Posterior pericardial annuloplasty in ischemic mitral regurgitation.

Background: Ischemic mitral regurgitation (IMR) is an important risk factor in coronary artery bypass grafting (CABG) operations. The decision to perform concomitant mitral annuloplasty along with the CABG depends on the surgeon's choice. The aim of this study was to evaluate the results of posterior annuloplasty procedures with autologous pericardium performed in patients with midadvanced and advanced functional ischemic mitral regurgitation.

Fenestration between the left atrial appendage and left superior vena cava in Kawashima operation.

The benefits of a baffle fenestration in essentially high-risk Fontan patients have been demonstrated. Described here is the use of a new fenestration between the left atrial appendage and the left superior vena cava after Kawashima operation in a patient with a double-outlet right ventricle with hypoplastic left ventricle, left atrial isomerism, bilateral superior vena cavae with no bridging vein, an interrupted inferior vena cava, and continuation of the hemiazygos vein to the left superior vena cava.

Complete transection of epicardial pacing lead during pregnancy.

Herein, we presented a case of pregnancy associated complete transection of epicardial pacing lead.

Pulmonary effects of noninvasive ventilation combined with the recruitment maneuver after cardiac surgery.

Background: The aim of our study was to evaluate the pulmonary effects of noninvasive ventilation (NIV) with or without recruitment maneuver (RM) after open heart surgery.

Methods: One-hundred patients undergoing coronary artery bypass surgery were randomized into four groups after the operation: 1) RM with sustained inflation during mechanical ventilation postoperatively (RM group, n = 25); 2) RM combined with NIV applied for 1/2-h periods every 6 h in the first postoperative day after tracheal extubation (RM-NIV group, n = 25); 3) NIV after tracheal extubation (NIV group, n = 25); and 4) a control group consisting of patients receiving neither RM nor NIV (control group, n = 25). Pulmonary function tests, oxygenation index, and atelectasis on chest radiograph were evaluated and compared among the groups.

Interventricular hydatid cyst imitating pulmonary stenosis.

Cardiac hydatid cyst is known to be a rarely occurring disease. The appearance of large cysts in the interventricular septum in childhood is even more rare. Although such cysts are usually asymptomatic, they can behave like valvular disorders, depending on their location.

Iatrogenic thrombosis on the tendinous cords of the tricuspid valve.

Iatrogenic thrombosis within the heart is rare following intracardiac operations. We undertook surgery to correct a 30-month-old girl with Fallot's tetralogy. After a period of 6 months following the operation, echocardiography revealed a thrombus measuring 16 by 12 millimetres attached to the tendinous cords supporting the antero-superior leaflet of the tricuspid valve.

Sinus of Valsalva aneurysm: surgical approaches to complicated cases.

Background: The authors herein report surgical experience with the aneurysms of sinus of Valsalva (SVA) complicated by coexisting pathologies.

Methods: Eight patients aged between 11 and 55 years underwent surgical repair of SVA. The aneurysms originated from the right coronary sinus in four patients, from the non-coronary sinus in four patients and from the left in one patient (one patient had aneurysms originating from both the left and right sinuses).

Successful repair of a large aortic abscess causing apical displacement of the anterior mitral valve.

Anatomic continuity between the anterior mitral leaflet and the aortic root may predispose those patients with aortic root pathology to functional changes of the mitral valve without any involvement of this valve. A 34-year-old man presented with aortic valve endocarditis. Transthoracic echocardiograpy showed severe aortic regurgitation with a large aortic root abscess.

Remodelling of the superior caval vein after angioplasty in an infant with superior caval vein syndrome.

An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein.

An unusual case of birdshot embolism.

There are numerous cases of arterial and venous bullet embolism to the heart. An unusual case of birdshot embolus to the right ventricle from the femoral vein caused diagnostic confusion. Distant migration of the foreign bodies via blood vessels has to be taken into consideration after gunshot wounds.

Tracheobronchial rupture: a considerable risk for young teenagers.

Tracheobronchial (TB) ruptures are ten times lower in children than in adults. Despite its rarity in the literature, we found that it is as common as in adults in our series. We investigated TB ruptures in childhood regarding age, trauma presentation, injury localization and treatment options.