Endocarditis caused by Abiotrophia defectiva.

A 35-year-old man with pre-existing rheumatic heart disease and aortic regurgitation (AR) presented with intermittent fever, ankle swelling and clinical evidence of endocarditis. Transoesophageal echocardiogram (TEE) revealed vegetations and destruction of the aortic valve (AV). Blood cultures grew a gram positive coccobacillus which was phenotypically identified as Abiotrophia defectvia (A.

Coronary bypass surgery in patients on thyroxin replacement therapy.

The outcome of coronary bypass surgery was analyzed in 25 patients who were on thyroxin replacement therapy for chronic thyroid disorders at the time of operation. It was hypothesized that if such patients were given only their routine dose of thyroxin on the day of surgery, hemodynamic and cardiorespiratory recovery may be poor. All the patients on thyroxin replacement therapy were given their routine dose of thyroxin orally or via a nasogastric tube in the perioperative period.

Coronary bypass surgery in patients with Sheehan's syndrome.

We present a small series of patients with Sheehan's syndrome (postpartum panhypopituitarism) and coronary artery disease. All four had uneventful coronary bypass grafting. We have successfully managed these patients peri-operatively by using intravenous hydrocortisone and oral thyroxin replacement.

Frequency of occurrence of cytomegalovirus and Chlamydia pneumoniae in lymphocytes of atherosclerotic patients.

Forty-three blood samples from atherosclerotic donors and 28 samples from normal individuals were analyzed to determine the frequency of occurrence of cytomegalovirus (CMV) and Chlamydia pneumoniae DNA sequences in lymphocytes of Saudi Arabian donors using Polymerase Chain Reaction (PCR). In non-atherosclerotic donors, no CMV DNA was detectable and only one sample was positive for C-pneumoniae DNA sequences. Of the 43 atherosclerotic patients, 22 were infected with CMV, 23 were infected with C-pneumoniae and 11 showed no infection.

Effect of the administration of recombinant activated factor VII (rFVIIa; NovoSeven) in the management of severe uncontrolled bleeding in patients undergoing heart valve replacement surgery.

Recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk A/S, Bagsvaerd, Denmark) is being increasingly used to secure haemostasis in difficult clinical situations. The role of rFVIIa in the treatment of patients undergoing open-heart surgery for valvular heart disease was evaluated in an open pilot study. Study objectives included evaluation of blood loss, haemostatic effect and safety and laboratory parameters following rFVIIa administration.