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The standard surgical management of patients with transposition of the great arteries, ventricular septal defect, and pulmonary stenosis is the Rastelli operation. Recently, en bloc rotation of the arterial trunk, by cutting out the aortic and the pulmonary root in one block and by rotating it 180°, has been introduced as a new option for anatomical repair.
To evaluate the effects of this surgical method on the conduction system, pre-operative, post-operative, and follow-up electrocardiograms as well as patient charts were reviewed retrospectively. A total of 16 consecutive patients with transposition of the great arteries and left outflow tract obstruction were treated with en bloc rotation.
During the post-operative period, there were two patients with complete atrio-ventricular block, one with junctional ectopic tachycardia, one with ventricular tachycardia, and one with supraventricular tachycardia. None of the patients had a typical right bundle branch block pattern before surgery; however, this pattern was detectable after surgery in eight out of 16 patients (50%), which persisted during the follow-up. All patients without typical right bundle branch block pattern showed a median QRS duration of 65 ms (54–112 ms) before surgery, 62 ms (54–122 ms) after surgery, and 84 ms (66–128 ms) at the last follow-up visit. This compares well with a similar Rastelli cohort, where a right bundle branch block prevalence of 77% was reported. Out of 16 patients, 12 showed non-specific ST changes and negative T-waves, which persisted during follow-up with an unknown significance for the future.
Our data suggest that en bloc rotation of the arterial trunk seems not to have more negative effects on the conduction system than the Rastelli operation.
This tribute to Professor Detlev Vagts of the Harvard Law School brings together his colleagues at Harvard and the American Society of International Law, as well as academics, judges and practitioners, many of them his former students. Their essays span the entire spectrum of modern transnational law: international law in general; transnational economic law; and transnational lawyering and dispute resolution. The contributors evaluate established fields of transnational law, such as the protection of property and investment, and explore new areas of law which are in the process of detaching themselves from the nation-state such as global administrative law and the regulation of cross-border lawyering. The implications of decentralised norm-making, the proliferation of dispute settlement mechanisms and the rising backlash against global legal interdependence in the form of demands for preserving state legal autonomy are also examined.
This Festschrift honours Professor Detlev Vagts and celebrates his profound scholarly contributions to and influence on the study and practice of transnational law over the last half-century.
On the occasion of his recent retirement from the Harvard Law School faculty and his eightieth birthday, the book brings together a wide range of leading scholars and practitioners from around the globe with a personal connection to the honouree: his colleagues at Harvard Law School and the American Society of International Law (ASIL, especially its Journal), as well as academics, judges and practitioners, many of them former students of Detlev Vagts, with whom his rich life and career have intersected. The book spans the entire spectrum of modern transnational law.
Soon after graduating from law school, Detlev Vagts realised that in the new reality of international relations, law may more readily be understood as extending beyond the classical State system. Philip Jessup, in his famous Storrs Lectures at Yale in 1956, labelled this phenomenon ‘transnational law’, which he defined as ‘all law which regulates actions or events that transcend national frontiers. Both public and private international law are included, as are other rules which do not wholly fit into such standard categories.’ The increasing mobility of people, capital and goods required an expansion of the legal horizon beyond classical public international law and a State-centred view of norm-making. Since then, transnational law has moved to the centre of the law curriculum everywhere.
In several respects, Justice Feliciano's personality and career embody at the highest level what it may mean in our contemporary world ‘to live greatly in the law’. After the Marrakesh Agreement had successfully strengthened the rule of law in international trade law through the establishment of a formalized dispute settlement mechanism, Justice Feliciano was chosen to be one of the first members of the Appellate Body. This choice was far from self-evident, in as much as Justice Feliciano not only came from the developing world and had the confidence of colleagues and governments from the developing world, but moreover, had no special experience in matters of international trade law. And as the new WTO was a first step towards institution-building for a globalized economy, the experiment of introducing a global rule of law for the trade sector depended, to a large extent, on the success in the initial period of the new dispute settlement system charged with the application and interpretation of new and old rules. Today, ten years after Marrakesh, the WTO dispute settlement system is often considered the most successful effort in the globalizing world to establish the rule of law, all the problems in detail notwithstanding. From 1995 to 2001, Justice Feliciano was a member of the Appellate Body, serving as its Chair from 2000 to 2001.
Remarkably enough, Justice Feliciano's experience in international economic law is not limited to trade law.