Unusual cause of dyspnoea: a case presentation of an echocardiographic pitfall.

Congenital or acquired communication between the left ventricle and the right atrium is known as the Gerbode defect, which is rarely diagnosed since the defect is very unusual and for this reason often misinterpreted as an eccentric tricuspid regurgitation jet. The entity and reason of the defect is unknown to many physicians, so that profound knowledge and a careful and meticulous echocardiogram are necessary in order to prevent misinterpretation of this defect as a pulmonary hypertension. We report the case of a 76-year-old Austrian woman who developed such a Gerbode defect after a recent bioprosthetic aortic valve replacement.

Self-retaining pledgeted suture as retractor for mitral procedure.

A simple reliable maneuver to optimize exposure of the left atrium for mitral valve operations is described. It offers more space to mobilize the valvular structure, facilitating complicated reconstruction in the posteromedial commisural area.

Unstable angina early after aortic valve replacement surgery in a female patient with normal coronary arteries preoperatively--a case report.

Background: Angina pectoris early after aortic valve replacement surgery in patients with previously normal coronary arteries may be life threatening and has to be assessed immediately.

Case Report: 12 weeks after aortic valve replacement surgery, a 60-year-old female patient was referred for evaluation of recent onset of severe chest pain on mild exertion and at rest. Coronary angiography showed severe stenosis involving the left coronary ostium and the left main stem.

Renal function is associated with risk of atrial fibrillation after cardiac surgery.

Background: Atrial fibrillation (AF) frequently occurs after cardiac surgery and is responsible for increased morbidity and resource use. The aim of the present study was to evaluate the association of impaired renal function and the development of postoperative AF.

Methods And Results: Patients undergoing elective cardiac surgery in the absence of significant left ventricular dysfunction (n=253; average age 65+/-11 years) were recruited to the present prospective study.

Intracoronary air embolism in open heart surgery--an uncommon source of myocardial ischaemia.

We report a case of air embolism detected by transesophageal echocardiography in a patient undergoing open heart surgery for acute mitral regurgitation. Intraoperative transesophageal echocardiography revealed an increased brightness of the apical wall and a severely compromised left ventricular myocardium with severe diffuse hypokinesis after removal of the aortic cross clamps and spontaneous resolution in the control echocardiography.

A head-to-head comparison of infusion and bolus doses of adenosine for stress myocardial contrast echocardiography.

Background: This study was a head-to-head, intraindividual comparison of the diagnostic accuracy and side effect profile of bolus and infusion administration of adenosine for stress myocardial contrast echocardiography (MCE).

Methods: Adenosine MCE was performed in 64 subjects, referred for stress thallium-201 single-photon emission computed tomography (SPECT) for known or suspected CAD. Each patient received adenosine by multiple boluses (6-12 mg/bolus) and infusion (140 mug/kg per min for 6 min) forms in random order, given at least 20 minutes apart.

Risk factors of postoperative atrial fibrillation after cardiac surgery.

Background: Postoperative atrial fibrillation (AF) occurs in up to 50% of cardiac surgery patients and represents the most common postoperative arrhythmic complication. The etiology of AF after open-heart surgery is incompletely understood and its prevention remains suboptimal. Identification of patients vulnerable for postoperative AF would allow targeting of those most likely to benefit from aggressive prophylactic intervention.

A comparison between oral antiarrhythmic drugs in the prevention of atrial fibrillation after cardiac surgery: the pilot study of prevention of postoperative atrial fibrillation (SPPAF), a randomized, placebo-controlled trial.

Background: Atrial fibrillation (AF) frequently occurs after cardiac surgical procedures, and beta-blockers, sotalol, and amiodarone may reduce the frequency of AF after open heart surgery. This pilot trial was designed to test whether each of the active oral drug regimens is superior to placebo for prevention of postoperative AF and whether there are differences in favor of 1 of the preventive strategies.

Methods And Results: We conducted a randomized, double-blinded, placebo-controlled trial in which patients undergoing cardiac surgery in the absence of heart failure and without significant left ventricular dysfunction (n = 253; average age, 65 +/- 11 years) received oral amiodarone plus metoprolol (n = 63), metoprolol alone (n = 62), sotalol (n = 63), or placebo (n = 65).