Congenital absence of right coronary artery: a rare coronary anomaly: case report.

Single coronary artery is a rare congenital anomaly in which a single coronary artery arises from the aortic root that supplies the entire heart. It has variable clinical presentations ranging from a completely benign course to sudden cardiac death. Identifying and categorizing to high-risk type based on clinical presentation and anatomical features can present adverse cardiac events and provides better prognosis.

Persistent Patent Arterial Duct Rather Than a Ligament in the Setting of Diverticulum of Kommerell.

We report a rare case of persistent patent arterial duct (PDA) in the combination of diverticulum of Kommerell, aberrant left subclavian artery, and total anomalous pulmonary venous connection (TAPVC). Surgical correction of the defect was done by ligating and dividing the PDA and correcting the TAPVC. ().

Cardiac Surgery and Small Island States: A Bridge Too Far?

Background: Small island developing states (SIDS) make up nearly 1% of the world's population, with 65 million people across 58 countries. Small island developing states have some of the highest rates of rheumatic heart disease in addition to a substantial burden of congenital heart defects and a growing burden of ischemic heart disease. Here, we present an overview of cardiac surgical services in SIDS, with a focus on Papua New Guinea, the Maldives, and Aruba.

Total arterial multivessels minimal invasive direct coronary artery bypass grafting via left minithoracotomy.

Background: Minimal Invasive Direct Coronary Artery Bypass Surgery (MIDCAB) is becoming popular and an important armamentarium for cardiac surgeons. We aimed to evaluate the result of MIDCAB total arterial revascularization.

Methods: We have evaluated 216 patients who underwent MIDCAB multivessel total arterial revascularization through a left anterolateral mini thoracotomy.

Challenges and possibilities of developing cardiac surgery in a peripheral hospital of low- and middle-income countries.

Objective: Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,500-3,000 cardiac surgeries are performed annually.

Functional Magnetic Resonance Imaging in the Evaluation of the Elastic Properties of Ascending Aortic Aneurysm.

Objective: To evaluate the aortic wall elasticity using the maximal rate of systolic distension (MRSD) and maximal rate of diastolic recoil (MRDR) and their correlation with the aortic size index (ASI).

Methods: Forty-eight patients with thoracic aortic aneurysm were enrolled in this study. A standard magnetic resonance imaging (MRI) protocol was used to calculate MRSD and MRDR.

Rheumatic Heart Disease Screening Among School Children in Central Nepal.

Rheumatic heart disease is the most common heart disease in developing countries. This Global Health Report uses the results of screening 28,050 school children clinically with 2-dimensional echocardiography. A total of 1,739 students had cardiac murmur, with the most dominant lesion being rheumatic mitral regurgitation.

Relationships Between Phenotype and Function of Blood CD4+ T-Cells and Ascending Thoracic Aortic Aneurysm: an Experimental Study.

Introduction: Non-familial ascending thoracic aorta dilation and aneurysms (TAAs) are silent diseases in elderly patients. Histopathology revealed that functionally polarized infiltrating CD4+ T-cells play a key role in aortic wall weakening.

Objective: To evaluate the possible associations between phenotype and cytokine production of circulating CD4+ T-lymphocytes and the presence of TAA in patients with aortic valve disease (AVD).

Right-Sided Minithoracotomy as a Surgical Approach for the Concomitant Treatment of Atrial Fibrillation.

Background: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in humans and therefore causes a high socioeconomic burden. The Cox-Maze IV procedure is the gold standard treatment for atrial fibrillation. Minimally invasive surgery for the treatment of AF is also promising.

Aorta-to-right ventricular outflow tract fistula with coronary cusp prolapse.

We describe a rare case of aorta-to-right ventricular fistula in a 20-year-old man who presented with signs and symptoms of congestive heart failure. He was successfully treated by closing the fistula with a Dacron patch from the aortic side. At follow-up, he was asymptomatic with no left-to-right shunt.

Pulmonary artery perforation by plug anchoring system after percutaneous closure of left appendage.

Patients receiving oral anticoagulant therapy for atrial fibrillation who are at high risk of bleeding are increasingly referred for percutaneous left atrial appendage exclusion. Although effective, this procedure is not free from risk. We report a case of pericardial tamponade due to pulmonary artery tear caused by a trespassing anchoring hook of an AGA plug.

Age-dependent changes in elastic properties of thoracic aorta evaluated by magnetic resonance in normal subjects.

Objectives: Aortic stiffness is an independent cardiovascular risk factor. Cardiac magnetic resonance (CMR) allows evaluation of aortic elastic properties by different indexes such as distensibility, the maximum rate of systolic distension (MRSD) and pulse wave velocity (PWV). We sought to define age-dependent changes of indexes of elastic properties of the thoracic aorta in healthy subjects.

Might type A acute dissection repair with the addition of a frozen elephant trunk improve long-term survival compared to standard repair?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with an acute type A dissection (TAAD) is a frozen elephant trunk in addition to standard aortic dissection repair advantageous in terms of improved long-term mortality and closure of the distal false lumen? Altogether more than 138 papers were found using the reported search, of which six represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Which cannulation (ascending aortic cannulation or peripheral arterial cannulation) is better for acute type A aortic dissection surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Which cannulation (ascending aortic cannulation or peripheral arterial cannulation) is better for acute type A aortic dissection surgery?' Altogether 393 papers were found using the reported search, of which 14 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Multiple recurrent periprosthetic leak after a mitral valve replacement in a 30-year-old man.

Partial detachment of intracardiac prosthesis is a common reality in cardiac surgical practice. Its identification and surgical correction can be very crucial for a patient, as well as for the surgeon. In this paper, we report a case of a 30-year-old man with partial detachment of mechanical mitral valve prosthesis.

Minimally invasive mitral valve surgery through right thoracotomy in patients with patent coronary artery bypass grafts.

We report our institutional experience, with 25 consecutive patients with patent coronary artery bypass grafts (71.8+/-12.7 years), who underwent video-assisted minithoracotomic approach for mitral valve surgery.