Incidental Finding of an Aspergillus Pseudoaneurysm in the Ascending Aorta of an Immunocompetent Patient.

Pseudoaneurysms of the ascending aorta are rare, yet they are life-threatening conditions and usually associated with poor outcomes due to insidious presentation. Many different etiologies have been associated with aortic pseudoaneurysms including; atherosclerosis, infections, connective tissue disorders, and traumatic causes. In addition, aortic pseudoaneurysms have been reported following thoracic surgeries, including aortic valve replacements, aortic dissection repair, and coronary artery bypass grafting.

Rare combination of bilateral divided atrial chambers and pulmonary vein stenosis with review of the literature.

The term cor triatriatum is used to describe a fibromuscular partition that divides an atrium into two compartments. It was first used by Borst in 1905, although the lesion had been described before by Church in 1868. Both described divided left atrial chamber (also referred to as cor triatriatum sinister).

Persistent left superior vena cava remnant causing cyanosis in a post-Fontan patient.

We report the successful surgical closure of a persistent left superior vena cava remnant draining into the pulmonary venous circulation causing cyanosis in a post-Fontan patient who had previously undergone Damus-Kaye-Stansel and bidirectional superior cavopulmonary connection followed by a transcatheter coil occlusion of his persistent left superior vena cava.

Primary cardiac paraganglioma with dual coronary blood supply presenting with angina chest pain.

Primary cardiac paraganglioma (pheochromocytoma) is very rare, constituting only 1% of cardiac tumours. A case of a 44-year-old woman presenting with angina chest pain and a tumour with dual blood supply from both the right and left coronary arteries is reported.

Venovenous malformation: a common finding after Kawashima operation.

Objectives: It has been reported that systemic venovenous malformation (VVM) can develop in patients with interrupted inferior vena cava (IVC) and univentricular type of congenital heart disease who undergo superior vena cava to pulmonary artery connection (Kawashima operation). These malformations can lead to profound systemic desaturation postoperatively. However, there have been few reports that characterise the prevalence, anatomic details and clinical correlations of these systemic VVM arising after Kawashima operation.

Late presenters with dextro-transposition of great arteries and intact ventricular septum: to train or not to train the left ventricle for arterial switch operation?

Objective: We report our experience in managing late presenters (older than 4 weeks) with dextro-transposition of great arteries and intact ventricular septum (d-TGA/IVS) in an effort to achieve successful arterial switch operation (ASO) in a third world setting.

Design: We retrospectively reviewed the charts of all late presenters with d-TGA/IVS. Patients were divided into two groups: left ventricular training (LVT) group and non-left ventricular training (non-LVT) group.

A unique milieu for perioperative care of adult congenital heart disease patients at a single institution.

Purpose: Adult patients with congenital heart disease presenting for cardiothoracic operation pose special demands for the arrangement of their perioperative care. This study describes the distinctive perioperative setup for adult congenital heart patients.

Materials And Methods: A retrospective review of 48 adult congenital heart disease cases that received operative intervention from July 2000 to October 2005.

Modification of Trusler's formula for the pulmonary artery banding.

Background: The major difficulty of pulmonary artery banding (PAB) is optimal intraoperative adjustment. In this study, a target intraoperative shunt ratio (Q(p)/Q(s)) was utilised to evaluate a fixed Trusler's formula for the degree of PAB of infants destined for either univentricular or biventricular surgical route.

Methods: Ten consecutive infants (median age, 1.

Impact of obesity on early outcomes after cardiac surgery: experience in a Saudi Arabian center.

Purpose: The prevalence of obesity is a public health concern in most countries, including Saudi Arabia. Obesity has been considered a major risk factor for adverse outcomes after cardiac surgery.

Materials And Methods: A single-center retrospective review (2001-2005) of adverse outcome after coronary artery bypass grafting (CABG) and valve surgery (total=462) categorized by body mass index (BMI) was performed.

Expanding the utilization of Contegra for ventricular septal defect repair.

Different patch materials have been utilized in repairing ventricular septal defect (VSD) with great success. In this report, in addition to the right ventricular outflow tract reconstruction, the VSD was repaired successfully in all cases by fashioning a patch from a segment of the Contegra xenograft conduit. The freedom from infection, thromboembolism, and reintervention during follow-up, in addition to the advantage of ready availability and cost-effectiveness offered by using the same bovine material, imply that Contegra xenograft is a promising alternative patch material for VSD repair.

Bovine valved xenograft (Contegra) conduit in the extracardiac Fontan procedure: the preliminary experience.

Objective: Constructing a competent valve using the xenograft valved conduit (Contegra) in the extracardiac Fontan connection may maintain better forward flow into the pulmonary circulation. The preliminary results and potential advantages of using the Contegra are discussed in this review.

Method: A retrospective review of 18 patients who underwent the extracardiac Fontan connection using the Contegra conduit from June 2002 to September 2005.

Propranolol: a new indication for an old drug in preventing postoperative junctional ectopic tachycardia after surgical repair of tetralogy of Fallot.

Junctional ectopic tachycardia (JET) is a major cause of postoperative morbidity after complete repair of tetralogy of Fallot (TOF). Propranolol is a known medication used in patients with TOF to prevent and control hypercyanotic spells. Despite this, there is little information regarding the relation between preoperative use of propranolol and the incidence of postoperative JET.

Concealed neo-aortic incompetence and new right ventricular outflow tract obstruction after arterial switch operation in a late presenter.

We report a 9 year old boy who presented late with cyanosis as a case of dextro-transposition of great arteries, intact ventricular septum and left ventricular outflow tract obstruction (D-TGA/IVS/LVOTO). Arterial switch operation (ASO) with resection of sub-neo aortic membrane and repair of mitral valve were done for the naturally trained LV. On the second postoperative day, the newly discovered right ventricular outflow tract obstruction (RVOTO) was relieved and mitral valve replacement (MVR) was done for significant mixed stenotic/regurgitant mitral valve disease, and intraoperative extra-corporeal membrane oxygenation (ECMO) support was instituted for pulmonary dysfunction for 4 days.

REMOVED: Newly developed right ventricular outflow tract obstruction after arterial switch operation in a late presenter.

This article has been removed, consistent with Elsevier policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).

High resolution spiral CT scan in the diagnosis of pseudoaneurysm of ascending aorta.

Pseudoaneurysms of the ascending aorta are rare (<1%), and extremely rare from aortic vent site, but can be a lifethreatening complication. The basic methods of diagnosis are computed tomography scan and aortography. We report high resolution spiral CT may provide the best less invasive means in the diagnosis of the pseudoaneurysm of the ascending aorta originated from the aortic vent site.

Repair of complete atrioventricular septal defects: results with maintenance of the coronary sinus on the right atrial side.

Background: This study was undertaken to determine that maintaining coronary sinus on the right atrial side during the surgical repair of complete atrioventricular septal defect (AVSD) does not increase the risk of postoperative complete heart block.

Methods: This is a retrospective study of 51 consecutive patients who underwent biventricular repair of complete AVSD from September 2000 to January 2005. Electrocardiograms and operative data were analyzed.

Is preoperative delineation of coronary artery pattern a prerequisite for arterial switch operation?

Objective: To determine the effect of preoperative echocardiographic delineation of coronary artery pattern on the immediate postoperative result of arterial switch procedures.

Methods: A retrospective review of a consecutive series of children who underwent the arterial switch operation at a single institution from February 2001 to December 2004.

Results: Sixty-six children underwent an arterial switch operation.

Extracorporeal membrane oxygenation support post-arterial switch procedure for a child with cystic fibrosis: case report.

This is a case report of an unusual presentation of transposition of the great arteries with a unique coronary artery pattern associated with cystic fibrosis in an infant whose management required the use of the extracorporeal life support after his arterial switch operation to ameliorate his postoperative pulmonary dysfunction.

Can the outcome of pediatric extracorporeal membrane oxygenation after cardiac surgery be predicted?

Purpose: The purpose of this study is to assess whether clinical and biochemical variables may be used to predict outcome in children treated with extracorporeal membrane oxygenation (ECMO) after cardiac surgery and to determine when to discontinue ECMO support.

Methods: We retrospectively reviewed the medical records of 26 children treated with ECMO after cardiac surgery at our institution from October 2000 to May 2004.

Results: Patients mean age was 16.

Effect of modified ultrafiltration on pulmonary function after cardiopulmonary bypass.

Background: Pulmonary dysfunction is one of the most common manifestations of inflammatory response after cardiopulmonary bypass (CPB).

Objective: This prospective randomized study was conducted to evaluate the effect of a modified ultrafiltration (MUF) technique on pulmonary function after CPB in children.

Methods: Forty patients weighing from 5 to 10 kg with congenital heart disease who required CPB for primary biventricular operative repair were prospectively randomized into two groups.

Resternotomy for a retrosternal cardiac pseudoaneurysm in a 1.5-year- old child: a case report.

Cardiac pseudoaneurysm is a contained rupture of the myocardium that can occur after cardiac surgery, chest trauma, and endocarditis. The wall of the pseudoaneurysm consists of fibrous tissue and lacks the structural elements found in a normal cardiac wall, and it is contained by the pericardial adhesions or the epicardial wall. Early surgery is recommended even for asymptomatic patients due to the propensity for rupture and fatal outcome.