Percutaneous femoral venoarterial ECMO decannulation at the bedside using the Manta vascular closure device.

A case of peripheral venoarterial extracorporeal membrane oxygenation decannulation using the Teleflex Manta vascular closure device is presented.

Postangioplasty aneurysm of right coronary artery.

Background: Coronary artery aneurysms are an uncommon disease whose incidence ranges from 0.3% to 5.3%.

Pericardiectomy for constrictive pericarditis.

Chronic constrictive pericarditis results from inflammation and fibrosis of the pericardium. This situation eventually leads to impairment of diastolic filling and right heart failure. Once the diagnosis is made, because the disease is basically irreversible, a pericardiectomy is the mandatory treatment.

Cardiac tamponade caused by a migrating sewing needle.

: Penetrating injuries of the heart caused by migrating needles have been rarely described. They usually occur accidentally or are self-inflicted in the setting of an underlying psychiatric disorder. We present an unusual case of cardiac tamponade caused by a sewing needle that migrated to the heart from the chest wall through the lung.

Levosimendan may improve weaning outcomes in venoarterial ECMO patients.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides temporary mechanical circulatory support in patients with refractory cardiogenic shock, allowing time for cardiac recovery. Levosimendan is a calcium sensitizer with inotropic and vasodilatory effects used in the treatment of severe heart failure. It does not increase myocardial oxygen consumption.

[Case report of a patient on extracorporeal memebrane oyxgenation for cardiogenic shock not suitable for weaning in a peripheral center. Just a "problem" or is it feasible a treatment before patient transfer to a Hub center?].

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is the treatment of choice for cardiogenic shock unresponsive to inotropes or intra-aortic balloon pumping. It provides a temporary mechanical circulatory support and blood oxygenation allowing time for cardiac recovery. If this is not the case, the patient may become suitable for heart transplantation or left ventricular assist device (LVAD) implantation and must be transferred to a referral center.

[Single cardiac metastasis from colorectal cancer: an unusual localization].

Metastasis to the heart from malignancy is a frequent but underestimated event. Tumors that are located in the mediastinum, such as pleural mesothelioma, are more frequently associated with cardiac colonization. Few reports have described metastasis from colon adenocarcinoma, which usually colonizes liver and lungs.

[Rare endocarditis due to Abiotrophia defectiva. Case report and literature review].

Endocarditis by Abiotrophia defectiva is rare but associated with high rates of complications and mortality. The microbiological identification is challenging. Two cases without preexisting valvulopathy and one case with mitral-aortic involvement are described in the literature.

Obstruction of the tricuspid valve orifice by a huge right atrial myxoma associated with the Carney complex: a case report.

Carney complex (CNC) is an inherited autosomal dominant disorder associated with multiple neoplasms. Myxomas associated with CNC differ from their sporadic forms because the former usually develop at a younger age and they may be multicentric and have a tendency to recur. Furthermore, their localization may be atypical.

Is lower limb venous drainage during peripheral extracorporeal membrane oxygenation necessary?

Extracorporeal membrane oxygenation (ECMO) is becoming a gold standard in acute heart failure, not responsive to inotrops and intra-aortic balloon contrapulsation. This diffusion is due to the possibility to implant it through peripheral cannulation and to perform long-time assistance. Nevertheless, this technique implies some problems concerning inferior limb perfusion.

Postinfarction septal dissection and rupture evolved as an inferobasal pseudoaneurysm: a specific anatomical pattern.

In rare cases of posterior myocardial infarction, septal rupture is the consequence of a dissecting interventricular hematoma that evolves as a fibrotic septal chamber with two separate communications, towards left and right ventricle. This unusual anatomical pattern is generally unsuspected and described as a normal interventricular defect associated with a basal left ventricular aneurysm or pseudoaneurysm. We present a case where echocardiography and ventricular angiography did not detect this situation.

Repair of posterior left ventricular aneurysm through transatrial approach.

Repair of posterior left ventricular ischemic aneurysms implies an extracardiac approach to reshape the ventricular geometry frequently associated with mitral surgery. A transatrial technique was described for lesions following mitral surgery or for subvalvular idiopathic cases. A transmitral approach was used for ischemic or traumatic pseudoaneurysm.

Off-pump technique: a systematic alternative for myocardial revascularization?

Objective: Many studies failed to show that off-pump myocardial revascularization achieved better results than on-pump revascularization, and also invited a lot of criticism for the criteria used for selection and inclusion of patients. To avoid these limitations, we systematically treated all candidates for coronary surgery with this technique evaluating early and follow-up results.

Methods: In 257 prospective consecutive patients, off-pump myocardial revascularization was performed by the same surgeon without any exclusion criteria.

An unusual left ventricular outflow pseudoaneurysm: usefulness of echocardiography and multidetector computed tomography for surgical repair.

Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures.

Short-term hemodynamic performance of the Sorin Freedom SOLO stentless valve.

Background And Aim Of The Study: The new Sorin Freedom SOLO pericardial stentless valve is designed for supra-annular implantation, and requires only one running suture. It can be implanted with a short cross-clamp time, and is designed to offer the same hemodynamic advantages of other stentless valves. The study aim was to evaluate the prospective postoperative and two-month follow up hemodynamic performance of this bioprosthesis.

Surgical treatment of ascending aorta and innominate artery trunk aneurysm with displaced brachiocephalic vessels.

The surgical treatment of ascending aortic and arch aneurysms, even though technically complex and requiring care to avoid neurological sequelae, is well established. Nevertheless, the presence of a significant innominate artery trunk aneurysm implies an adaptation of the surgical options available. We report a case of an aortic aneurysm that involved the ascending aorta, the proximal transverse arch and the brachiocephalic trunk with cranial displacement of the right subclavian and common carotid arteries.

Cyanosis in atrial septal defect without pulmonary hypertension: a case of platypnea-orthodeoxya syndrome.

Cyanosis in atrial septal defect typically occurs when pulmonary hypertension develops. Platypnea-orthodeoxya is an uncommon syndrome, still under debate, characterized by breathlessness and arterial oxygen desaturation exacerbated in the upright position. An interatrial communication is a common finding in this syndrome, but the absence of a right to left pressure gradient complicates the physiopathological picture.

[Validation of a new scoring system to predict the risk of postoperative acute renal failure in cardiac surgery].

Background: The aim of this study was to cross validate a new scoring system, based on preoperative risk factors, in predicting the risk of postoperative dialysis after cardiac surgery and recently proposed by Thakar et al.

Methods: Between January 2003 and March 2006, 1642 consecutive patients underwent cardiac surgery. From our clinical database, using Thakar's method, we calculated the total score for each patient.

Aortic valve repair after blunt chest trauma: repair of traumatic aortic valve rupture.

A frequent reason of admission to the emergency room is blunt chest trauma following car accidents. Chest injuries may cause a wide range of cardiac lesions, extending from myocardial contusion, to heart or great vessels rupture, to valvular lesions. We present a case of aortic valve rupture after blunt chest trauma.

Triangular resection and folding of posterior leaflet for mitral valve repair.

The conventional treatment of mitral insufficiency, due to posterior leaflet prolapse, is quadrangular resection. This technique sacrifices a great amount of valve tissue resulting in leaflet stiffness and altered annular geometry. To avoid such problems we performed a small triangular leaflet resection sparing the second-order chordae, a folding plasty, implantation of artificial chordae, and annuloplasty.

[Risk evaluation in coronary surgery: a single center experience using the EuroSCORE].

Background: One of the most utilized systems for risk stratification in cardiac surgery is the EuroSCORE. It considers some risk factors that should influence the surgical risk. The aim of this study was to evaluate if our results, related to isolated coronary artery bypass surgery, are well predictable by this system and which are the parameters statistically significant for hospital mortality.