Unconventional Cardiovascular Risk Factors and Systematic Coronary Risk Estimation (SCORE) in the Lebanese Rural Population: The Forgotten Factors.

Purpose: To evaluate the correlation between unconventional risk factors and the Systematic Coronary Risk Estimation (SCORE), and estimate the prevalence of conventional and unconventional cardiovascular (CV) risk factors in the rural Lebanese population in order to assess their CV risk.

Methods: This is a retrospective descriptive study conducted between November 2017 and June 2019 among the Lebanese rural population. The risk factors were analyzed from the files of the patients who presented for the CV disease screening days organized by a non governmental organization.

Myocardial extraction of intracellular magnesium and atrial fibrillation after coronary surgery.

Background: The effects of magnesium loading on the incidence of atrial fibrillation following coronary artery bypass graft surgery (CAGB) are equivocal. None of the previous studies assessed the influence of myocardial extraction of magnesium in these settings. The current trial aims to elucidate whether the incidence of atrial fibrillation following CABG is affected by the preoperative rate of myocardial extraction of magnesium.

Postoperative oral amiodarone versus oral bisoprolol as prophylaxis against atrial fibrillation after coronary artery bypass graft surgery: a prospective randomized trial.

Background: Postoperative atrial fibrillation (AF) occurs in up to 50% of patients undergoing coronary artery bypass (CABG) surgery and is associated with complications. Amiodarone and beta blockers are effective as prophylaxis for AF after CABG. The purpose of this study was to compare oral amiodarone versus oral bisoprolol for prevention of AF after CABG.

[Segmental variations of great saphenous vein diameters in a coronary triple vessel disease population].

Background: Great saphenous vein is one of the most used grafts in cardiovascular surgery. There is little amount of data in the medical literature describing dimensions of this vein. This series describes dimensions of the great saphenous vein in a coronary population and their variations.

Staged anesthesia for combined carotid and coronary artery revascularization: a different approach.

Objective: Combined coronary artery bypass graft (CABG) surgery and carotid endarterectomy (CEA) are performed in an attempt to reduce the risk of postoperative stroke after CABG surgery in patients with significant or symptomatic carotid artery stenosis. The choice between regional and general anesthesia for CEA is still under debate. Regional anesthesia offers an excellent monitoring technique of the neurologic status of the awake patient during carotid clamping.

[Balloon dilation of critical neonatal aortic stenosis: early and midterm results].

Objectives: We evaluated our immediate and midterm results of balloon dilation of critical valvular aortic stenosis in 15 consecutive neonates.

Methods: Balloon dilatation was attempted in 15 neonates at a mean age of 14 days. Three patients (20%) had associated left heart hypoplasia.

[Percutaneous closure of atrial septal defects using the Amplatzer device].

Percutaneous closure of an atrial septal defect (ASD) was undertaken in 10 patients aged from 3 to 33 years. The Amplatzer device was introduced intravenously and positioned under fluoroscopic and echographic control. The size of the ASD varied from 13 to 20 mm and that of the devices from 15 to 32 mm.

[Imaging of an aberrant occipital artery arising from the extracranial segment of the internal carotid artery].

We report a case of asymptomatic occlusion of the right internal carotid artery owing to the presence of a rare anatomic variant (occipital artery originating from the extracranial segment of the internal carotid artery). During the preoperative workup for a coronary artery bypass grafting (CABG) in a 65-year-old patient, an occlusion of the right internal carotid artery was visualized on Duplex ultrasound. Distally to the occluded site, the artery was patent thanks to a vessel parallel to it but with a reverse blood flow.

[Transcatheter closure of the patent ductus arteriosus in children. The first Lebanese series].

Unlabelled: Percutaneous closure of the patent ductus arteriosus (PDA) has become an efficient and safe technique in children. We report the first Lebanese series of 8 children who had their PDA closed percutaneously with a coil or an Amplatzer Duct Occluder.

Methods: Patients median age was 3.

[Hydatid cyst of the heart simulating coronary ischemia].

Cardiac echinococcosis is rare despite endemic occurrence of echinococcosis in some regions of the world. Clinical presentation can vary and may be misleading. Diagnosis is facilitated by new imaging techniques.

Recurrence of left ventricular outflow tract obstruction after left anterior descending coronary artery revascularization in a patient with hypertrophic obstructive cardiomyopathy.

A patient with known hypertrophic obstructive cardiomyopathy presented with an anteroseptal myocardial infarction which resulted in the disappearance of his subaortic pressure gradient. Surgical revascularization of his left anterior descending coronary artery after the viability of his myocardium had been documented led to the recurrence of his left ventricular outflow tract obstruction and subaortic pressure gradient.

Aortic valve papillary fibroelastoma.

Cardiac papillary fibroelastomas are rare tumors of the heart and affect primarily the cardiac valves. These lesions are responsible for embolic accidents that clinically manifest as neurological and cardiovascular symptoms. We describe the case of a 40-yr-old woman who presented with a neurological deficit caused by a papillary tumor of the aortic valve.

X-linked transposition of the great arteries and incomplete penetrance among males with a nonsense mutation in ZIC3.

We report on a Lebanese family in which two maternal cousins suffered and died very early in life from cardiac malformations. Both presented with a transposition of the great arteries associated with one or several other cardiac defects. Various minor midline defects were also observed, but there were no situs abnormalities other than a persistent left superior vena cava in one.

[Autosomal dominant Mendelian midline complex. Secundum atrial septal defect associated with cardiac and facial-thoracic defects. A familial case].

The kindred of 38 individuals reported here have various anomalies: 1. facio-thoracic malformations: hypertelorism, nasal deviation, cleft lip and palate, upper-incisors diastema and pectus excavatum; 2. cardiac anomalies: sinus node bradycardia, atrial fibrillation, nodal rhythm, atrial septal defect.

Acute rupture of a left ventricular false aneurysm.

Left ventricular aneurysm develop when rupture of the free ventricular wall is contained by the inflammatory surrounding tissues. These false aneurysms rupture secondarily and should be treated soon after diagnosis. The diagnosis is suggested by echocardiography and confirmed by cardiac catheterization.

[Recurrent cerebrovascular accident: unusual and isolated manifestation of myxoma of the left atrium].

The authors report an unusual case of left atrial myxoma in a 30-year-old woman, discovered after a recurrent stroke. This tumor was misdiagnosed earlier because of an exclusive neurologic symptomatology, a normal cardiac exam without any sign of mitral obstruction (unusual high implantation of the myxoma within the roof of the left atrium), and the lack of doing an echocardiography which should be systematically done after an ischemic stroke, even if its etiology seems to be evident. Surgical resection of the tumor led to prevent further myxomatous emboli, but unfortunately, the patient keeps severe neurological sequelae.

Autosomal dominant secundum atrial septal defect with various cardiac and noncardiac defects: a new midline disorder.

We report on a Lebanese family in which 12 persons had an atrial septal defect and various cardiac and noncardiac anomalies. Cardiac anomalies are left axis deviation of QRS, right bundle branch block, atrial fibrillation, Wolff-Parkinson-White syndrome, nodal atrioventricular rhythm, aortic stenosis, pulmonic valve stenosis, mitral stenosis (Lutembacher syndrome), and low implantation of the tricuspid valve (Ebstein disease). Noncardiac abnormalities consisted specially of the presence of hypertelorism, cleft lip, and pectus excavatum.

[Mycotic aneurysm of the external ilial artery: a very rare complication of coronary angioplasty].

Vascular complications, mostly hematomas and false aneurysms, are rare after coronary angiography. Infectious problems are even less frequent and a mycotic aneurysm is an extremely rare complication. Our patient presented with a mycotic aneurysm of the external iliac artery following percutaneous transluminal coronary angioplasty.

[Coronary surgery in patients 70 years and older. Report of 70 cases].

Between January 1993 and January 1995, seventy patients over 70 years of age underwent coronary artery revascularization and were retrospectively reviewed. The anesthetic protocole, the surgical technique and the intraoperative myocardial protection were similar for all patients. Fourteen patients (19.

Concomitant cerebral, brachiocephalic trunk, and cardiac revascularization. An unusual case.

Extensive transthoracic brachiocephalic revascularization is rarely performed. Instances of this operation performed concomitantly with cardiac revascularization and carotid endarterectomy have been reported in fewer than 10 cases in the literature. We report the case of a patient requiring complex brachiocephalic revascularization associated with coronary bypass grafting and a left carotid endarterectomy.

Spontaneous cholesterol embolization. A rarely reported entity.

Cholesterol embolization sometimes occurs after invasive procedures involving manipulation of the aorta or its major branches, and less commonly occurs after thrombolytic therapy for acute myocardial infarction. Rarer still is spontaneous cholesterol embolization, a case of which we now report. Our patient experienced peripheral embolization, the origin of which was traced to the infrarenal aortic segment and the common iliac vessels.

Spontaneous cholesterol embolization--a rare clinical entity.

Embolization of cholesterol crystals from atheromatous plaques is a rare entity most often seen after invasive procedures involving manipulation of the aorta. Spontaneous CE has been reported in very rare cases. Peripheral signs include livedo reticularis, muscle pain and palpable pulses.

Traumatic rupture of the thoracic aorta--case report.

Acute traumatic rupture of the thoracic aorta due to blunt trauma is a relatively common injury after deceleration accidents. However, only one fifth of these patients survive to reach medical facilities. The limiting factor to successful management is early diagnosis and prompt treatment.

Total anomalous pulmonary venous connection in adults--a surgical review.

The authors report a case of surgical repair of total anomalous pulmonary venous connection in a 36-year-old male. This is a very rare disease in adulthood since over 80% of the infants die before one year of age. Fifty-two surgical cases were previously reported in the literature.