Combined mitral and aortic valve replacement for rheumatic heart disease: fifteen-year follow up and long-term results.

Background And Aim Of The Study: Rheumatic heart disease is the most common cause of multivalvular disease in developing countries. Unless aggressive and timely intervention in the form of valve replacement is pursued, the condition progresses rapidly to disability and death. Combined mitral-aortic valve replacement represents a major technical challenge, and carries high early and late mortality rates.

Anomalous left anterior descending coronary artery from pulmonary artery with ventricular septal defect.

Anomalous origin of the left anterior descending coronary artery with associated congenital defects is very rare. An angiogram of a 47-year-old woman admitted for a ventricular septal defect closure revealed an anomalous left anterior descending coronary artery arising from the left posterior sinus of the pulmonary artery. During the surgical procedure, the origin of the left anterior descending coronary artery was closed with pledgetted polypropylene sutures through the pulmonary artery.

Emergency valve replacement in rheumatic heart disease.

Background And Aim Of The Study: Emergency valve replacement is defined as surgery undertaken to correct valvular heart disease which otherwise would have proved fatal within 24 h.

Methods: Among 1,742 patients who underwent valve replacement during the past 15 years at the authors' institution, 61 who had emergency surgery formed two groups. Group 1 (n = 24) had a previous good circulatory status but suffered a sudden change in valvular function, in the initial period after closed mitral valvotomy (CMV), and in later years after balloon aortic valvotomy (BAV) or balloon mitral valvotomy (BMV) for aortic or mitral valvular stenosis.

Unruptured aneurysm of the sinus of Valsalva presenting with right ventricular outflow obstruction.

Sinus of Valsalva aneurysms rarely present until rupture occurs. We describe the case of a patient who presented with acute right heart failure and upon investigation was found to have an unruptured sinus of Valsalva aneurysm causing right ventricular outflow obstruction; there was an associated subaortic ventricular septal defect. To the best of our knowledge, only 1 other case with these features has been reported in the medical literature.