De Bono Procedure Research Articles

Operação de Bentall e De Bono para correção das doenças da raiz aórtica: análise de resultados a longo prazo

A retrospective study was performed in a series of consecutive patients who underwent a Bentall and De Bono procedure. Data were removed of medical records and follow-up data were obtained from clinical records and direct contact with patients. A total of 39 patients were studied between January 1996 and December 2005. The median age was 47 years (range 14-70). There were 33 males and six females. Eleven (25.5%) patients presented Marfan syndrome and one (2.5%) Turner syndrome. Nineteen (48.5%) patients had hypertension, eight (20.5%) had history of smoking, six (15.5%) had history of alcoholism, eight (20.5%) had dyslipidemia, two (5.0%) had diabetes and one (2.56%) had myocardial infarct previously. Twenty-eight (72%) patients were in II-III NYHA class in the moment of the surgery. Annulo-aortic ecstasy was present in 14 (35.9%) patients and aortic aneurysms in 16 (41%). The median time in intensive care unit was 8.79 days with range 2-23 days. Four (10.0%) patients underwent an emergency operation and 35 (90%) elective. The overall hospital mortality was 5% (2/39). The event-free survival is 94.87% at 1 year and 84.61% at in 5 and 10. The median time of follow-up was 46.5 months (range 14-120 months). The Bentall and De Bono technique obtained excellent results in the short-term and long-term, which support the continued use of the compositive graft technique as the preferred method of treatment for patients with aortic root disease. Our findings confirm the current literature data.

Spaces for Creativity and Innovation in Two Established Organizations

Organizational work environments are increasingly strategically designed to support creativity and innovation processes, although a consistent theoretical frame for such an endeavour has not been developed yet. Creativity‐ and innovation‐oriented design of work environments requires an understanding of the principles of the underlying processes and their spatial implications. Both creativity and innovation processes are complex and display in different phases convergent and divergent characteristics. The processes are dependent on both individual and group effort. In this article these dimensions are discussed from a theoretical perspective and are used for evaluating the two cases presented here. The first case, the Interactive Creativity Landscape as integral part of the Fraunhofer Office Innovation Center in Germany has been designed interpreting the convergent and divergent phases of creative processes. The second case, the Learning Garden of a Scandinavian financial institution has been designed having de Bono's procedure in mind. The article concludes with the suggestion that increasingly organizations will offer diversity for spatially supporting creativity and innovation processes; solutions will be manifold but will follow certain principles – some of which are discussed here.

Cirurgia de Bentall - De Bono associada a revascularização direta do miocárdio: relato de caso

A cirurgia preconizada para correção de ectasia ânulo âortica é a operação de Bentall e De Bono. A associação desta doença com aterosclerose coronária é infreqüente. Os autores relatam o caso de uma paciente de 57 anos portadora dessa associação, que foi submetida à cirurgia de Bentall e De Bono com concomitante revascularização do miocárdio. Com auxílio de circulação extracorpôrea e proteção miocárdica com retroplegia sangüínea gelada, realizaram a troca valvar aórtica e a porção ascendente da aorta por tubo valvulado de pericárdio bovino e a revascularização do miocárdio utilizando a anastomose da artéria torácica interna com a artéria interventricular anterior e de um segmento de veia safena saindo em ipsilon da artéria torácica interna para o ramo marginal da circunflexa. Tanto a operação como o pós-operatório transcorreram sem intercorrências.

Surgical consideration of replacement of the ascending aorta and aortic valve with a composite valve graft--operative and long-term results of Bentall and DeBono procedure.

Our experience with the Bentall and DeBono procedure is reviewed. Between April, 1977 and April, 1985, seventeen patients underwent repair of annulo-aortic ectasia (9 cases), and dissecting aneurysm with aortic regurgitation (8 cases). Three patients had cardiac tamponade due to rupture of dissecting aneurysm. In regard to this procedure, we recently performed the continuous suture method on the prosthetic valve ring, coronary ostia, and distal anastomosis sites. In this study, there was one early death due to a sudden rupture of the dissecting aneurysm of the left thoracic cavity on the 10th postoperative day. In addition, there were two late deaths due to sepsis and suspected arrhythmia. The late follow-up period ranged from 6 months to 8 years (mean 35 months), and all patients were in NYHA Class I or II. We conclude that the composite valve graft method is an excellent technique for annuloaortic ectasia and ascending aortic dissections with aortic regurgitation because of its low operative mortality and fair survival rate.