Reoperative mitral valve surgery via sternotomy or right thoracotomy: A propensity-matched analysis.

Background: There is, as yet, no broad consensus regarding the optimal surgical approach for patients requiring reoperative mitral valve surgery. Consequently, we sought to evaluate the perioperative outcomes for patients undergoing redo mitral surgery via right mini thoracotomy as compared with traditional resternotomy.

Methods: A comprehensive retrospective review of our prospectively collected database was undertaken from January 2011 to December 2017.

Prosthetic Valve Legionella Endocarditis.

This report describes the case of an 80-year-old man with culture-negative prosthetic valve endocarditis who ultimately was given a diagnosis of Legionella pneumophila endocarditis.

Sutureless repair of spontaneous coronary dissection with free wall rupture and cardiac tamponade.

Left ventricular free wall rupture is a feared complication of acute myocardial infarction typically presenting with cardiogenic shock. We present a case of spontaneous coronary artery dissection with free wall rupture and cardiac tamponade in an uncommon demographic. Friable myocardial tissue frequently precludes suture technique making biological glue repair a suitable option.

Intracaval resection of a partially obstructing intravascular hemangioma using deep hypothermic circulatory arrest.

We report a case of an obstructing hemangioma within the lumen of the inferior vena cava adjacent to the hepatic veins. The technique of resection and pathology are described.

Exchange transfusion before cardiopulmonary bypass in sickle cell disease.

Cardiac operations in patients with sickle cell disease present the surgical team with many challenges. We describe a method of complete intraoperative exchange transfusion in the operating room that reduces the hemoglobin S (Hb S) level to less than 5%, without preoperative exchange transfusions. Plasma and platelet fractions separated intraoperatively from the patient's native red cell mass were used, in addition to hemoconcentration while on cardiopulmonary bypass, to effectively reduce the red cell and clotting factor transfusion requirements after the procedure.

Chylopericardium presenting as cardiac tamponade secondary to an anterior mediastinal cystic teratoma.

Cardiac tamponade, the accumulation of fluid in the pericardial space, leads to impaired venous return, loss of left ventricular preload, and hemodynamic collapse. The many causes of tamponade include malignancy, infection, inflammation, connective tissue disorders, and uremia. Herein, we report the case of a young woman who presented with syncope.

Thrombosed right coronary artery aneurysm presenting as a myocardial mass.

A coronary artery aneurysm is defined as coronary dilatation that exceeds the diameter of normal adjacent artery segments, or is 1.5 times the diameter of the largest coronary artery. Coronary artery aneurysms are rare with an incidence of between 1.

Spontaneous right ventricular disruption following treatment of sternal infection.

Background: Spontaneous right ventricular disruption is a rare and frequently catastrophic event that occurs during the treatment of mediastinitis complicating median sternotomy wound.

Objective: The purpose of this study is to understand the pathogenesis of the spontaneous right ventricular disruption and to suggest strategies for the prevention and treatment of this rare but potentially fatal complication of cardiac surgery.

Methods: We report three cases as an introduction to the review of 39 cases found in the English-language literature.

Carbon dioxide embolism during minimally invasive vein harvesting.

Gas embolism is a known complication of minimal access procedures in which carbon dioxide insufflation is used. We report a case of significant venous and right heart gas embolization, which occurred during performance of routine minimally invasive vein harvesting. This was manifest by hemodynamic deterioration secondary to transmission by a patent foramen ovale into the left heart and coronary circulation.

Development of pulmonary hypertension after lung volume reduction surgery.

This prospective, longitudinal study was designed to assess the hemodynamic changes occurring in patients who undergo lung volume reduction surgery (LVRS). Patients with emphysema treated with LVRS underwent hemodynamic evaluation before and after surgery. The study group consisted of nine patients with an average age of 64.