Transcatheter Valve-in-Valve Replacement Through Apicoaortic Conduit for Aortic Bypass Valve Failure.

We report a case of a 69-year-old woman who required an apicoaortic bypass conduit after stenosis of a biological aortic prosthesis valve previously implanted 4 years earlier. The patient was admitted to the emergency department 8 years later with a diagnosis of congestive heart failure. Echocardiography and nuclear magnetic resonance revealed severe regurgitation of the conduit valve.

Transapical aortic valve implantation in bicuspid aortic valves: must be an absolute contraindication?

Transcatheter Aortic Valve Implantation (TAVI) is a new therapeutic option for patients with severe aortic stenosis with unacceptable surgical risk for conventional aortic valve surgery. A Bicuspid Aortic Valve (BAV) is the most common congenital cardiac disorder (1% of the population) and currently is considered exclusion criteria for TAVI, because it predicts an increased risk of adverse aortic events as incomplete sealing, severe paravalvular regurgitation, or dislocation due to more frequent elliptic shape and asymmetric calcifications in BAV annulus. Only few cases have been published in recent literature, so in this case report we illustrate our experience and management of TAVI in a BAV, with excellent outcomes and no late complications at 1 year follow-up.

Mitral valve repair in a patient with mitral regurgitation and osteogenesis imperfecta tarda.

We present the case of a 62-year-old female with a diagnosis of osteogenesis imperfecta and mitral valve regurgitation. The patient underwent a mitral valve repair without complications. We describe the case and our surgical technique.

Management of aortic valve dysfunction after transapical approach using the technique "valve after valve".

We report a case of a 77-year-old patient with severe aortic stenosis who underwent transapical aortic valve implantation with a 23-mm Edwards Sapien valve (Edwards Lifesciences Inc, Irvine CA). This procedure was complicated with the occurrence of an acute regurgitation due to entrapment of one of the leaflets that was successfully managed by valve after valve technique.

Spontaneous closure of pseudoaneurysm after transapical aortic valve implantation.

Transcatheter aortic valve implantation by an apical approach has been developed as an alternative to conventional aortic valve replacement. Complications with these relatively new procedures are being reported. We report a case of transapical transcatheter aortic valve implantation, in which a pseudoaneurysm at the apex of the left ventricle as a complication of the procedure developed in the patient and was treated without surgery.

Mitroaortic valve replacement after aortic transapical approach failure in a patient with essential thrombocytosis.

There is a lack of published information about intraoperative and postoperative course of cardiac surgery in patients with essential thrombocytosis using cardiopulmonary bypass. Both risks of intraoperative thrombosis of extracorporeal conduits or uncontrolled postoperative bleeding are present, but its incidence and treatment are not well known. Here, we present a rare case of a patient with essential thrombocytosis, moderate mitral regurgitation and severe aortic stenosis who had a transapical aortic valve implantation with short-term severe periprosthetic regurgitation, who needed a mitroaortic replacement on cardiopulmonary bypass with no complications.

Current indications for infective endocarditis antibiotic prophylaxis.

Indications of endocarditis prophylaxis have changed in the past years, because of the absence of any evidence that justified its use. The last guidelines only recommend prophylaxis in patients with underlying cardiac conditions with the higher risk of adverse outcomes, including patients with a previous history of infective endocarditis, patients with prosthetic heart valve or prosthetic material used for valve repair, patients with a valvulopathy after cardiac transplantation, and patients with an specific congenital heart disease. The list of procedures in which prophylaxis is necessary has been limited too.

Indications for surgery and operative techniques in infective endocarditis in the present day.

Despite medical advances, the mortality in infective endocarditis is today very high. Its clinical and epidemiological characteristics are changing over time, with more elderly patients affected, with more underlying co-morbidities and with Staphylococci as the most frequent pathogen. Effective treatment in complicated cases needs a multidisciplinary approach, and surgery is necessary in 40-50% of cases.

Video-assisted cardioscopy for removal of primary left ventricular fibroma.

We present a case of a cardiac fibroma affecting the base of the anterior papillary muscle resected under cardiopulmonary bypass with cardioscopy and video-assisted thoracic surgery (VATS) instruments through the mitral valve. The surgical approach and instrumentation of previous case reports are reviewed.

Replacement of A2 and A3 by pericardium due to endocarditis of the anterior leaflet of the mitral valve.

We present a case of acute endocarditis due to enterococcus faecalis involving partially A2 and completely A3 (Carpentier classification) with destruction of the free margin of the mitral valve. Repair was performed by using glutaraldehyde treated porcine pericardium to replace the defect and neochordae of polytetrafluoroethylene sutured to the free margin of the pericardium to achieve competence. Intraoperative and follow-up echocardiogaphies showed no regurgitation.

Aortic valve endocarditis by Capnocytophaga haemolytica.

We report a case of a 51-year-old patient with suspected prosthetic valve endocarditis. Capnocytophaga haemolytica was isolated in blood cultures and the repeated echocardiograms showed growth of vegetations and disruption of the proximal prosthetic valve suture line with progressive aortic regurgitation. The patient underwent a root debridement and replacement with a stentless bioprosthesis.

Intestinal wall damage in simple ileus in rabbits: immune-modulator role of somatostatin.

Background/aims: We aim to determine in which way the local immune system would be responsible for the structural changes in intestinal obstruction, and how these are influenced by Somatostatin, an intestinal peptide with immunomodulatory properties. Simple ileus causes a series of functional and anatomical changes, which have been related to the peptidergic neural system, and inflammatory mediators. These changes are reversible with the use of Somatostatin.