Surgical repair of post-infarct true posterobasal ventricular aneurysm with mitral valve replacement and coronary revascularization: a case report.

Post-infarction ventricular aneurysm is a complication of myocardial infarction. While the involvement of the anterior wall is quite common, posterobasal left ventricular aneurysm is a rare clinical complication in this setting. In this case report, we report a post-infarction posterobasal left ventricular aneurysm combined with ischemic mitral regurgitation due to coronary artery disease, for which we successfully performed triple coronary artery bypass and ventricular geometry restitution via a modified Dor's procedure with mitral valve replacement through an extracardiac approach.

Does preoperative clopidogrel increase bleeding after coronary bypass surgery?

Antiplatelet therapy has been demonstrated to reduce the risk of cardiac events in patients presenting with acute coronary syndrome, yet all effective therapies also increase the risk of bleeding. This study aimed to test the hypothesis that patients undergoing coronary artery bypass grafting, who received clopidogrel within 5 days before surgery, have worse bleeding outcomes and blood transfusion requirements than those who stopped clopidogrel >5 days earlier. We recruited 342 patients who underwent on-pump elective coronary artery bypass grafting between January 2004 and December 2008.

Off-pump coronary bypass grafting for kawasaki disease.

A 6-year-old girl, a known case of Kawasaki disease, presented with acute thrombotic occlusion of right coronary artery (RCA) with symptoms of acute angina and myocardial dysfunction. She underwent beating heart off-pump coronary artery bypass graft (CABG) surgery with right internal mammary artery (RIMA) grafted to distal RCA. Follow-up computed tomography angiogram revealed well-flowing RIMA with no obstruction or kink.

Aortic arch replacement with moderate hyperthomia and a modified 3-pump circuit.

A strategy employing moderate hypothermia for replacement of the aortic arch is proposed to avoid the complications of profound hypothermic circulatory arrest. Two patients underwent complete replacement of the aortic arch using three pumps (Figure 1a - one to perfuse the brain, one for the thoracoabdominal aorta and the third for the heart). There were no complications and the patients were extubated uneventfully.