Protective effect of ambroxol on pulmonary function after cardiopulmonary bypass.

Background: To evaluate whether ambroxol administered orally during the perioperative period has a protective effect against postoperative pulmonary dysfunction in on-pump coronary artery bypass surgery.

Methods: Fifty younger patients without known pulmonary disease were randomly assigned into 2 groups. In ambroxol group (n = 25), patients were given ambroxol for a week before and after the elective coronary artery bypass grafting.

Circulating CD4+CD25+ T cells in rheumatic mitral stenosis.

Background And Aim Of The Study: Autoimmunity plays an essential role in the pathogenesis of rheumatic heart disease. Although the ongoing rheumatic process has been demonstrated with high levels of inflammatory markers, the cellular mechanism(s) of autoimmunity have not yet been investigated. The study aim was to examine levels of circulating CD4+CD25+ T cells in patients with rheumatic mitral stenosis, and to evaluate the relationship between regulatory CD4+CD25+ T-cell count and clinical and echocardiographic measures.

A rare cause of sudden vision loss in a young male: papillary fibroelastoma of the aortic valve.

Cardiac papillary fibroelastoma (CPF) is a rare cardiac neoplasm predominantly affecting the cardiac valves. Although it is most commonly an incidental finding, it can result in life-threatening complications, such as coronary and cerebral embolism, acute valvular dysfunction, and sudden death. In this report, we describe a case of a patient with aortic valve papillary fibroelastoma, which presented with sudden vision loss due to branch retinal artery occlusion.

QT dispersion significantly increases after implantable cardioverter-defibrillator shocks.

Objective: To determine whether QT dispersion (QTd), a noninvasive electrocardiographic parameter of ventricular tachyarrhythmia risk assessment, is changed by implantable cardioverter-defibrillator (ICD) shocks delivered during implantation process, to analyze the duration of these changes, and to further evaluate the effect of amiodarone on these parameters.

Methods: Twenty-six consecutive patients who are scheduled to undergo ICD implantation for aborted sudden cardiac death or documented symptomatic sustained ventricular tachycardia were enrolled into the study. A simultaneous 12-lead electrocardiogram (ECG) was recorded after the ICD implantation just before starting the testing shock when the patients were under general anesthesia (baseline record) and at 1st, 5th, 10th, 15th, 20th, 25th, and 30th minutes after the successful shocks.

Double right coronary artery arising from the left main stem and right coronary sinus associated with ventricular septal defect in an adult: an extremely rare case.

Anomalies of the coronary arteries are often asymptomatic and uncommon in general population. In this report we describe a case of a 48-year-old male patient with ventricular septal defect and double right coronary artery originating from the left main coronary artery and the right coronary sinus.

Comparison of the electrocardiographic features of complete left bundle branch block in patients with ischemic and nonischemic left ventricular dysfunction.

Background: Differentiating ischemic (ILVD) from nonischemic left ventricular dysfunction (NILVD) is important prognostically and therapeutically but might be difficult clinically. The differentiating role of electrocardiographic (ECG) features in the presence of left bundle-branch block (LBBB) is debatable on differentiating ILVD from NILVD.

Objective: The present study assessed whether there is the role of certain ECG features in differentiating ILVD from NILVD in the presence of the complete LBBB.

Clinical features of isolated ventricular noncompaction in adults long-term clinical course, echocardiographic properties, and predictors of left ventricular failure.

Background: Isolated ventricular non-compaction (IVNC) is a rare disorder characterized by prominent trabecular meshwork and deep recesses. We retrospectively assessed the clinical characteristics and natural course of IVNC in adults diagnosed at our hospital.

Methods And Results: Sixty-seven adult patients (44 male, mean age 41 +/- 18 years) with the diagnosis of IVNC were evaluated in this retrospective cohort.

Plasma level of soluble P-selectin in patients with rheumatic mitral stenosis and sinus rhythm undergoing percutaneous mitral balloon valvuloplasty.

Objective: To determine whether plasma level of soluble P-selectin (sP-selectin) increases in rheumatic mitral stenosis (MS) patients with sinus rhythm, who have scheduled for percutaneous mitral balloon valvuloplasty (PMBV), and to examine the effect of PMBV on sP-selectin level.

Methods: Twenty-six patients with MS and sinus rhythm (study group, 20 female, mean age 33 +/- 8 years) and a well-matched control group composed of 21 healthy volunteers (15 female, mean age 35 +/- 6 years) were enrolled in the study. In each patient left atrial (LA) thrombus was excluded by transesophageal echocardiography.

Penetrating trauma to the mitral valve and ventricular septum.

Penetrating cardiac trauma is typically life-threatening and often requires urgent surgical intervention. Penetrating injury can cause damage in more than 1 cardiac structure that may be difficult to identify at the initial urgent operation. We describe the case of a young man in whom a perimembranous ventricular septal defect and perforation of the anterior leaflet of the mitral valve were caused by a screwdriver wound.

Hemodynamic change in transmitral gradient during Valsalva maneuver and its relation with left atrial function, functional capacity, and pulmonary artery pressure in patients with mitral stenosis in sinus rhythm.

Background: The hemodynamic factors contributing to the clinical symptomatology in patients with mitral stenosis (MS) have been under investigation. The objective of this study was to evaluate the use of the Valsalva maneuver in patients with MS and whether there is an association between the degree of the hemodynamic changes in transmitral gradient (TG) in response to Valsalva maneuver and functional status, systolic pulmonary artery pressure, and left atrial function in patients with MS in sinus rhythm.

Methods: The study prospectively evaluated 42 patients (37 female, mean age 40 +/- 10 years) with a diagnosis of pure MS in sinus rhythm.

Effect of low-dose amiodarone and magnesium combination on atrial fibrillation after coronary artery surgery.

Background: To evaluate whether postoperative administration of intravenous low-dose amiodarone and magnesium sulfate (MgSO(4)) combination would reduce the incidence of atrial fibrillation following coronary artery bypass grafting (CABG) in normomagnesemic high-risk patients for postoperative atrial fibrillation (POAF).

Methods: A total of 136 patients undergoing elective CABG and had > or =3 risk factors for POAF were prospectively randomized to one of three groups, to receive a single dose of amiodarone (5 mg/kg) and MgSO(4) (1.5 g) (combination group, n = 44), or an equal dose of amiodarone (amiodarone group, n = 44) or equal volumes of saline (control group, n = 48) at early postoperative period.

Electrocardiographic changes after coronary artery surgery.

The electrocardiographic changes early after uncomplicated coronary artery bypass with complete revascularization were examined preoperatively and on the 1st and 3rd postoperative days in 53 patients. Heart rate, PR index, corrected PR interval, corrected P dispersion, corrected duration of QRS complex, corrected QT dispersion, corrected QT interval, rhythm, QRS axis, ST-segment changes, and blocks were determined. Changes in new parameters obtained by different combinations of R, S, and T waves were also studied.

A rare form of communication between the left internal thoracic artery and the left anterior descending artery.

Extracardiac collaterals generally from bronchial and internal thoracic arteries to coronary circulation have been described in the literature. In this report, we present a case of 59-year-old male patient with collaterals from the left internal thoracic artery to the left anterior descending artery developed after coronary artery bypass grafting and aneurysmectomy surgery. It is likely the collaterals developed as a result of the postoperative adhesions.

Non-compaction cardiomyopathy associated with myocardial bridging: A frequently overlooked or misdiagnosed cardiomyopathy.

Isolated ventricular non-compaction (IVNC) is an unclassified cardiomyopathy which occurs due to a morphogenetic abnormality involving an arrest of compaction of the loose myocardial meshwork during fetal ontogenesis. Despite recent advances in knowledge, diagnosis remains problematic because of its similarity to other diseases of the myocardium and endocardium. In this report, we describe a case of IVNC and myocardial bridging.

Comparison of presence and extent of coronary narrowing in patients with left bundle branch block without diabetes mellitus to patients with and without left bundle branch block but with diabetes mellitus.

We prospectively analyzed the clinical, echocardiographic, and coronary arteriographic data of 51 patients with type 2 diabetes mellitus with left bundle branch block (LBBB), 51 patients with type 2 diabetes mellitus without LBBB, and 51 patients with isolated LBBB matched for age and gender. Extent of coronary artery disease (CAD) was classified according to the standard method into 1-, 2-, or 3-vessel disease and was estimated by calculation of the Gensini score. The left ventricular ejection fraction was analyzed by echocardiography.

Serum level of lipoprotein (a) is inversely associated with the development of coronary collateral circulation.

Background: This study sought to determine the relationship between serum lipoprotein (a) levels and angiographically visible coronary collateral circulation and to evaluate whether lipoprotein (a) exerts any effect on vascular endothelial cell growth factor.

Methods: The study population included 60 patients (39 men, mean age 59+/-13 years) with angiographically documented total occlusion in one of the major coronary arteries. Development of collaterals was classified by Rentrop's method.

Systemic lupus erythematosus: an unusual cause of cardiac tamponade in a young man.

Although pericarditis and pericardial effusion are common cardiac complications of systemic lupus erythematosus (SLE), cardiac tamponade is a very rare initial manifestation of this disease. We describe a case of a young male patient in whom cardiac tamponade secondary to a loculated pericardial effusion was the presenting symptom of SLE.

Aberrant patent ductus arteriosus associated with double brachiocephalic trunk and interrupted left subclavian artery.

Although patent ductus arteriosus (PDA) is the most common type of extracardiac shunt, aberrant PDA associated with other cardiac malformations as double brachiocephalic trunk and interrupted left subclavian artery is extremely rare. To the best of our knowledge, the literature contains no other report of a patient who has PDA originated from left subclavian artery associated with ventricular septal defect (VSD), double brachiocephalic trunk and interrupted left subclavian artery.

Preserved systolic function with isolated left ventricular noncompaction in an elderly patient.

Isolated left ventricular noncompaction (IVNC) is a rare congenital cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis. Clinical presentations of IVNC include systolic and diastolic dysfunction, systemic embolism and ventricular arrhythmias. In recent years there has been an increasing awareness of this anomaly; however, especially in elderly, clinical characterization and natural course of IVNC are still in question.

Evaluation of flow characteristics of the left internal thoracic artery graft: perioperative color Doppler ultrasonography versus intraoperative free-bleeding technique.

From October 2000 through April 2001, we prospectively evaluated the flow characteristics of the left internal thoracic artery (LITA) graft in a homogenous group of 44 men with isolated severe proximal left anterior descending coronary artery stenosis who underwent elective coronary artery bypass grafting with cardiopulmonary bypass. We performed transthoracic color Doppler ultrasonography preoperatively and repeated this examination in each patient between the 5th and 7th postoperative days, obtaining cross-sectional area, total flow volume, diastolic velocity, systolic velocity, mean velocity, pulsatility index, and resistance index. These results were compared with those of the intraoperative free-bleeding technique.