Giant Circumflex Aneurysm With Arteriovenous Fistula Surgery Guided by Three-Dimensional Printing.

A giant coronary artery aneurysm is an infrequent anomaly encountered as an incidental finding. An even more rare condition is its association with a coronary artery fistula. We report the case of a 61-year-old woman that combines two of the rarest coronary anomalies: a 70-mm giant circumflex aneurysm with an arteriovenous fistula tract draining to the superior vena cava.

Dissected aberrant right subclavian artery with Kommerell diverticulum.

Aberrant right subclavian artery is the most frequent anomaly of the aortic arch, and in 60% of cases is associated with Kommerell diverticulum. It is usually asymptomatic but may present with dysphagia or asthma due to esophageal and tracheal compression. Indications for surgical repair have not been established; however, when Kommerell diverticulum is complicated by aortic dissection the treatment is surgery.

Treatment of Hepatic Embryonal Undifferentiated Sarcoma With Cardiothoracic Involvement.

Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided.

TWEAK and NT-proBNP levels predict exercise capacity in hypertrophic cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) is characterized by inappropriate hypertrophy, myocyte disarray and increased interstitial fibrosis. The tumour necrosis factor-like weak inducer of apoptosis (TWEAK) is a cell surface cytokine with biological activities including stimulation of cell growth, induction of inflammatory cytokines and stimulation of apoptosis. There are controversial data about the potential role of TWEAK in different cardiovascular pathologies.

Experience, outcomes and impact of delayed indication for video-assisted wide septal myectomy in 69 consecutive patients with hypertrophic cardiomyopathy.

Objectives: The aim of this study was to evaluate outcomes in our department after surgery for obstructive hypertrophic cardiomyopathy and to establish the impact of a delay on the indication for surgery.

Methods: From January 1998 to February 2011, 69 patients with obstructive hypertrophic cardiomyopathy and left ventricular outflow tract obstruction at rest were operated on by the same team, and followed up for at least 1 year. We retrospectively analysed clinical data, echocardiography and ambulatory Holter electrocardiogram findings before surgery, early after surgery, at 3 months and annually at follow-up, to detect possible prognostic determinants.

Left ventricular mass index as a prognostic factor in patients with severe aortic stenosis and ventricular dysfunction.

Ventricular dysfunction and high hypertrophy may influence surgical outcome in aortic stenosis. Our aim was to determine whether an excessive left ventricular mass index (LVMI) discriminates different risk profiles in aortic stenosis with low ventricular ejection fraction (LVEF). Three hundred and thirty-nine patients with severe aortic stenosis underwent valve replacement (Mar-1994 and Nov-2001).

Prognostic value of chronic obstructive pulmonary disease in coronary artery bypass grafting.

Objective: Coronary and chronic lung diseases have become a common association. This comorbidity has been generically considered by most of the operative risk scores, but its functional severity has seldom been addressed by these models. Our objective was to analyze its prognostic relevance considering preoperative pulmonary function parameters.

Patient-prosthesis mismatch in aortic valve replacement: really tolerable?

Objective: Several studies have demonstrated favorable results despite patient-prosthesis mismatch after aortic valve replacement with the use of third generation prostheses. Our aim was to determine whether this mismatch is always tolerable.

Methods: A clinical-echocardiographic study has been performed in 339 consecutive patients who underwent aortic valve replacement because of aortic stenosis.

[Ablation of permanent atrial fibrillation in cardiac surgery. Short-term and mid-term results].

Introduction: Surgical ablation of atrial fibrillation is currently a simple procedure that can be done during cardiac surgery in most patients. A number of different energy sources now available allow to easily create ablation lines in the atria. We describe our experience during the previous three years.

[Anatomic atrial remodeling after mitral valve surgery in permanent atrial fibrillation].

Background: Mitral valve pathology is frequently associated with atrial dilation and fibrillation. Mitral surgery allows immediate surgical atrial remodeling, and in those cases in which sinus rhythm is achieved, it is followed by late remodeling. The aim of this study was to investigate the process of postoperative atrial remodeling in patients with permanent atrial fibrillation who undergo mitral surgery.

Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?

Objective: Increased left ventricular mass index has been associated with higher mortality. We analyze the effect of increased left ventricular mass index on outcomes in patients undergoing aortic valve replacement.

Methods: Echocardiographic left ventricular dimensions were used to calculate left ventricular mass index in 614 patients who underwent aortic valve replacement between June 1993 and November 2001.

[Surgery ablation of atrial fibrillation with epicardial and endocardial biauricular radiofrequency: initial experience].

Background: Atrial fibrillation is frequent in surgical patients with cardiac valvulopathies. Radiofrequency energy applied by means of surgical probes permits the reproduction of atriotomies described in the maze surgical procedure for the ablation of atrial fibrillation in a fast, safe and efficient way. This study presents our initial experience in treatment of chronic atrial fibrillation through radiofrequency performed in patients with surgical cardiac valvulopathies.