Minimally Invasive Valvular Surgery in the Elderly - Safety, Early Recovery, and Long-Term Outcomes.

Background: For elderly people, the benefit of minimally invasive cardiac surgery (MICS) is unclear, so we evaluated the safety, recovery, and long-term survival in elderly MICS patients.

Methods and results: 63 propensity score-matched pairs of 213 consecutive patients (≥70 years old) who underwent mitral and/or tricuspid valve surgery between 2010 and 2020 (121 right mini-thoracotomies vs. 92 full sternotomies) were compared.

Afebrile Pannus-Induced Blood Culture-Negative Mechanical Valve Endocarditis.

The diagnosis of prosthetic valve endocarditis may be challenging in patients with an atypical clinical presentation. Virtually all infections associated with mechanical prosthetic valves are localized to the prosthesis-tissue junction at the sewing ring and are accompanied by tissue destruction around the prosthesis. Because the orifice of the mechanical prosthetic valve is made of metal and pyrolytic carbon, which do not enable the adherence of microorganisms, any vegetation originating from the interior of the valve orifice is usually rare.

Long-Term Quality of Life after Cardiac and Thoracic Aortic Surgery for Very Elderly Patients 85 Years or Older.

Purpose: We evaluated the outcomes of open heart surgery and long-term quality of life for patients 85 years and older.

Methods: We enrolled 46 patients 85 years and older who underwent cardiac and thoracic aortic surgery between May 1999 and November 2012. Long-term assessment was performed for 43 patients; three patients who died in the hospital were excluded.

Swinging Calcified Amorphous Tumors With Related Mitral Annular Calcification.

Among cardiac calcified amorphous tumors, the mitral annular calcification-related calcified amorphous tumor is extremely rare. We herein describe 3 surgical cases of swinging calcified amorphous tumor with related mitral annular calcification. The clinical, echocardiographic, and pathophysiologic features are reported here together with a brief review of the literature.

A right thoracotomy approach for mitral and tricuspid valve surgery in patients with previous standard sternotomy: comparison with a re-sternotomy approach.

Background: To compare the outcomes of mitral and/or tricuspid valve surgery in patients with previous sternotomy between those who underwent a right thoracotomy and those who underwent re-sternotomy.

Methods: Between October 2009 and May 2015, eighteen patients underwent a right thoracotomy (R group) and 28 underwent re-sternotomy (re-S group). The right thoracotomy was prioritized for previous coronary artery bypass grafting.

Technical aspects of mitral valve repair in Barlow's valve with prolapse of both leaflets: triangular resection for excess tissue, sophisticated chordal replacement, and their combination (the restoration technique).

Background: Histological degeneration in Barlow's valve mainly starts in the rough zone, frequently expands toward the chordae, and advances to the clear zone, resulting in a saccular aneurysm-like morphology in the prolapsed region. On this basis, we have repaired the prolapsed segment by triangular resection, chordal replacement and the combination (the restoration technique). The aim of this study was to report our initial findings and evaluate the efficacy of our technique.

Free-floating left atrial ball thrombus after mitral valve replacement with patent coronary artery bypass grafts: successful removal by a right minithoracotomy approach without aortic cross-clamp.

A free-floating thrombus in the left atrium without attachment to either the atrial wall or the mitral valve is extremely rare. We describe a case in a 79-year-old woman with chronic atrial fibrillation and a recent stroke who had undergone mitral valve replacement 25 years previously and coronary artery bypass grafting 5 years previously. Redo cardiac surgery represents a clinical challenge due to a higher rate of peri-operative morbidity and mortality.

Asymptomatic and isolated accessory mitral valve tissue in an adult.

Accessory mitral valve (AMV) tissue is a congenital anomaly that occurs in association with other congenital anomalies, and is an uncommon cause of left ventricular outflow tract obstruction. It is usually detected in early childhood when accompanied by symptoms of obstruction of the left ventricular outflow tract, and is rarely diagnosed in adults. We present a case of a 53-year-old man who was referred to our institution for evaluation of a systolic heart murmur.

Deep vein thrombosis associated with iliac lymph node metastasis of an unknown primary tumor: report of a case.

Secondary deep vein thrombosis associated with iliac lymph node metastasis of an unknown primary tumor has not been previously reported. The patient was a 57-year-old male with persistent right leg edema. Computed tomography demonstrated a mass surrounding the right external iliac vessels, and deep vein thrombosis in the right external iliac and femoral veins.

Delayed closure technique using the ventral hernia repair prosthesis for a ruptured abdominal aortic aneurysm: report of a case.

In spite of modern advances in medical care, the operative mortality of ruptured abdominal aortic aneurysm remains high at 40%-50%. Multiple organ failure is one of the reasons for the high mortality rates. An acute increase in intra-abdominal pressure and abdominal compartment syndrome are common causes of multiple organ failure.

Surgical embolectomy of a floating right heart thrombus and acute massive pulmonary embolism: report of a case.

Right heart thrombus represents a mobilized deep venous thrombosis that is lodged temporarily in the right atrium and ventricle, and is often referred to as "emboli in transit." Floating right heart thrombus is an uncommon but life-threatening condition, and usually coexists with an already massive pulmonary embolism. The presence of floating right heart thrombus appears to substantially increase the risk of mortality compared to the presence of pulmonary embolism alone.

Mitral valve repair during acute phase infective endocarditis with extensive destruction of the anterior leaflet rough zone and cerebral infarction.

Some reports suggest that mitral valve repair has good outcomes and may, therefore, be the preferred surgical approach in patients with active infective endocarditis (Doukas et al. in Heart 92(3):361-363, 2006); Ruttmann et al. in J Thorac Cardiovasc Surg 130(3):765-771, 2005; Sternik et al.

Multicenter trial of carperitide in patients with renal dysfunction undergoing cardiovascular surgery.

Purpose: The aim of this study was to evaluate the efficacy of carperitide in maintaining renal function during intraoperative and postoperative management of patients with renal dysfunction undergoing elective cardiovascular surgery.

Methods: The subjects were 88 patients with a preoperative serum creatinine level ≥1.2 mg/dl who underwent elective cardiovascular surgery using cardiopulmonary bypass.

Intermittent coronary artery occlusion caused by a floating thrombus in the left coronary sinus of valsalva of a patient with a normal aorta and protein C deficiency.

A floating thrombus in the ascending aorta is an uncommon source of embolism. We report a case in which a floating mass in the left coronary sinus of Valsalva caused intermittent left main coronary trunk occlusion, leading to myocardial ischemia and cardiogenic shock. The mass was surgically resected.

A case of pulmonary infective endarteritis associated with patent ductus arteriosus: surgical closure under circulatory arrest.

A 35-year-old man was admitted to the hospital with prolonged high-grade fever. Chest computed tomography revealed multiple pulmonary infiltrations in both lungs, suggesting septic emboli. Echocardiography revealed patent ductus arteriosus and mobile large vegetations in the pulmonary artery.

Ten years experience of aortic root replacement using a modified bentall procedure with a carrel patch and inclusion technique.

Objective: A modified Bentall procedure with a Carrel patch and inclusion technique (Modified Bentall Procedure) has been used to treat combined disease of the aortic valve and aortic root. The current study examined the outcomes of this surgical technique.

Materials And Methods: Between April 1999 and March 2009, 16 patients (10 males, 6 females; 63.

Double patch technique for closing acute ventricular septal perforation.

Purpose: Ventricular septal perforation (VSP) is a rare but life-threatening complication of acute myocardial infarction (AMI). Even with assisted circulation heart failure often progresses quickly, and urgent surgical intervention is required to close the VSP. For several years, we have been performing a double patch closure technique using an equine pericardial patch.

Seven-year results of endovascular aneurysm repairs of abdominal aortic aneurysms with custom-made stent grafts.

Background: The purpose of this study was to determine the long-term results of a 7-year follow-up of endovascular aneurysm repairs (EVARs) of abdominal aortic aneurysms (AAAs) using custom-made stent grafts (SGs).

Methods And Results: We performed a retrospective review of 17 patients (14 males, 3 females; mean age: 74.3 +/- 7.