[Unruptured aneurysm of non-coronary sinus of Valsalva mimicking a right atrial mass].

Sinus of Valsalva aneurysms are extremely rare with a predominance in the Asian population. The clinical presentation may be ambiguous, depending on which sinus is affected and on the conditions of the lesion. We report a case of a 33-year-old patient with Down syndrome.

[Pulmonary artery catheterization in 9071 cardiac surgery patients: a review of complications].

Background: The safety of pulmonary artery catheterization has been questioned. We report our experience on the incidence of complications in a large series of patients requiring cardiac operations by evaluating the learning curve of the operators.

Methods: Since 1988 at our Institution a pulmonary artery catheter (PAC) register records the following data from each patient: type of surgical procedure, insertion site of the venous introducer, type of PAC used, final position of the catheter, and complications associated with central venous access and those determined by PAC positioning and stay.

[Measurement of cardiac output with continuous thermodilution. b1 Clinical experience with the Intellicath-Vigilans system].

Background: Thermodilution cardiac output measurements are commonly obtained by a manual bolus technique with a pulmonary artery catheter.

Methods: A new thermodilution catheter has been developed which utilizes an integral thermal filament and provides semicontinuous online cardiac output. The response of this new device in 25 patients undergoing coronary artery bypass grafting was examined.

[Propofol in coronary diseases. Haemodynamic evaluation of some anesthetic regimes].

The haemodynamic effect of two regimens of propofol-fentanyl anaesthesia versus a standard isoflurane-fentanyl anaesthesia were compared perioperatively in 30 patients with good left ventricular function undergoing coronary artery bypass grafting. Anaesthesia was induced in all patients with fentanyl 14 micrograms/kg, pancuronium 0.1 mg/kg, and thiopental 1 mg/kg.

[Effects of clonidine vs trinitroglycerin on myocardial oxygen balance and on pulmonary gas exchange after myocardial revascularization].

The authors examined the effects of clonidine, a preferential alpha-adrenergic agonist, upon myocardial oxygen balance and pulmonary function during the perioperative period in patients undergoing CABG surgery. Anesthesia was provided by fentanyl infusion reaching the final dose of 100 micrograms.kg.

[Catheterization of the pulmonary artery in 1,207 patients].

The pulmonary artery catheterization has been reviewed in 1207 patients submitted to cardiovascular surgery. The feasibility of the technique in skilled hands has been outlined and a routine and prophylactic use of pulmonary artery monitoring as a safe way to manage critically ill patients has been advocated.

Central shunt and pulmonary valvotomy in the treatment of critical pulmonary stenosis.

Pulmonary valvotomy combined with a central shunt ("U shaped" Gore-tex graft) for palliative treatment of critical pulmonary stenosis is reported. The same graft was employed for right ventricular outflow reconstruction at the time of the definitive repair.

Anomalous origin of right pulmonary artery from the ascending aorta.

Anomalous origin of one pulmonary artery from the ascending aorta without associated intracardiac defects is a rare congenital malformation. About 60 anatomic and surgical descriptions have been reported in the literature. Up to 1974, 22 of the 50 reported cases underwent surgical correction with a 40% mortality rate.

Giant left atrium and mitral valve replacement: risk factor analysis.

Giant left atrium (GLA) associated with mitral valve disease (MVD) has been reported as a significant risk factor in mitral valve surgery with mortality ranging from 8%-32%. Plication of the left atrium has been suggested to reduce postoperative left ventricular failure, respiratory failure and mortality. The 203 consecutive patients with MVD operated upon between 1980 and 1986 were reviewed and divided in two groups: group A without GLA (165 patients) and group B with GLA (38 patients = 19%).

Cardiorespiratory effects of protamine sulphate in man: intra-aortic vs intra-right atrial rapid administration after cardiopulmonary bypass.

The effects of protamine sulphate on several cardiorespiratory variables were studied under clinical situations in twenty patients following cardiopulmonary bypass. Because recent reports suggest that there may be advantages of intra-aortic versus intra-venous administration we prospectively evaluated cardiorespiratory features 1 and 10 minutes after rapid administering of protamine sulphate either into the aortic arch (through a catheter percutaneously inserted via the radial artery for monitoring purposes) or into the right atrium. Significant variations in some parameters were found in the patients receiving the drug via the aorta, such as a drop of systemic vascular resistances (p less than 0.

Intracaval and intracardiac leiomyomatosis of uterine origin.

Intracaval leiomyomatosis of uterine origin is a rare disease. Extension to the right heart is exceptional. Based on the review of 11 cases reported in the literature and the case presented herein, which was treated successfully, the diagnostic and therapeutic problems are discussed.