Choice of anesthesia technique is associated with earlier hospital discharge and reduced costs after transcatheter transfemoral aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) has become a viable alternative to palliation in patients with severe aortic stenosis. We compared general anesthesia to conscious sedation for TAVI procedures with respect to post operative morbidity, hospital length of stay, and financial burden.

Methods: We conducted a retrospective review of prospectively collected data in patients undergoing transfemoral TAVI procedures from 2012 to 2017.

Superior Vena Cava Resection and Reconstruction with Resection of Primary Lung Cancer and Mediastinal Tumor.

The superior vena cava is a short ∼7-cm valveless vessel that brings blood from the upper half of the body to the heart but has connections to the infracardiac venous structures as well. It can become obstructed, mostly by advanced lung cancer but benign conditions account for one-fourth of cases. When possible, reconstruction can be by biological material or via ring reinforced grafts.

Redo sternotomy versus left ventricular assist device explant as risk factors for early mortality following heart transplantation.

Objectives: There is an increasing proportion of patients with a previous sternotomy (PS) or durable left ventricular assist device (LVAD) undergoing heart transplantation (HT). We hypothesized that patients with LVAD support at the time of HT have a lower risk than patients with PS and may have a comparable risk to patients with a virgin chest (VC).

Methods: This is a single-centre retrospective cohort study of all adults who underwent primary single-organ HT between 2002 and 2017.

Behcet Disease Presenting With Cardiac and Pulmonary Masses.

Computed tomography and magnetic resonance imaging features of inflammatory intracardiac and pulmonary masses secondary to Behcet disease have not been well described in the literature. We present a case of Behcet disease, presenting with enhancing cardiac and pulmonary inflammatory masses that mimicked the imaging appearance of metastatic cardiac angiosarcoma. Subsequent magnetic resonance imaging examination showed the mass reduced in size with immunosuppressive therapy.

Transcatheter aortic valve implantation and left ventricular assist device: a word of caution.

Aortic valve disease in the setting of a left ventricular assist device presents unique challenges. We present the case of a patient who underwent transcatheter aortic valve implantation to replace a stenotic aortic valve to facilitate left ventricular assist device explantation. Thirty-three days later, the porcine pericardial valve cusps were fused and a thick pseudomembrane had occluded the left ventricular outflow tract, forcing the explant to be aborted.

Left ventricular apical papillary fibroelastoma resection via mediastinoscope through the aortic valve.

This case report describes a novel minimally invasive technique for complete resection of a cardiac papillary fibroelastoma by directly visualizing the mass via an intraoperative mediastinoscope placed through the aortic valve. A 68-year-old man presented to the emergency department with two episodes of transient ischemic attack. Echocardiography demonstrated a pedunculated, mobile mass in the left ventricular apex.

Cystic tumor of the atrioventricular node: rare antemortem diagnosis.

Background: The cystic tumor of the atrioventricular node (TAV) is a rare, congenital cardiac tumor, typically located at the base of the atrial septum. Histologically benign, this multicystic mass is a tumor of the conduction system and is considered the smallest tumor capable of causing sudden and unexpected death. TAV has shown a predilection for women with a mean age at presentation of 38 years.

Cardiac angiosarcoma: a case report and review of the literature.

We present the case of a 36-year-old woman with widespread metastatic cardiac angiosarcoma to the lungs and the liver. She was treated with preoperative chemotherapy and underwent extensive surgical resection of the cardiac mass and is currently doing well. Analysis of the effectiveness of various treatment modalities from cases which have been reported has also been reviewed and discussed.

Surgical management of cardiac tumors.

Cardiac tumors, though rare, can affect all parts of the heart, from venous structures to atria to ventricles, valves, and great vessels. Although most are benign and have good long-term prognosis, surgery for malignant tumors, whether primary or secondary, usually carries poor long-term survival. Surgery follows examination by 2D echo, CT, MRI, and possibly coronary angiography.