Takayasu Arteritis with Multiple Coronary Artery Fistulas to Bronchial Arteries.

Takayasu arteritis (TA) is an inflammatory disease that commonly occurs in young females. Coronary involvement occurs rarely and mostly with stenosis. Here, we present a case of TA associated with fistulas between the coronary arteries and the bronchial arteries.

Type B interrupted aorta in an adult patient.

Introduction: Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.

Case Presentation: We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.

Comparison of conventional and no-touch techniques in harvesting saphenous vein for coronary artery bypass grafting in view of endothelial damage.

Background: Optimization of saphenous vein patency for myocardial revascularization.

Objective: The goal of this study was to present the no-touch technique of saphenous vein preparation. This technique consists of harvesting the vein with a pedicle of surrounding tissue, which protects the vein from distension pressure.

Sequential in situ left internal thoracic artery grafting to the circumflex and right coronary artery areas.

Background: Several bilateral internal thoracic artery (ITA) grafting patterns have been proposed to enhance 3-vessel coronary artery revascularization. We present the outcomes of sequential in situ left ITA grafting to the circumflex and right coronary artery (RCA) areas.

Methods: Between January 2001 and September 2007, 102 patients with 3-vessel coronary artery disease underwent arterial myocardial revascularization with bilateral in situ ITA grafts.

Long term follow up results of sequential left internal thoracic artery grafts on severe left anterior descending artery disease.

Purpose: Several alternative procedures have been proposed to achieve complete revascularization in the presence of diffuse left anterior descending coronary artery (LAD) disease. With the extensive use of internal thoracic artery grafts in coronary artery bypass procedures, sequential anastomosis of the left internal thoracic artery (LITA) to LAD has gained popularity in these challenging cases. The long term results of sequential LITA to LAD anstomosis were examined in this study.

Coronary artery bypass grafting in cold-induced urticaria.

Cold-induced urticaria is an unusual systemic disorder that develops in response to exposures to cold temperatures in susceptible individuals. Patients with cold urticaria are potentially at risk of severe systemic anaphylactic shock-like reactions. This disorder is of unique clinical importance in cardiac surgery, considering the use of cardiopulmonary bypass and hypothermia.

Combined internal mammary artery graft in coronary bypass: 18-year follow-up.

Graft preference is a key point for long-term patency in coronary artery bypass grafting. We present a patient with multivessel coronary artery disease who underwent coronary artery bypass grafting 18 years ago. Revascularization of the left coronary system was performed by using a combined internal mammary artery (IMA) graft, which consisted of an end-to-end anastomosis of left IMA (in situ) and right IMA (free), with the interposition of a small piece of vein.

The effect of coronary revascularization on new-onset complete atrioventricular block due to acute coronary syndrome.

Background: Coronary artery disease is one of the most common causes of complete atrioventricular block (AVB) in adults. In this study, we evaluated whether prompt revascularization of the coronary artery occlusion can ameliorate new-onset complete AVB due to acute coronary syndrome (ACS).

Methods: Five patients (4 men and 1 woman) with a mean age of 69.

Surgical treatment of postinfarction pseudoaneurysms of the left ventricle.

Background: Left ventricular pseudoaneurysm is a rare and frequently fatal complication of acute myocardial infarction. It occurs as a consequence of rupture of the ventricular free wall that gets confined by a portion of the pericardium. The purpose of this study was to present our surgical experience of postinfarction left ventricular pseudoaneurysms and to evaluate mid-term results.

Left ventricular rhabdomyoma with severe left ventricular outflow tract obstruction: development of delayed hemiplegia after cardiopulmonary bypass.

The incidence of cardiac tumors increased with the improvement of imaging techniques in infants. Rhabdomyomas are the most common tumors in this group of patients. We herein report a 40-day-old male patient with left ventricular rhabdomyoma.

The use of pulmonary autograft patch for type A aortic interruption and Swiss-cheese ventricular septal defect (VSD).

The surgical management of the aortic arch pathologies is controversial. Primary anastomosis and patch aortoplasties combined with end-to-end anastomosis have some complications like recurrence and aneurysm formation. Surgical repair of apical muscular (Swiss-cheese) defects is also still under debate.

Off pump repair of aortic arch anomalies with concomitant intracardiac defects via anterior approach.

Background: The authors evaluated the surgical treatment of aortic arch anomalies associated with intracardiac pathologies, through median sternotomy on beating heart without using cardiopulmonary bypass (CPB).

Methods: A consecutive series of 10 patients with aortic coarctation were operated upon. Median age at repair was 3.

Arch-first technique via clamshell incision: successful surgical reoperation for aortic arch dissection.

We report a case of successful reoperation for aortic arch dissection with use of the "arch-first" technique in a patient who had Marfan syndrome. Extracorporeal circulation was initiated via right subclavian artery cannulation, and the chest was entered through a clamshell incision for the best exposure. When the patient was cooled to 18 degrees C, the perfusion was stopped.

Myocardial ischemia after Cabrol operation.

A 33-year-old woman who had undergone a Cabrol-type aortic root replacement for acute aortic dissection during labor 27 months ago was admitted with chest pain. Electron-beam tomography and coronary angiography showed stenosis at the level of the anastomosis. Urgent coronary revascularization was performed using bilateral internal mammary artery grafts.

Postinfarction ventricular septal rupture: surgical intervention and risk factors influencing hospital mortality.

Postinfarction rupture of the interventricular septum is usually fatal without surgical intervention and requires urgent closure. Between 1989 and 2003 twenty consecutive patients (15 male, 5 female), underwent postinfarction ventricular septal rupture (VSR) repair. Mean age of the patients was 62.

Repair of multiple muscular ventricular septal defects: septal obliteration technique.

Background: The management of the apical multiple muscular ventricular septal defects (VSDs) remains still controversial. There are various surgical techniques and approaches for closure of "Swiss-cheese" VSDs. In this study, we report the outcome of multiple muscular VSDs repair, using the septal obliteration technique.

A novel technique for creation of a systemic-to-pulmonary arterial shunt.

A systemic-to-pulmonary arterial shunt is still widely used for palliation of some neonates with cyanotic congenital cardiac lesions. This procedure, however, is well known to be associated with some degree of morbidity and mortality. To reduce the incidence of iatrogenic pulmonary arterial deformities, we have devised a new and simple technique to create the shunt using a partial sternotomy, and have used our technique in 10 neonates with cyanotic cardiac malformations.

Unusual presentation of myocardial ischemia after arterial switch operation.

Ischemic changes and acute or subacute cardiac failure after arterial switch operation generally results from imperfect transfer of coronary arteries to the neoaorta. Peroperative and early postoperative myocardial ischemia is the main cause of death in these patients. We present an unusual cause of myocardial ischemia and cardiac failure after arterial switch: a congenital coronary artery fistula between the circumflex artery and the right ventricle.

Sinus of Valsalva aneurysm: surgical approaches to complicated cases.

Background: The authors herein report surgical experience with the aneurysms of sinus of Valsalva (SVA) complicated by coexisting pathologies.

Methods: Eight patients aged between 11 and 55 years underwent surgical repair of SVA. The aneurysms originated from the right coronary sinus in four patients, from the non-coronary sinus in four patients and from the left in one patient (one patient had aneurysms originating from both the left and right sinuses).

Diagnosis, management, and results of treatment for aortopulmonary window.

The aortopulmonary window is a communication between the ascending aorta and the pulmonary trunk in the presence of two separate arterial valves. This uncommon congenital anomaly is reported rarely in the literature. We present here our experience with 16 patients, emphasizing the importance of early closure of the defect by a transaortic approach.

Arterial switch operations for single coronary artery ostium or intramural coronary artery.

Background: Successful transfer of the coronary arteries is the most critical step during arterial switch operations for patients with transposition of the great arteries with a single coronary artery ostium and/or intramural coronary arteries. Various techniques have been reported and the present study was an evaluation of them in 10 neonatal patients.

Methods And Results: Coronary artery transfers are achieved by implantation of coronary buttons to the previously anastomosed neo-aorta using pericardial or pulmonary artery hood techniques.