How to create patient-specific loops for correcting mitral valve prolapse through a minimally invasive approach.

A 72-year-old woman with a 6-month history of severe mitral valve regurgitation presented at our institution with dyspnea (NYHA II-III) and left ventricular impairment (LVEF 50%). Echocardiography showed P2-P3 prolapse with chordal rupture. A posterior mitral valve repair was performed using the loop technique through a minimally invasive approach.

How to remove multiple mediastinal and pericardial hydatid cysts.

A 61-year-old male who lived for 30 years in a rural area presented chest pain of 3 months duration. Multiple hydatid cysts (Echinococcus granulosus) were diagnosed in the pericardium and the mediastinum by echocardiography and computed tomography. The cysts were removed successfully with the patient on cardiopulmonary bypass and beating heart.

Situation Awareness for Circumflex Artery Injury During Mitral Valve Surgery.

Injury of the circumflex artery (Cx) during mitral valve surgery is a rare and underrecognized life-threatening complication. A retrospective analysis of patients undergoing mitral valve operations at 2 centers was conducted. Five mitral valve operations are described.

Complex Reoperation for Late Complications After Acute Type A Aortic Dissection Surgery.

The correct management of acute Type A dissection continues to be a challenge. The primary goal is to save the patient´s life. However, the decision regarding the surgical approach determines possible later complications.

Two-Stage Procedure for Infected Aortic Graft Pseudoaneurysm: 10-Year Follow Up after Omental Prosthesis Wrapping.

Prosthetic graft infections with mediastinitis following aortic surgery are rare, yet represent grave complications yielding high morbidity and mortality. We present the case of a 57-year-old female patient with past history of emergent surgery for iatrogenic Type A dissection treated by supracoronary ascending aortic replacement. Four months after the initial surgery, a sternal fistula had formed and due to severe bleeding emergent reoperation was required.

Longevity after aortic root replacement: is the mechanically valved conduit really the gold standard for quinquagenarians?

Background: The choice of the best conduit for root/ascending disease and its impact on longevity remain controversial in quinquagenarians.

Methods And Results: A total of 205 patients (men=155) between 50 and 60 years (mean, 55.7 ± 2.

Long-term survival after composite mechanical aortic root replacement: a consecutive series of 448 cases.

Objective: To determine the effect of different etiologies on the outcome and mortality after mechanical composite aortic root/ascending replacement.

Methods: From February 1998 to June 2011, 448 consecutive patients (358 men, age, 52.8 ± 12.

Embolic occlusion of the left main coronary artery following an isolated aortic valve replacement.

Coronary occlusion after aortic valve replacement due to embolization is a rare complication. We report the case of a patient who developed acute heart failure due to occlusion of the left main coronary artery following an aortic valve replacement. Successful treatment was achieved with emergent coronary bypass surgery.

Surgical experience with 77 primary cardiac tumors.

Background: To assess the prognosis and to develop management strategies for primary cardiac tumors all patients were included in an ongoing study.

Method: From Oct. 1994 until December 2003 we prospectively evaluated all patients with cardiac tumors.

Successful surgical treatment of a right atrial myxoma complicated by pulmonary embolism.

We report on a rare case of a 65-year-old woman who was admitted with orthopnea (NYHA class IV) and a single syncopal episode. A transthoracic echocardiography examination showed a 7x6x6-cm mass located in the right atrium and perfusion lung scan showed embolization. Complete surgical removal of the right atrial myxoma and tumor embolectomy was successfully performed with deep hypothermia and circulatory arrest.

Beating heart aortic valve replacement after previous coronary artery bypass surgery with a patent internal mammary artery graft.

Re-sternotomy for aortic valve replacement (AVR) in patients with a patent internal mammary artery (IMA) graft may present a challenging surgical problem. Thus, strategies to prevent IMA graft injury include avoiding its dissection and leaving the graft open. However, when aortic cross clamping and cardioplegia are required, this approach may be associated with cardioplegia washout, suboptimal myocardial protection, and anterior myocardial wall injury.

Intracardiac thrombus causing systemic embolism in a child with idiopathic ventricular tachycardia and heterozygous activated protein C resistance.

Systemic embolism in childhood is rare but often disastrous. Most often the concomitant occurrence of more than one prothrombotic factor is responsible for the acute event. We report on a child in whom an intracardiac thrombus embolized into the descending aorta resulting in subtotal occlusion.

Extending the in situ right internal mammary artery graft with retrocaval positioning.

Bilateral internal mammary artery grafting is associated with improved long-term patient outcomes. In situ right internal mammary artery grafting of the obtuse marginal artery, through the transverse sinus, is often limited by conduit length. We describe the technique of retrocaval positioning of the right internal mammary artery graft to extend its functional length for grafting of the circumflex territory.