Protective effects of angiotensin II type-1 receptor blockade with olmesartan on spinal cord ischemia-reperfusion injury: an experimental study on rats.

Background: Spinal cord injury is a major complication of thoracoabdominal aortic operations. We aimed to investigate neuroprotective role of olmesartan administered to rats before ischemia against ischemia-reperfusion (I-R) injury.

Methods: Twenty-four Wistar albino rats were randomly divided into three groups (n = 8 per group): group I (control group, the sham-operation group), group II (the I-R group undergoing aortic occlusion without pharmacologic treatment), and group III (olmesartan-treated group receiving 3 mg/kg/d olmesartan for 14 days before ischemia).

Hemorrhage into a pericardial cyst and associated right ventricular compression after blunt chest trauma.

Hemorrhage into a pericardial cyst is an extremely rare event after blunt chest injury and may lead to compression of cardiac chambers. Most pericardial cysts develop adjacent to the sternum, at the right or left cardiophrenic angle; therefore a direct blow to the chest may be associated with hemorrhage into a pericardial cyst. Surgical resection is reasonable because hemorrhagic content of cysts may cause failure of percutaneous interventions.

Detachment of an annular patch following the Manougian procedure.

Detachment of the prosthetic patch material is a rare complication in the early postoperative period following a Manougian's procedure. We present the case of a young adult presenting with significant mitral regurgitation associated with a defect in the anterior mitral leaflet early after an uneventful Manougian's procedure performed with a prosthetic patch.

Endocardial fibroelastosis of the right ventricle and tricuspid valve in a young adult with Behcet's disease.

Endocardial fibroelastosis is characterized by massive proliferation of collagenous and elastic tissue, in which the pathological process is restricted to the endocardium. In this report, we present the case of a 20-year-old man with Behcet's disease and endocardial fibroelastosis of the right ventricle involving tricuspid valve resulting in a tumor mass that was resected along with tricuspid valve replacement. The clinical and pathological features of this rare entity are reviewed.

Reinfusion of blood within aneurysm sac: a simple method of intraoperative blood conservation in elective abdominal aortic surgery.

Autologous blood conservation reduces postoperative morbidity and mortality. In elective abdominal aortic aneurysm repair, the blood within the aneurysm sac is generally neglected during surgery. We present a simple method of additional blood conservation in elective abdominal aortic surgery, which involves reinfusion of autologous blood within the aneurysm sac in the perioperative period.

Bilateral renal artery occlusion due to intraoperative retrograde migration of an abdominal aortic aneurysm endograft.

Retrograde (proximal) migration of an abdominal aortic aneurysm endograft is an extremely rare event during endovascular insertion and may lead to occlusion of the bilateral renal arteries and dialysis-dependent renal failure. This case report describes the intraoperative retrograde migration of a bifurcated abdominal aortic endograft during the initial endovascular procedure after deployment of an extender limb graft into the right iliac artery and associated bilateral renal artery occlusion. This was treated with renal artery bypass, and the patient had a favorable outcome.

Posterior root enlargement for aortic valve replacement associated with unexpected anomalous right coronary artery.

Anomalous right coronary artery (ARCA) generally follows a course between the aorta and pulmonary artery. When ARCA follows a course posterolateral to the aortic root behind the noncoronary sinus of Valsalva, the vessel can be at risk of injury during posterior aortic root enlargement. We present the case of a 21-year-old man with congenital aortic stenosis and small aortic root, who had an intraoperative diagnosis of ARCA.

Combined surgical approach to multiple giant coronary artery aneurysms.

Multiple giant coronary artery aneurysms are rare but can develop in the presence of an underlying atherosclerotic vessel disease. Nevertheless, there is no consensus on the ideal surgical treatment or on operative procedures, including aneurysm resection, ligation, distal bypass, and graft interposition. We present the case of a 72-year-old woman with a history of multiple arterial aneurysms who was admitted to the emergency clinic with sudden-onset chest pain and dyspnea.

Pulmonary vascular protective mechanisms in adult patients with an isolated large ventricular septal defect: a 21-year experience.

Background: Ventricular septal defects (VSDs) are one of the most common congenital heart defects in adults. In adult patients with an anatomically large VSD and relatively preserved pulmonary vascular system, several pulmonary flow-limiting cardiac morphologic alterations (PFMA) are encountered.

Patients: Ninety-eight male patients (mean age 22.

Free-floating tumor thrombus in the left atrium associated with non-small cell lung cancer.

A free-floating tumor thrombus in the left atrium is an unusual metastasis of non-small cell lung cancer. Surgical resection of free-floating tumor thrombus prior to adjuvant therapy relieves cardiac symptoms such as exertional dyspnea, and prevents life-threatening complications including systemic embolization, mitral obstruction, or sudden death.

Stentless bioprosthesis provided excellent hemodynamic performance in a military scuba diver with infective endocarditis.

Infective endocarditis is a diagnostic and therapeutic challenge that ultimately requires surgical intervention in 20% of all cases. Surgical treatment of active infective endocarditis requires not only hemodynamic repair, but also special emphasis on the eradiation of the infectious focus to prevent recurrence. This goal can be achieved by the combination of aggressive debridement of infective tissue and appropriate and adequate antibiotic treatment.

Resection of intrapericardial hibernoma associated with constrictive pericarditis.

Hibernoma is a benign soft-tissue tumor, which arises from the remnants of fetal brown adipose tissue. Out of less than 300 cases of hibernoma described to date, pericardial sac is an unusual localization to develop. When the tumor increases in size, this benign pathology can lead to compression of cardiac chambers and cause life-threatening complications in an asymptomatic patient.

Iliac arterial intussusception from an aortic endoclamp catheter.

Minimally invasive cardiac surgical procedures are gaining widespread acceptance with the advent and development of the femoral route for cardiopulmonary bypass. Aortic endoclamps are widely used and are one of the most important parts of these surgical techniques. This report presents iliac arterial intussusception from an aortic endoclamp catheter, which is a very rare complication with this type of device.

Interrupted aortic arch associated with aortopulmonary window in a 20 year-old young adult.

Interrupted aortic arch (IAA) and aortopulmonary window (APW) are rare but well-described congenital malformations. However, coexistence of these anomalies in young adults is an unusual event. Patients rarely reach adulthood without surgical correction in the neonatal period.

Left main coronary artery and supravalvular aortic stenosis in adult: treatment with ostial patchplasty and modified Brom procedure.

Left main coronary artery (LMCA) stenosis accompanying to supravalvular aortic stenosis is a very uncommon, serious congenital abnormality. Aortic valve leaflet fusions and intimal thickening of the aortic valve leaflets and coronary artery are the underlying pathologies for the LMCA stenosis. We operated on a 21-year-old male patient for supravalvar aortic stenosis with LMCA ostial stenosis.

Left sinus of valsalva aneurysm in an adult with congenital unicuspid aortic valve.

Unicuspid aortic valve (UAV) is rare, but well-described congenital malformation in adults. Although aortic root and ascending aortic aneurysms can develop in unicommissural UAV, coexistence with left sinus of Valsalva aneurysm is an unusual event. Surgical correction is necessary to relieve left ventricular outflow tract obstruction associated with aortic stenosis in unicuspid aortic valve, and to decrease the substantial risk of impending rupture of sinus of Valsalva aneurysm.

Posterior pericardial ascending-to-descending aortic bypass through median sternotomy.

Background And Aim: Adult patients with complex forms of descending aortic disease remain a surgical challenge and have a high risk of postoperative mortality and morbidity. Surgical management may be complicated when there is an associated cardiac defect, necessitating repair, or a hostile anatomy exists. We present our experience with extra-anatomic bypass through posterior pericardial route at the same stage with intracardiac/ascending aortic aneurysm repair.

An alternative patch repair technique during valve replacement for native valve endocarditis.

A patient with native valve endocarditis and vegetation on anterior mitral leaflet underwent aortic valve replacement with preservation of aortic noncoronary leaflet as a patch over the inflamed intervalvular fibrous body. This technique may minimize prosthetic material use, which is the most important risk factor for reinfection.

Mitral valve replacement with bileaflet preservation for complex annular calcification.

Extensive calcification of mitral apparatus may preclude optimal valve repair, thus requiring debridement. We performed mitral valve replacement in a 55-year-old woman with a modified bileaflet preservation technique to avoid complications related to extensive debridement. Posterior transposition of the anterior leaflet as a buttress over the posterior ventricular wall provided extra support for the weakened tissues and covered the decalcified areas, which protected against debris embolism.

Coarctation of the aorta associated with left subclavian artery aneurysm: a case report.

Aneurysm of the left subclavian artery (LSA) in association with coarctation of the aorta (CoAo) is a rare phenomenon, especially in the younger population. A 19-year-old male patient was admitted for lower extremity varices and diagnosed to have severe CoAo and a 45-mm LSA aneurysm after digital subtraction angiography following detection of nonpalpable lower extremity pulses on physical examination. Corrective surgery was performed from a left posterolateral thoracotomy through the 4th intercostal space, and a discrete ring-like coarctation tissue was observed in the aorta just below the level of the LSA orifice.