination of the best approach to such problems is likely to hinge on patients' perceptions of the risk-to-benefit ratio, measured by their perceived QOL. Findings from QOL research need to be developed into interventions to enhance patient outcomes. As noted by Whitehead, QOL and potentially lethal noncompliance may be linked. Can we develop immune suppressive protocols that maintain clinical benefits while minimizing QOL burdens? Pilot studies suggest that QOL can be enhanced prior to transplant, and that health-related QOL prior to transplant may predict survival and clinical outcomes. As noted by Ramsey et al, multicenter studies are needed to achieve sufficient numbers for multivariate and subset analyses and to address issues such as the impact of diagnosis (indication for transplant) on QOL outcomes and cost-effectiveness. QOL and cost measures must be incorporated into large, longitudinal, multicenter clinical trials and observational studies to address those issues.
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PMID:The cost of lung transplantation and the quality of life post-transplant. 918 30