Repair of coarctation of the aorta in adults with simultaneous aortic valve replacement and coronary artery bypass grafting.

The authors present three patients who had either coronary artery disease or severe aortic stenosis or both along with congenital coarction of the aorta. The use of a heterotopic bypass (Dacron tube implanted between the ascending and descending aorta) allowed the surgeons to correct the coarction through a median sternotomy and perform the coronary artery bypass grafting and valve replacement at the same time. The authors are convinced that the scarcely mentioned heterotopic bypassing of the coarcted aorta should be added to the armamentarium of the surgeons who operate on patients with coarctation or recoarctation of the aorta in adulthood or with coarctation that is associated with cardiac lesions.

[Implantable pacemaker-cardioconverter-defibrillator].

The aim of this article is to introduce the automatic, implantable cardioverter-defibrillator (AICD) device in connection with the first two cases in Hungary. At present time, the indications of the AICD implantation in the European Community are as follows: recurrent sustained episodes of ventricular tachycardia ventricular fibrillation or aborted sudden cardiac (arrhythmic) death, when the treatment of the underlying heart disease and/or the application of antiarrhythmic drugs, antitachycardia surgery (or catheter ablation procedures) proved to be unsuccessful in the prevention of the ventricular tachyarrhythmias (guided by serial intracardiac electrophysiologic testing and exercise testing), Holter monitoring. On the one hand the implantation of an AICD is not a causative treatment, on the other hand the cost of an AICD is extremely expensive.

[Surgical management of left cor triatriatum in adults].

Cor triatriatum sinistrum is a rare congenital cardiac anomaly in which a membrane divides the left atrium. Severity of the disease depends on the size of the opening on the membrane. The anomaly presents with severe pulmonary hypertension and prognosis is unfavourable without surgery.

Total correction of tetralogy of Fallot in adolescents and adults.

From 1976 to 1988, 23 adolescent and adult patients underwent total correction of tetralogy of Fallot. There were 13 males and 10 females, ranging in age from 16 to 47 years (mean 24.3 +/- 8.

Ruptured aneurysms of the sinus of Valsalva.

From 1969 to 1989, 15 patients with an aneurysm of the sinus of Valsalva underwent operative correction. This represents 0.23% of 6515 cardiac operations with cardiopulmonary bypass during that time.