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Article ; Online: Comparison of the internal thoracic artery flow dissected by video endoscopy or conventional technique.

Gib, Marcelo Curcio / Zanirati, Thamyres / Simas, Pauline / Wender, Orlando Carlos Belmonte / Cavazzola, Leandro Totti

2021 Volume 36, Issue 8, Page(s) e360803

Abstract: Purpose: To compare the blood flow in the internal thoracic artery when dissected endoscopically in a conventional manner, in addition to develop a reliable experimental training model for the surgical team.: Methods: Paired experimental study. Ten ... ...

Abstract	Purpose: To compare the blood flow in the internal thoracic artery when dissected endoscopically in a conventional manner, in addition to develop a reliable experimental training model for the surgical team. Methods: Paired experimental study. Ten pigs were operated and had both internal thoracic arteries dissected, the right with a conventional technique and the left by video endoscopy. The main outcomes to be studied were flow, length, and time of dissection of each vessel. Results: Blood flow measurements were performed with mean heart rate of 100 ± 16 bpm and mean arterial pressure of 89.7 ± 13 mm Hg. The mean blood flow of endoscopic dissection of the internal thoracic artery was 170.2 ± 66.3 mL/min and by direct view was 180.8 ± 70.5 (p = 0.26). Thus, there was no statistically significant difference between the flows, showing no inferiority between the methods. Conclusions: The minimally invasive dissection of the internal thoracic artery was shown to be not inferior to the dissection by open technique in relation to the blood flow in the present experimental model. In addition, the model that we replicated was shown to be adequate for the development of the learning curve and improvement of the endoscopic abilities.
MeSH term(s)	Animals ; Dissection ; Endoscopy ; Hemodynamics ; Mammary Arteries/surgery ; Swine
Language	English
Publishing date	2021-10-08
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2012156-8
ISSN	1678-2674 ; 1678-2674
ISSN (online)	1678-2674
ISSN	1678-2674
DOI	10.1590/ACB360803
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Article ; Online: Infective endocarditis profile, prognostic factors and in-hospital mortality: 6-year trends from a tertiary university center in South America.

Tagliari, Ana Paula / Steckert, Gabriela Vieira / da Silveira, Lucas Molinari Veloso / Kochi, Adriano Nunes / Wender, Orlando Carlos Belmonte

Journal of cardiac surgery

2020 Volume 35, Issue 8, Page(s) 1905–1911

Abstract: Background: Infective endocarditis (IE) remains an expressive health problem with high morbimortality rates. Despite its importance, epidemiological and microbiological data remain scarce, especially in developing countries.: Aim: This study aims to ... ...

Abstract	Background: Infective endocarditis (IE) remains an expressive health problem with high morbimortality rates. Despite its importance, epidemiological and microbiological data remain scarce, especially in developing countries. Aim: This study aims to describe IE epidemiological, clinical, and microbiological profile in a tertiary university center in South America, and to identify in-hospital mortality rate and predictors. Methods: An observational, retrospective study of 167 patients, who fulfilled modified Duke's criteria during a six-year enrollment period, from January 2010 to December 2015. The primary outcome was defined as in-hospital mortality analyzed according to treatment received (clinical vs surgical). Multivariate analysis identified mortality predictors. Results: The median age was 60 years (Q Conclusion: This study presents IE profile and all-cause mortality in a large patient's cohort, comprising a 6-years' time window, a rare initiative in developing countries. Elderly and male patients predominated, while S. aureus was the main microbiological agent. Patients conservatively treated presented higher mortality than surgically managed ones. Epidemiological studies from developing countries are essential to increase IE understanding.
MeSH term(s)	Cohort Studies ; Endocarditis/epidemiology ; Endocarditis/microbiology ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; South America/epidemiology ; Time Factors
Language	English
Publishing date	2020-06-29
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.14787
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Article: Mediastinitis: mortality rate comparing single-stage surgical approach and preconditioning of wound.

Gib, Marcelo Curcio / Alvarez, Juglans Souto / Wender, Orlando Carlos Belmonte

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular

2013 Volume 28, Issue 2, Page(s) 200–207

Abstract: Objective: This study aims to compare hospital mortality rate of surgical debridement followed by primary wound closure versus surgical debridement with closure after preconditioning of the wound.: Methods: A historical cohort of 43 patients with ... ...

Abstract	Objective: This study aims to compare hospital mortality rate of surgical debridement followed by primary wound closure versus surgical debridement with closure after preconditioning of the wound. Methods: A historical cohort of 43 patients with postoperative mediastinitis type III and IV between 2000 and 2008. The diagnosis of mediastinitis was based on physical examination and laboratory tests. Patients were divided into two groups: patients who received the protocol of preconditioning of the wound (Group 2) and those who did not (Group 1). Results: Of the 43 patients, 15 received the protocol and were assigned to Group 2, and 28 patients to Group 1. Myocardial revascularisation was the surgical intervention most affected by infection, accounting for 69.8% of patients in Group 1 and 64.3% in Group 2.Staphylococcus aureus was the predominant pathogen, accounting for 58.1% of all cases, 50% in Group 1 and 73.3% in Group 2. Hospital mortality rate was 42.9% in Group 1 and 20% in Group 2 (P=1.86), with relative risk of 2.14 and CI [0.714-6.043]. Among the 28 (65.1%) patients who underwent single-stage surgical approach, 12 (27.9%) underwent primary wound closure with irrigation, seven (16.3%) only primary closure, six (14%) omental flap, and three (7%) pectoralis muscle flap. Conclusion: Due to the lack of established guidelines, the choice of the surgical approach is based largely on low-level evidence references. Preconditioning of the wound appears to lead to a reduction in mortality in these patients, being a good surgical option.
MeSH term(s)	Aged ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/mortality ; Debridement/methods ; Female ; Hospital Mortality ; Humans ; Male ; Mediastinitis/etiology ; Mediastinitis/mortality ; Middle Aged ; Postoperative Complications/mortality ; Reproducibility of Results ; Risk Factors ; Surgical Wound Infection/mortality ; Time Factors ; Treatment Outcome ; Wound Closure Techniques/mortality
Language	English
Publishing date	2013-06
Publishing country	Brazil
Document type	Comparative Study ; Journal Article
DOI	10.5935/1678-9741.20130029
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Article ; Online: Spontaneous Left Anterior Descending Coronary Artery Dissection Requiring Coronary Artery Bypass Surgery.

Tagliari, Ana Paula / Kochi, Adriano Nunes / Rohde, Luis Eduardo Paim / Wender, Orlando Carlos Belmonte

Brazilian journal of cardiovascular surgery

2017 Volume 32, Issue 6, Page(s) 536–538

Abstract: Introduction: Spontaneous coronary artery dissection is a sudden separation between the layers of a coronary artery wall, non-iatrogenic or trauma related, that has been recognized as an important cause of myocardial infarction.: Objective: To report ...

Abstract	Introduction: Spontaneous coronary artery dissection is a sudden separation between the layers of a coronary artery wall, non-iatrogenic or trauma related, that has been recognized as an important cause of myocardial infarction. Objective: To report an emblematic case, in terms of angiographic images, clinical presentation and predisposing factors, whose clinical management failure led to surgical intervention. Methods: A previously healthy 48-year-old male farmer was admitted to the emergency room complaining of anterior chest pain described as "tearing", which started after physical exertion. Anterior wall ST-segment depression was observed in the electrocardiogram and troponin levels were increased. The patient then underwent coronary catheterization. Angiography showed a tortuous left anterior descending coronary artery with a dissection line involving proximal and middle segments, resulting in mild to moderate luminal stenosis. At first, a conservative approach was chosen. Control cardiac catheterization, 3 months later, showed dissection progression to the distal segment. Results: The patient was referred to surgical treatment. Internal thoracic artery and a great saphenous vein graft were used to revascularize the target vessels. He had an uneventful postoperative course. Conclusion: In this report, we describe a typical clinical manifestation of an uncommon cause of acute myocardial infarction. The dissection was started by an extreme physical effort, which is a known triggering factor. Management of these cases is always challenging because there are no evidence-based therapies or guideline-based recomendations.
MeSH term(s)	Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessel Anomalies/diagnostic imaging ; Coronary Vessel Anomalies/etiology ; Coronary Vessel Anomalies/surgery ; Humans ; Male ; Middle Aged ; Physical Exertion ; Vascular Diseases/congenital ; Vascular Diseases/diagnostic imaging ; Vascular Diseases/etiology ; Vascular Diseases/surgery
Language	English
Publishing date	2017-12-21
Publishing country	Brazil
Document type	Case Reports ; Journal Article
ZDB-ID	2031026-2
ISSN	1678-9741 ; 0102-7638
ISSN (online)	1678-9741
ISSN	0102-7638
DOI	10.21470/1678-9741-2017-0140
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Article: Performance evaluation of phase angle and handgrip strength in patients undergoing cardiac surgery: Prospective cohort study.

da Silva, Taís Kereski / Perry, Ingrid Dalira Schweigert / Brauner, Janete Salles / Wender, Orlando Carlos Belmonte / Souza, Gabriela Corrêa / Vieira, Sílvia Regina Rios

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

2017 Volume 31, Issue 5, Page(s) 284–290

Abstract: Background and aims: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical ... ...

Abstract	Background and aims: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity. This study aimed to evaluate the behaviour of PA and HGS in patients undergoing cardiac surgery and associate these factors with clinical outcomes and prognosis. Methods: This was a prospective cohort study of 50 consecutively recruited patients (aged ≥18 years) undergoing cardiac surgery. Measures PA and HGS were at three set points: preoperative, at hospital discharge and three months postoperative. The following data were collected: time of cardiopulmonary bypass (CPB), ischemia, mechanical ventilation (MV), Intensive Care Unit (ICU) length of stay (LOS) and hospital LOS after surgery; the EuroSCORE was also calculated. Results: A decrease in PA was observed between the preoperative and the two postoperative stages (p<0.001). There was a reduction in HGS between the preoperative and hospital discharge assessments (p<0.001) and a recovery three months postoperative (p<0.001). The MV and EuroSCORE were inversely associated with PA and HGS in all three assessments. The PA was correlated with EuroSCORE in the first assessment (p=0.007) and in the second and third assessments (p<0.001), as well as with MV in all three assessments (p<0.001). The HGS was correlated with EuroSCORE and MV in the first and second assessments (p<0.001) and in the third assessment (p=0.010 and p=0.018, respectively). Conclusion: PA and HGS appear to be related to MV time, ICU LOS and hospital LOS after surgery in patients undergoing cardiac surgery.
MeSH term(s)	Cardiac Surgical Procedures ; Electric Impedance ; Female ; Hand Strength ; Humans ; Intensive Care Units ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Prognosis ; Prospective Studies
Language	English
Publishing date	2017-11-16
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1159493-7
ISSN	1878-1721 ; 1036-7314
ISSN (online)	1878-1721
ISSN	1036-7314
DOI	10.1016/j.aucc.2017.09.002
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Article ; Online: Design and implementation of a fully electronic surgery database based on Google tools: an initial experience in cardiovascular surgery.

Tagliari, Ana Paula / da-Silveira, Lucas Molinari Veloso / de-Souza, Anderson Castro / Gib, Marcelo Curcio / de-Freitas, Tanara Martins / Martins, Cristiano Blaya / Wender, Orlando Carlos Belmonte / Cavazzola, Leandro Totti

Revista do Colegio Brasileiro de Cirurgioes

2019 Volume 46, Issue 2, Page(s) e2123

Abstract: Objective: to describe, in a practical and step-by-step manner, the construction of a fully electronic platform for data collection, storage, and analysis, initially proposed for cardiovascular surgery, with interfaces that are reproducible and ... ...

Title translation	Criação e implementação de um banco de dados cirúrgico totalmente informatizado baseado nas ferramentas Google: experiência inicial em cirurgia cardiovascular.
Abstract	Objective: to describe, in a practical and step-by-step manner, the construction of a fully electronic platform for data collection, storage, and analysis, initially proposed for cardiovascular surgery, with interfaces that are reproducible and applicable to other surgical specialties, as well as to present the initial work experience with this instrument in cardiac surgery and the preliminary results obtained after its implementation in a Brazilian tertiary university hospital. Methods: the platform was developed based on Google tools, which are free, easy to use, and widely accessible. From the beginning of this initiative, in May 2015, to the preliminary analysis, in February 2017, data from 271 consecutive patients submitted to cardiovascular surgery were prospectively recorded and preliminarily analyzed. Results: the initiative was implemented with full success, with 100% of patients included and without loss of any variable, in a database composed of more than 500 variables. The most frequent immediate postoperative complications were: atrial fibrillation (22.5%), bronchopneumonia (10.7%), delirium (10.3%), acute renal failure (10%), stroke (5%), and death (7%). Comparing mortality rates in the first and second years of the initiative, a reduction from 10.8% to 4% (p=0.042), respectively, was evidenced. Conclusion: the new proposal of data collection and storage presented in this work was fully feasible and effective. It may be useful to other surgical specialties that wish to develop methods to evaluate success and postoperative complication rates, as well as quality improvement programs.
MeSH term(s)	Aged ; Brazil ; Cardiovascular Surgical Procedures ; Databases, Factual/standards ; Female ; Forms as Topic ; Hospitals, University ; Humans ; Internet ; Male ; Middle Aged ; Outcome and Process Assessment, Health Care ; Quality Improvement ; Reproducibility of Results ; Software/standards
Language	English
Publishing date	2019-05-27
Publishing country	Brazil
Document type	Evaluation Study ; Journal Article
ZDB-ID	2223714-8
ISSN	1809-4546 ; 1809-4546
ISSN (online)	1809-4546
ISSN	1809-4546
DOI	10.1590/0100-6991e-20192123
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Article: Outcomes of patients subjected to aortic valve replacement surgery using mechanical or biological prostheses.

Almeida, Adriana Silveira de / Picon, Paulo Dornelles / Wender, Orlando Carlos Belmonte

Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular

2011 Volume 26, Issue 3, Page(s) 326–337

Abstract: Objective: This paper evaluates outcomes in patients subjected to surgery for replacement of the aortic valve using biological or mechanical substitutes, where selection of the type of prosthesis is relevant.: Methods: Three hundred and one patients, ...

Abstract	Objective: This paper evaluates outcomes in patients subjected to surgery for replacement of the aortic valve using biological or mechanical substitutes, where selection of the type of prosthesis is relevant. Methods: Three hundred and one patients, randomly selected, who had been subjected to aortic valve replacement surgery between 1990 and 2005, with a maximum follow-up period of 20 years. Results: Survival at 5, 10 and 15 years after surgery using mechanical substitute was 83.9%, 75.4% and 60.2% and, for biological substitute, was 89.3%, 70.4% and 58.4%, respectively (P = 0.939). Factors associated with death were: age, obesity, pulmonary disease, arrhythmia, bleeding and aortic valve failure. Probability free of reoperation for these patients at 5, 10 and 15 years after surgery using mechanical substitute was 97.9%, 95.8% and 95.8% and, for those using bioprostheses, was 94.6%, 91.0% and 83.3%, respectively (P = 0.057). Factors associated with reoperation were: renal failure, prosthesis endocarditis and age. Probability free of bleeding events at 5, 10 and 15 years after surgery using mechanical substitute was 94.5%, 91.7% and 91.7% and, for bioprostheses, was 98.6%, 97.8% and 97.8%, respectively (P = 0.047). Factors associated with bleeding events were: renal failure and mechanical prostheses. Conclusions: The authors have concluded that: 1) mortality was statistically similar in the groups; 2) patient characteristics at baseline were a major determinant of late mortality after surgery; 3) there was a tendency toward reoperation in the bioprostheses group; 4) patients using mechanical prosthesis had more bleeding events as time passed; 5) data presented in this paper is in accordance with current literature.
MeSH term(s)	Aged ; Aortic Valve/surgery ; Bioprosthesis/adverse effects ; Bioprosthesis/statistics & numerical data ; Brazil/epidemiology ; Cause of Death ; Epidemiologic Methods ; Heart Valve Prosthesis/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Heart Valve Prosthesis Implantation/mortality ; Humans ; Middle Aged ; Postoperative Hemorrhage/epidemiology ; Reoperation/statistics & numerical data ; Treatment Outcome
Language	Portuguese
Publishing date	2011-11-12
Publishing country	Brazil
Document type	Journal Article ; Research Support, Non-U.S. Gov't
DOI	10.5935/1678-9741.20110006
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Article: Experimental model for the study of chronic renal ischemia in rats: morphologic, histological and ultra-structural analysis.

Konopka, Clóvis Luís / Jurach, Alexandre / Wender, Orlando Carlos Belmonte

Acta cirurgica brasileira

2006 Volume 22, Issue 1, Page(s) 12–21

Abstract: Purpose: To evaluate a model of chronic renal ischemia in rats and to characterize the effects on renal tissue.: Methods: 168 Wistar rats were divided into two equal groups, control (GC) and ischemia (GI). The animals of the GI (n=84) were submitted ... ...

Abstract	Purpose: To evaluate a model of chronic renal ischemia in rats and to characterize the effects on renal tissue. Methods: 168 Wistar rats were divided into two equal groups, control (GC) and ischemia (GI). The animals of the GI (n=84) were submitted to partial ligation of the left renal artery, and the animals of GC (n=84) stayed with the renal artery intact. In seven successive and identical periods of time, in weekly intervals, 12 animals of each group were submitted to nephrectomy, with morphometric determinations and histological and ultra-structural analysis. Results: The GI presented progressive reduction in renal weight, volume and cortical thickness observed from the 7th day of the experiment, reaching maximum degree in the 49th day (p < 0.05). The proximal tubular atrophy in the GI was observed in 75/84 analysis (89,2%), with highly significant difference among the groups starting from the 7th day (p=0 .0009) and in the other periods of the experiment (p=0 .00001). The most prevalent interstitial alteration was the infiltrate, present in 98,8% of the GI, with highly significant difference among the groups in the whole experiment (p=0 .00001). Ultra-structural analysis didn't demonstrate glomerular lesions, evidencing that the glomerule preserves its intact architecture during chronic ischemia. Conclusion: The model showed that chronic renal ischemia in rats provokes progressive renal atrophy, with preservation of glomerular structure.
MeSH term(s)	Analysis of Variance ; Animals ; Atrophy/pathology ; Chronic Disease ; Disease Models, Animal ; Female ; Hypertension, Renal/pathology ; Ischemia/etiology ; Ischemia/pathology ; Kidney/blood supply ; Kidney/surgery ; Kidney Glomerulus/pathology ; Kidney Tubules, Proximal/pathology ; Ligation ; Microscopy, Electron ; Nephrectomy ; Nephritis, Interstitial/etiology ; Nephritis, Interstitial/pathology ; Rats ; Rats, Wistar ; Renal Artery Obstruction/complications ; Renal Artery Obstruction/pathology ; Statistics, Nonparametric
Language	English
Publishing date	2006-11-15
Publishing country	Brazil
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2012156-8
ISSN	1678-2674 ; 0102-8650
ISSN (online)	1678-2674
ISSN	0102-8650
DOI	10.1590/s0102-86502007000100003
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Article ; Online: Extracorporeal membrane oxygenation for postpneumonectomy ARDS.

Saueressig, Maurício Guidi / Schwarz, Patrícia / Schlatter, Rosane / Moreschi, Alexandre Heitor / Wender, Orlando Carlos Belmonte / Macedo-Neto, Amarilio Vieira de

Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

2014 Volume 40, Issue 2, Page(s) 203–206

MeSH term(s)	Adult ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Hypertension, Pulmonary/diagnostic imaging ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/therapy ; Pneumonectomy/adverse effects ; Postoperative Complications/therapy ; Radiography
Language	Portuguese
Publishing date	2014-05-15
Publishing country	Brazil
Document type	Case Reports ; Letter
ZDB-ID	2223157-2
ISSN	1806-3756 ; 1806-3713
ISSN (online)	1806-3756
ISSN	1806-3713
DOI	10.1590/s1806-37132014000200018
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Article ; Online: Comparison of clinical outcomes in patients undergoing mitral valve replacement with mechanical or biological substitutes: a 20 years cohort.

Ribeiro, Angela Henrique Silva / Wender, Orlando Carlos Belmonte / de Almeida, Adriana Silveira / Soares, Luciana Eltz / Picon, Paulo Dornelles

BMC cardiovascular disorders

2014 Volume 14, Page(s) 146

Abstract: Background: The choice of prosthesis for mitral valve replacement still remains controversial. This study assessed mortality, bleeding events and reoperation in patients who underwent mitral valve replacement surgery with biological or mechanical ... ...

Abstract	Background: The choice of prosthesis for mitral valve replacement still remains controversial. This study assessed mortality, bleeding events and reoperation in patients who underwent mitral valve replacement surgery with biological or mechanical substitutes. Methods: A total of 352 patients who underwent mitral valve replacement surgery between 1990 and 2008 with 5 to 23 years of follow-up were retrospectively evaluated in a cohort study. Results: The 5, 10, 15 and 20 year survival rates after surgery using a mechanical substitute were 87.7%, 74.2%, 69.3% and 69.3%, respectively, while after surgery with a biological substitute, they were 87.6%, 71.0%, 64.2% and 56.6%, respectively. There was no significant difference between the two groups (p = 0.38). In the multivariate analysis, the factors associated with death were age, bleeding events and renal failure. The probabilities of remaining free of reoperation at 5, 10, 15 and 20 years after surgery using a mechanical substitute were 94.4%, 92.7%, 92.7% and 92.7%; after surgery with a bioprosthesis, they were 95.9%, 86.4%, 81.2% and 76.5%, respectively (p = 0.073). There was a significantly higher incidence of reoperation for the bioprosthetic valve replacement group (p = 0.008). The probabilities of remaining free of bleeding events at 5, 10, 15 and 20 years after surgery using a mechanical substitute were 95.0%, 91.0%, 89.6% and 89.6%, respectively, while after surgery with a bioprosthesis, they were 96.9%, 94.0%, 94.0% and 94.0%, (p = 0.267). Conclusions: The authors concluded that: 1) mortality during follow-up was statistically similar for both groups; 2) there was a greater tendency to reoperation in the bioprosthesis group; 3) the probability of remaining free from reoperation remained unchanged after 10 years' follow-up for patients with mechanical substitute valves; 4) the probability of remaining fee from bleeding events remained unchanged after 10 years' follow-up for patients given bioprostheses; 5) the baseline characteristics of patients were the greatest determinants of later mortality after surgery; 6) the type of prosthesis was not an independent predictive factor of any of the outcomes tested in the multivariate analysis.
MeSH term(s)	Aged ; Bioprosthesis ; Brazil ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Heart Valve Diseases/diagnosis ; Heart Valve Diseases/mortality ; Heart Valve Diseases/surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/instrumentation ; Heart Valve Prosthesis Implantation/mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mitral Valve/surgery ; Multivariate Analysis ; Postoperative Hemorrhage/mortality ; Postoperative Hemorrhage/surgery ; Proportional Hazards Models ; Prosthesis Design ; Prosthesis Failure ; Reoperation ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2014-10-18
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/1471-2261-14-146
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