http://repub.eur.nl/res/aut/13260/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/5292/ 1984-01-01T00:00:00Z Six cases of acute myocardial infarction with blood in the pericardial sac are described. In one case rapid death followed myocardial rupture leaving no time for the possibility of intervention. Of two other cases acute symptoms developing after myocardial rupture, one was operated on promptly and the other, whose condition improved on pericardiocentesis, after a delay of a few hours. Both are now long term survivors A fourth patient probably had two episodes of rupture which apparently sealed off. He underwent cardiac catheterization, but no epicardial leak was found. Subsequently at operation a sealed myocardial rupture was detected and sutured over. The fifth patient suffered a silent myocardial rupture. A false aneurysm was diagnosed four months later and he withstood successful surgery. In the sixth patient, the course was similar to that of case 1, namely rapid death with a clinical picture suggestive of tamponade. Postmortem examination showed a covert rupture with some evidence of attempts to plug the opening. The purpose of this report is to emphasize the varying course which myocardial rupture can take. http://repub.eur.nl/res/pub/4093/ 1983-01-01T00:00:00Z Of 1041 patients with consecutive aortocoronary bypass operations, 53 (5.1%) underwent reoperation during a mean follow-up time of three and a half years. The operative mortality of first operations was 1.2%, and of reoperations 3.8%. The anatomical reason for reoperation was failure of the bypass graft in 41 (77%) patients, which in 18 was accompanied by progression of disease. Progression alone was seen in seven (13%). When symptoms occurred within six months after the first operation, failure of the bypass graft(s) was nearly always found--in 32 out of 36 instances. Progression in non-bypassed arteries was seen only when symptoms occurred later. Late results in angina pectoris were less favourable in the group undergoing reoperation: 31 (65%) of the 48 operated on twice and 406 (46%) of the 877 patients operated on once still had angina at late follow-up. The same fraction in both groups was improved by operation: 88% versus 89%. http://repub.eur.nl/res/pub/4098/ 1983-01-01T00:00:00Z http://repub.eur.nl/res/pub/25766/ 1979-04-18T00:00:00Z The justification for clinical cardiac transplantation is that it should solve end-stage cardiac disease when no other medical or surgical treatment is available (76). However, after cardiac transplantation the main barriers to long-term survival and complete rehabilitation include the management of acute rejection episodes, the complications related to the immunosuppressive therapy and the progression of graft arteriosclerosis or chronic rejection (77). Although a progressive increase in patient survival has become apparent (77), many aspects of the process of acute and chronic cardiac allograft rejection have yet to be studied.