A Simple Approach for Minimally Invasive Combined Aortic and Mitral Valve Surgery.

Background:  There is now extension of minimally invasive techniques to involve concomitantly aortic and mitral valves through a single small incision. We share our experience in such surgeries through upper partial sternotomy with approaching the mitral valve through the dome of the left atrium.

Methods:  Two matched groups of cases receiving concomitant aortic and mitral valve surgeries are compared regarding the surgical outcomes: the minimally invasive group (group A) including 72 patients and the conventional group (group B) including 78 patients.

N-Terminal Pro-B-Type Natriuretic Peptide as a Predictor of Adverse Outcomes After Off-Pump Coronary Artery Bypass Surgery: A Prospective Study.

Background: The strength of association between preoperative natriuretic peptide levels and adverse outcomes after cardiac surgery recently has been studied in different research, but results still are diversely variable.

Methods: Sixty-five consecutive patients undergoing elective off-pump coronary artery bypass grafting prospectively were recruited. Preoperative levels of NTproBNP were measured in venous blood samples collected before induction of anesthesia.

Minimally invasive coronary artery bypass grafting via a lower ministernotomy for left anterior descending artery myocardial bridging: mid-term results.

Objectives: Coronary artery bypass grafting or supra-arterial myotomy is now suggested as a better therapeutic option in myocardial bridging (MB) when medical treatment fails to control symptoms. For left anterior descending (LAD) MB, minimally invasive coronary artery bypass via a lower ministernotomy can be offered.

Methods: Forty-four consecutive patients who underwent elective minimally invasive coronary artery bypass surgery from 2005 to 2014 via an inferior sternotomy using the left internal mammary artery as a bypass graft for LAD MB were evaluated retrospectively.

The Warden procedure for partial anomalous pulmonary venous connection in children: 10 years experience in 65 cases.

Introduction: In this study, we share our experience in the Warden procedure for the repair of partial anomalous pulmonary venous connections (PAPVCs) draining high in the superior caval vein in 65 cases of the paediatric age group over a period of 10 years.

Patients And Methods: In total, 65 patients receiving the Warden procedure for the repair of high PAPVCs (draining above the cavoatrial junction) over a period of 10 years starting from January, 2010 to January, 2020 were included in this study.

Results: In total, 34 were males (52.

Results of Coronary Artery Bypass Grafting Alone Versus Combined Surgical Revascularization and Mitral Repair In Patients with Moderate Ischemic Mitral Regurgitation.

Background: This is a prospective randomized-controlled study done to evaluate the best surgical option for moderate ischemic mitral regurgitation through either coronary artery bypass grafting only or by performing additional mitral repair.

Methods: Over a nine-month period, 60 patients with ischemic heart disease associated with moderate ischemic mitral regurgitation were equally divided into two groups. Group 1 included 30 patients who had coronary artery bypass grafting with mitral valve repair; Group 2 included 30 patients who had only coronary artery bypass grafting.

Mitral valve replacement in mitral stenosis; the problem of small left ventricle.

Background: Mitral valve stenosis in adults especially due to rheumatic heart disease may be associated with a smaller than normal left ventricular cavity. Mitral valve replacement in such cases may lead to hemodynamic instability either during weaning from cardiopulmonary bypass or in the early postoperative period manifested by the need for inotropic support and even mortality due to low cardiac output syndrome.

Patients And Methods: 184 patients with predominately severe stenotic mitral valves who underwent elective isolated mitral valve replacement in the period between January 2012 and January 2018 at our hospital were included in this study.

Ring, Band or Suture in Tricuspid Annuloplasty for Functional Tricuspid Regurgitation; Which is Better and More Durable?

Background: In this study, we evaluate different annuloplasty modalities to repair functional tricuspid regurgitation.

Patients And Methods: Between January 2011 and January 2017, 200 patients with moderate or greater functional tricuspid regurgitation received tricuspid valve repair as part of primary surgeries on the left side of their cardiac valves. Of these, 39 patients received rings (Group A), 84 patients received bands (Group B), and 77 patients received suture annuloplasty (Group C).

Rescue Cardiac Surgeries After Pediatric Catheter-Based Interventions: A Ten-Year Retrospective Study.

Background: Catheter-based interventions for treating congenital cardiac defects have gained wide acceptance as they reduce the risks associated with surgery. However, these procedures are associated with some complications, such as the embolization of devices or stents and the injury of surrounding structures, which might need a rescue surgical intervention.

Methods: Data from 25 patients who needed rescue surgery following interventional catheterization between January 2008 and January 2018 were retrospectively collected and statistically analyzed to review the decision and timing of surgery as well as the surgical techniques and results.

Predictors of In-Hospital Mortality in Isolated Total Anomalous Pulmonary Venous Connection.

Background: We assessed risk factors for early mortality in isolated total anomalous pulmonary venous connection over a modern era excluding emergent cases to eliminate the influence of associated factors on surgical outcome.  Methods: 70 patients with isolated total anomalous pulmonary venous connection who were repaired electively between January 2013 and February 2018 were included.

Results: In-hospital mortality was encountered in 4 patients (5.

Iatrogenic diaphragmatic hernia after pulmonary artery banding operation through median sternotomy.

Diaphragmatic hernias following cardiac surgeries in general are being reported after coronary artery bypass grafting using the right gastro-epiploic artery as a conduit as well as in patients with ventricular assist devices, orthotopic heart transplants, or subxiphoid epicardial pacemakers. We report a case of an iatrogenic diaphragmatic hernia following pulmonary artery banding operation through median sternotomy which was discovered 4 years later during the debanding and ventricular septal defect closure operation. The diaphragm was most likely injured during insertion of the retro-sternal tube during the first operation.

Predictors of surgical outcome in isolated prosthetic mitral valve endocarditis.

Background Most previous studies dealing with predictors of surgical outcome in prosthetic valve endocarditis included patients with aortic and/or mitral valve prostheses. Here, we concentrate on isolated prosthetic mitral endocarditis due to heterogeneity of epidemiological data, anatomical factors, and surgical techniques between mitral, prosthetic mitral, and aortic endocarditis between prosthetic mitral and prosthetic aortic endocarditis. Methods Data of 40 patients reoperated upon due to isolated prosthetic mitral endocarditis between July 2015 and March 2017 were retrospectively collected and analyzed.

Removal of an endometrioid stromal sarcoma from the inferior vena cava and right atrium.

Entometrioid stromal sarcomas are seen in extra-uterine as well as extra-gonadal sites and have a strong association with endometriosis. Although having better prognosis than other sarcomas, yet these tumors may relapse (whether local or distant) in up to 56% of cases, even as late as 20 years after surgery. We report a case of a 30-year-old female patient with a mass in the inferior vena cava and right atrium which was surgically removed using cardiopulmonary bypass and deep hypothermic circulatory arrest and turned to be an entometrioid stromal sarcoma.

Repair of Morgagni hernia and ventricular septal defect through sternotomy.

We report a case of Morgagni hernia occupying the anterior mediastinum and right hemithorax in a male infant with Down syndrome, who also had a perimembranous ventricular septal defect. Through a median sternotomy, the hernia sac was freed from the right pleura, and the pericardium was opened to reduce its contents (colon) into the abdomen. The diaphragmatic defect was closed with Prolene mesh and the hernia sac was used to reinforce the diaphragmatic defect.

Predictors of Surgical Outcome in Isolated Tricuspid Valve Endocarditis: Single Center Experience of 60 Patients.

Background: Tricuspid valve (TV) endocarditis may be associated with serious complications, and 25% of patients require surgical intervention. However, indications and outcomes of surgery are not clearly identified. In this study, 60 patients are retrospectively reviewed to determine preoperative predictors of surgical outcome.