Early thrombosis of a tricuspid annuloplasty ring and mild hyperhomocysteinemia.

Tricuspid annuloplasty ring thrombosis is an extremely infrequent pathology, and no evidence-based antithrombotic management has been described. We present the case of a 40-year-old female with isolated mild hyperhomocysteinemia and early ring thrombus formation after surgical primary closure of an atrial septal defect and ring tricuspid annuloplasty. Clinical management, antithrombotic treatment, and hyperhomocysteinemia implications are discussed.

Cryoablation of atrial fibrillation in cardiac surgery: outcomes and myocardial injury biomarkers.

Objective: Elevations of myocardial injury biomarkers after cardiac surgery without ablation of atrial fibrillation (AF) are related to perioperative myocardial ischemia and associated with an increased risk of mortality and cardiac events. However, there have not been any studies that examined the release of cardiac biomarkers after AF cryoablation procedures with concomitant cardiac surgery. The authors determined the levels of these biomarkers for 2 different procedures involving cryoablation and assessed their clinical implications.

Giant left main coronary artery to right atrium fistula.

Aneurysmal arterial origin of coronary fistulae is an extremely rare combination. We report a case of a giant left main coronary artery to right atrium fistula in a 48-year-old male. We describe the clinical course and management options.

Emergent surgery for ruptured aortic arch aneurysm in an octogenarian patient: quo vadis?

Aortic arch aneurysms induce great morbidity and mortality especially when clinical signs of rupture are present. Surgical indications for repair in the high-risk octogenarian population are controversial. We present the case of an 87-year-old man with a ruptured aortic arch aneurysm with a good surgical outcome.