Acute Right Coronary Artery Occlusion After Tricuspid Valve Ring Annuloplasty.

A patient was submitted to mitral valve replacement and tricuspid ring annuloplasty. During immediate postoperative course, signs of inferior myocardial ischemia appeared. Acute entrapment of the right coronary artery due to tricuspid ring sutures was confirmed by coronary angiography.

[Pneumoperitoneum after cardiac surgery. A complete anamnesis is the clue].

Herein we present the case of an 82 year-old patient undergoing cardiac surgery for mitral valve replacement. Fifteen years earlier, the patient had undergone surgery to replace his aortic valve, so that it was now a cardiac reoperation. Through sternotomy, and release of pericardial adherences, there was an accidental opening of a small portion of the peritoneum, proceeding to repair with simple suture.

Perivalvular pannus and valve thrombosis: two concurrent mechanisms of mechanical valve prosthesis dysfunction.

A 78-year-old woman was admitted to our institution with progressive dyspnea. She had previously been diagnosed with rheumatic heart disease and had undergone cardiac surgery for mechanical mitral valve replacement ten years previously. Transesophageal echocardiography revealed blockage of the mechanical prosthesis and the patient was scheduled for surgery, in which a thrombus was removed from the left atrial appendage.

A concealed atriopleural fistula resulting from a cardiac stab wound.

A young male presented with a right parasternal stab wound. The chest radiography was normal and transthoracic echocardiography ruled out pericardial tamponade. He remained hemodynamically stable until three hours later when signs of progressive anemia were observed.

A bovine aortic arch in humans.

We describe a curious congenital variation of human aortic arch (AA) branching pattern termed the "bovine aortic arch". Rather than arising directly from the AA as a separate branch as occurs in the most common AA branching pattern, the left common carotid artery moves to the right and merges from the brachiocephalic trunk. It is the normal AA branching pattern presented in a number of animals (canines, felines or Macaque monkeys) but it has nothing to do with anatomy of AA in ruminant animals, including cattle and buffalo.

Intramedullary cervical abscess in the setting of aortic valve endocarditis.

Spinal cord tissue has a remarkable resistance to infection. An intramedullary abscess is an exceptional complication of infective endocarditis in the post-antibiotic era. We describe the case of a 42-year-old man who presented with fever and cephalea.

Survival after major cardiac surgery: performance and comparison of predictive ability of EuroSCORE II and logistic EuroSCORE in a sample of Mediterranean population.

Background: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II has been recently introduced to improve mortality prediction in cardiac surgery. We compare the predictive ability of the new EuroSCORE II with that of the original logistic EuroSCORE and we made an evaluation of a sample of our population submitted to major cardiac surgery in the context of a Mediterranean country.

Materials And Methods: Predicted and observed mortality were recorded in 1,200 consecutive patients undergoing major cardiac surgery at our institution with both logistic EuroSCORE and EuroSCORE II.

Amplatzer Amulet left atrial appendage occluder entrapment through mitral valve.

We report on a 77-year-old woman in whom percutaneous left atrial appendage (LAA) closure was performed. The patient had a left atrial myxoma resection 3 years previously, and 2 years later, she suffered a transient ischemic attack. Atrial fibrillation was detected and anticoagulation therapy was established.

Pravastatin improves endothelial function in arteries used in coronary bypass grafting.

Internal mammary artery (IMA) and radial artery (RA) are the 2 main arterial conduits used in coronary artery bypass grafting (CABG). The aim of this study was to analyze in vitro the vasoreactive properties in both vessels and to investigate the effects of pravastatin incubation on vascular function. IMA and RA rings obtained from patients undergoing CABG were studied in organ baths.

Left ventricular mass index as a prognostic factor in patients with severe aortic stenosis and ventricular dysfunction.

Ventricular dysfunction and high hypertrophy may influence surgical outcome in aortic stenosis. Our aim was to determine whether an excessive left ventricular mass index (LVMI) discriminates different risk profiles in aortic stenosis with low ventricular ejection fraction (LVEF). Three hundred and thirty-nine patients with severe aortic stenosis underwent valve replacement (Mar-1994 and Nov-2001).

Prognostic value of chronic obstructive pulmonary disease in coronary artery bypass grafting.

Objective: Coronary and chronic lung diseases have become a common association. This comorbidity has been generically considered by most of the operative risk scores, but its functional severity has seldom been addressed by these models. Our objective was to analyze its prognostic relevance considering preoperative pulmonary function parameters.

Patient-prosthesis mismatch in aortic valve replacement: really tolerable?

Objective: Several studies have demonstrated favorable results despite patient-prosthesis mismatch after aortic valve replacement with the use of third generation prostheses. Our aim was to determine whether this mismatch is always tolerable.

Methods: A clinical-echocardiographic study has been performed in 339 consecutive patients who underwent aortic valve replacement because of aortic stenosis.

[Ablation of permanent atrial fibrillation in cardiac surgery. Short-term and mid-term results].

Introduction: Surgical ablation of atrial fibrillation is currently a simple procedure that can be done during cardiac surgery in most patients. A number of different energy sources now available allow to easily create ablation lines in the atria. We describe our experience during the previous three years.

[Anatomic atrial remodeling after mitral valve surgery in permanent atrial fibrillation].

Background: Mitral valve pathology is frequently associated with atrial dilation and fibrillation. Mitral surgery allows immediate surgical atrial remodeling, and in those cases in which sinus rhythm is achieved, it is followed by late remodeling. The aim of this study was to investigate the process of postoperative atrial remodeling in patients with permanent atrial fibrillation who undergo mitral surgery.

Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?

Objective: Increased left ventricular mass index has been associated with higher mortality. We analyze the effect of increased left ventricular mass index on outcomes in patients undergoing aortic valve replacement.

Methods: Echocardiographic left ventricular dimensions were used to calculate left ventricular mass index in 614 patients who underwent aortic valve replacement between June 1993 and November 2001.

[Surgery ablation of atrial fibrillation with epicardial and endocardial biauricular radiofrequency: initial experience].

Background: Atrial fibrillation is frequent in surgical patients with cardiac valvulopathies. Radiofrequency energy applied by means of surgical probes permits the reproduction of atriotomies described in the maze surgical procedure for the ablation of atrial fibrillation in a fast, safe and efficient way. This study presents our initial experience in treatment of chronic atrial fibrillation through radiofrequency performed in patients with surgical cardiac valvulopathies.