Histopathologic analysis of atrial tissue in patients with atrial fibrillation: comparison between patients with atrial septal defect and patients with mitral valvular heart disease.

Background: Atrial fibrillation (AF) in adult patients with atrial septal defect (ASD) accompanies an enlarged right atrium (RA) with a less enlarged left atrium (LA), which is the opposite situation in patients with AF and mitral valvular disease. This study was to compare the histopathological change in the atrium of patients with AF of two different etiologies: ASD and mitral disease.

Methods: Twenty-four patients were enrolled.

A case of partial congenital pericardial defect presenting as acute coronary syndrome.

Congenital pericardial defects are rare and asymptomatic for both partial and complete defects. However, some patients can experience syncope, arrhythmia, and chest pain. When a patient experiences a symptom, it may be caused by herniation and dynamic compression or torsion of a heart structure including the coronary arteries.

Anti-alpha-Gal antibody response following xenogeneic heart valve implantation in adults.

Background And Aim Of The Study: The study aim was to investigate the xenoreactive immune response directed at Galalpha1, 3-Galbeta1-4GlcNAc-R (alpha-Gal) which is known to be a major barrier in xenotransplantation, and to identify factors such as age, gender, ABO group and type of implanted tissue that might affect the anti-alpha-Gal immune response in adults subjected to bioprosthetic heart valve (BHV) implantation.

Methods: A total of 103 early survivors aged > 20 years who underwent cardiac surgery using cardiopulmonary bypass was enrolled. Among the patients (45 males, 58 females; mean age 62.

Surgical treatment of chronic atrial fibrillation combined with rheumatic mitral valve disease: Effects of the cryo-maze procedure and predictors for late recurrence.

Objective: The aim of this study was to evaluate the effects of the modified maze procedure using cryoablation for treating chronic atrial fibrillation (AF) associated with rheumatic mitral valve disease and to assess the risk factors for late failure of sinus rhythm restoration.

Methods: Between March 2000 and June 2004, 170 consecutive patients, who underwent the modified maze procedure using cryoablation concomitant with mitral valve surgery for atrial fibrillation associated with rheumatic mitral valve disease, were divided into two groups based on the type of right-sided maze: the modified Cox-maze III (CM group, n=93) and modified Kosakai-maze (KM group, n = 77) procedures. The postoperative and mid-term follow-up results were analyzed and compared between the two groups.

Alternative Fontan connection for apicocaval juxtaposition.

We present an alternative technique to the modified Fontan procedure used in a 3-year-old boy who had complex heart defects with bilateral superior vena cava and apicocaval juxtaposition. The left superior vena caval pathway was used behind the ventricle to connect the inferior vena cava to the pulmonary artery. We proved the technical feasibility of this with good midterm results at the 5-year follow-up angiography.

Commissural malalignment of aortic-pulmonary sinus in complete transposition of great arteries.

Background: Translocation of the coronary artery to the neoaorta is essential in the arterial switch operation. The goal of this study is to investigate (1) the frequency of commissural malalignment in complete transposition of the great arteries, (2) the usefulness of echocardiography in diagnosis of commissural malalignment, and (3) the impact of commissural malalignment on surgery.

Methods: We retrospectively reviewed the medical records of 28 patients with complete transposition of the great arteries who underwent an arterial switch operation from February 2000 to August 2001.

Aortic arch reconstruction using regional perfusion without circulatory arrest.

Objectives: Deep hypothermic circulatory arrest during repair of aortic arch anomalies may induce neurological complications or myocardial injury. Regional cerebral and myocardial perfusion may eliminate those potential side effects.

Methods: From March 2000 to March 2002, 48 neonates or infants with complex arch anomaly were operated on using the regional perfusion technique.