Echocardiographic changes and quality of life after surgical unroofing of myocardial bridges.

Objective: To examine the echocardiographic changes and quality of life (QoL) after surgical unroofing of myocardial bridges (MBs) involving the left anterior descending (LAD) coronary artery compared with optimal medical therapy (OMT).

Methods: Twenty-two patients (median age, 24 years; interquartile range, 16-40 years) with MBs of the LAD artery and exertional angina from 2018 to 2019 were retrospectively analyzed. Twelve patients underwent OMT and 10 underwent surgery.

Echocardiographic screening for the anomalous aortic origin of coronary arteries.

Aims: We sought to determine the diagnostic performance, clinical profiles and outcomes of anomalous aortic origin of coronary arteries (AAOCA) using a standardised echocardiographic approach in young adults and athletes.

Methods: In 2015-2019, we screened 5998 outpatients (age 16 years (Q1-Q3: 11, 36)), referred for routine echocardiography, using four specific echocardiographic windows: parasternal short/long axis and apical 4/5-chambers view. Coronary CT confirmed AAOCA.

Fast track extubation in paediatric cardiothoracic surgery in developing countries.

In recent years, low-dose, short-acting anesthetic agents, which replaced the former high-dose opioid regimens, offer a faster postoperative recovery and decrease the need for mechanical ventilatory support. In this study, the aim was to determine the success rate of fast-track approach in surgical procedures for congenital heart disease. There is some evidence, mostly from retrospective analyses, that fast tracking can be beneficial.

A case of co-existence of muscle bridge and anomalous origin of coronary artery.

Introduction: Coronary artery anomalies result from disturbances which may occur to the fetus in the third week of development. These disturbances may lead to anatomical variations which may affect the origin, trajectory, and termination of these arteries, or alterations in their intrinsic anatomy.

Presentation Of Case: We report an unusual case in which both anomalous origin of the right coronary artery and myocardial bridge on left anterior descending artery were detected concurrently.

Surgical Treatment of Idiopathic Enlargement of the Right Atrium.

Idiopathic enlargement of the right atrium (IERA) is a very rare abnormality. Approximately one-half (48%) of the patients with a congenital enlargement of the right atrium have no symptoms. When they occur, symptoms include shortness of breath (28% of cases), palpitations (17%), arrhythmias (12%), and in rare cases, right heart failure and extreme tiredness.

Evolution of a rare ECG pattern in an aggressive case of neonatal tuberous sclerosis complex.

Introduction: Rhabdomyomas are the most frequent cardiac tumors in children. Furthermore, they are often associated to tuberous sclerosis complex, an autosomal dominant neurocutaneous disorder characterized by tumor-like malformations that involve many organ systems.

Presentation Of The Case: We describe a rare ECG pattern in a severe case of neonatal tuberous sclerosis complex.

Obstructive neonatal atrial myxoma.

Introduction: Cardiac myxoma is a benign neoplasm representing the most common primary cardiac tumor in adults, however it is unusual in neonates. It is represented by an endocardial mass that occupies the cardiac chamber. Although the majority of myxomas are attached to the fossa ovalis of the interatrial septum, they also attach to the walls of the cardiac chambers and to valve leaflets surfaces.

Paediatric Nonfunctioning Adrenocortical Carcinoma with Extension up to Right-Side Heart: Cardiac Surgery Approach.

Adrenocortical carcinoma is a rare malignancy. Due to late diagnosis and no adequate effective adjuvant treatment, prognosis remains poor. Only approximately 30% of these malignancies are confined to the adrenal gland when they are diagnosed, as these tumors tend to be found years after their genesis.

Reversible Closure of the Ductus Arteriosus.

There are cases in which ligation of the ductus arteriosus is part of a palliative or reparative procedure where the opportunity to reopen the ductus in the early period after surgery could be beneficial. This applies, particularly, to patients with borderline left ventricle in whom a biventricular repair is performed or in small babies in whom a modified Blalock-Taussig shunt is performed, particularly when a very small polytetrafluoroethylene graft is used. Conventional ductal ligation is generally irreversible.

Anterior and posterior leaflets augmentation to treat tricuspid valve regurgitation.

In congenital non-Ebstein anomalies of the tricuspid valve, the septal leaflet is often involved and tethered. We describe a standardized approach to address septal leaflet tethering by concomitant augmentation of the anterior and posterior leaflets.

Huge left ventricular pseudoaneurysm rupture in an African young adult patient.

A pseudoaneurysm of the ventricle is formed when there is rupture of the myocardial wall with the discontinuity being roofed over by the pericardium and mural thrombus or fibrous tissue without myocardial elements. Cardiac pseudoaneurysm is a rare and a potentially life-threatening event. Early prophylactic surgical aneurysmectomy has been the treatment of choice.

Surgical management of giant fibroelastoma of the aortic valve with repair through valve sparing technique.

Background: Fibroelastomas account for less than 10% of all cardiac tumors, representing the most common valvular and the second most common cardiac benign tumor, following myxomas.Fibroelastomas are histologically benign, but they can result in life-threatening complications such as stroke, acute valvular dysfunction, embolism, ventricular fibrillation, and sudden death.

Methods: A valve-sparing technique with simple shave excision of the tumor was undertaken with success.

Giant fibroelastoma of the aortic valve.

Fibroelastomas account for less than 10% of all cardiac tumours, representing the most common valvular and the second most common cardiac benign tumour, following myxomas. Fibroelastomas are histologically benign; they can result in life-threatening complications such as stroke, acute valvular dysfunction, embolism, ventricular fibrillation, and sudden death. Surgical resection should be offered to all patients who have symptoms and to asymptomatic patients who have pedunculated lesions or tumors larger than 1 cm in diameter.

Tricuspid-valve repair for pacemaker leads endocarditis.

In non-addicted patients, several states, such as permanent pacemakers, can provide the predisposing factors for tricuspid-valve endocarditis. In this report, we present a case of a 66-year-old man with pacemaker lead infection and tricuspid-native-valve endocarditis, related to Staphylococcus hominis, very rare cause of infective endocarditis that carries a high-mortality risk. Surgery was indicated for the patient due to persistent enlarging vegetation on the tricuspid valve, severe tricuspid regurgitation, septic pulmonary emboli and finally uncompensated respiratory and heart failure.

A case of mistaken identity of arrhythmogenic right ventricular dysplasia in a 75-year-old patient.

We present an uncommon case of a 75-year-old woman who was admitted to our department for the evaluation of her double valvular disease that hid a diagnosis of arrhythmogenic right ventricular dysplasia (ARVD). In the course of preoperative workup, a mass of tissue substituting the right ventricular free wall was identified and documented with transthoracic echocardiography, computed tomography scanning, and nuclear magnetic resonance imaging. This pathology was not identified as ARVD.

Spontaneous left main coronary artery dissection.

Spontaneous coronary artery dissection is a rare and generally fatal disease. A review of the literature demonstrates that the aetiopathogenesis of the disease is unknown and that the histology is rarely described. It usually occurs in young women during the post-partum period or while taking oral contraceptives.