Simplified percutaneous closure of patent foramen ovale and atrial septal defect with use of plain fluoroscopy: Single operator experience in 110 consecutive patients.

Objective: Percutaneous closure of patent foramen ovale (PFO) and atrial septal defect (ASD) is routinely performed under general anesthesia or deep sedation and use of transesophageal (TEE) or intracardiac echocardiography, incurring longer duration and higher cost. We have used a simplified, economical, fluoroscopy-only guided approach with local anesthesia, and herein report our data.

Methods: The study includes 112 procedures in 110 patients with PFO (n=75) or ASD (n=35), with use of an Amplatzer occluder, heparin and prophylactic antibiotics.

Right ventricular outflow tract obstruction caused by double-chambered right ventricle presenting in adulthood.

Congenital heart diseases that cause obstruction of the right ventricular outflow tract are often difficult to diagnose. We report the case of a 49-year-old man who presented with long-standing shortness of breath on exertion. Imaging revealed right ventricular outflow tract obstruction caused by a double-chambered right ventricle, and he was referred for surgical correction.

C-reactive protein/interleukin-6 ratio as marker of the size of the uncomplicated thoracic aortic aneurysms.

Objectives: The role of C-reactive protein (CRP) and interleukin-6 (IL-6) as markers in the prognosis of asymptomatic thoracic aortic aneurysm (TAA) patients has not been well established. As such, we evaluated a group of patients for a possible association between serum CRP and IL-6 and aneurysm dimension.

Methods: Serum CRP and IL-6 were determined and aneurysmal size was measured in 26 patients with TAA.

Aortic root replacement in case of isolated aortitis and previous coronary artery bypass.

The surgical management of aortic regurgitation in a patient with aortitis is potentially of high risk, especially if it is a reoperation. We present the case of a 59-year-old man for whom coronary artery bypass surgery was not feasible due to structural abnormalities of the aorta and hybrid management was applied. The histopathological examination showed aortitis.

Repair of aortic coarctation in an adult by direct aortoplasty.

Various techniques have been proposed for surgical correction of aortic coarctation in adults. We describe direct aortoplasty repair in a 28-year-old woman with native coarctation. Four-year follow-up with magnetic resonance angiography confirmed a good result.

Serum levels of matrix metalloproteinases -1,-2,-3 and -9 in thoracic aortic diseases and acute myocardial ischemia.

Background: Matrix metalloproteinases (MMPs) constitute a family of zinc-dependent proteases (endopeptidases) whose catalytic action is the degradation of the extracellular matrix components. In addition, they play the major role in the degradation of collagen and in the process of tissue remodeling. The present clinical study investigated blood serum levels of metalloproteinases- 1, -2, -3 and -9 in patients with acute and chronic aortic dissection, thoracic aortic aneurysm and acute myocardial ischemia compared to healthy individuals.

Atypical atrial myxomas in two asymptomatic patients: a case report.

Background: Atypical cardiac myxomas are a rare occurrence and may present with a variety of clinical manifestations depending on the morphology and location.

Case Presentation: Two cases of cardiac myxomas atypically located in asymptomatic patients, diagnosed by transthoracic and transoesophageal echocardiography, are presented. In the first case a myxoma is located under the anterior mitral valve leaflet and in the second case a myxoma is located in the right atrium.

Acute mechanical prosthetic valve thrombosis after initiating oral anticoagulation therapy. Is bridging anticoagulation with heparin required?

Prosthetic valve thrombosis (PVT) represents a serious and potentially lethal complication. It can be attributed more frequently to inadequate anticoagulant therapy. We present a case of acute aortic mechanical valve thrombosis six months after implantation.

Successful repair of a huge right coronary artery to a right ventricular fistula: report of a case.

Congenital coronary artery fistulas account for only 0.27%-0.4% of all congenital cardiac defects.

Concomitant cholecystectomy and open heart surgery.

Purpose: Cholelithiasis may be present concomitantly with cardiac disease. We performed a retrospective study to verify the safety and efficacy of synchronous cholecystectomy and open heart surgery.

Methods: Between 1999 and 2004, we performed synchronous cholecystectomy and open heart surgery in nine patients (group A) and open heart surgery alone in 1248 patients (group B).

Influence of fast-track recovery after coronary artery bypass in the elderly.

We retrospectively analyzed 711 consecutive patients who had isolated coronary artery bypass grafting between January 2000 and December 2004; 572 younger patients (< 70 years) were compared with 139 elderly patients (> or = 70 years). A rapid recovery program based on an anesthetic protocol for early extubation was applied to all patients. The overall hospital mortality rate was 3.

Revascularization and mitral valve replacement in a patient with porcelain aorta.

In cases of severe atherosclerosis of the ascending aorta, alterations in the standard surgical technique are mandatory. We report mitral valve replacement and coronary artery bypass grafting in a patient with a severely atherosclerotic aorta. Cardiopulmonary bypass was conducted via an arterial cannula in the femoral artery and two single venous cannulas.

Cartilaginous and osseous metaplasia with bone marrow formation in the aortic valve of a patient with giant cell aortitis.

We describe the case of a 40-year-old man who presented with an ascending aortic aneurysm and aortic valve regurgitation. The patient underwent a Bentall surgical procedure. Pathologic findings were consistent with giant cell aortitis with synchronous cartilaginous and osseous metaplasia with bone marrow formation in the degenerated aortic valve.