Papillary fibroelastoma of an anomalous mitral valve chorda.

Cardiac papillary fibroelastoma (CPF) is a rare primary cardiac tumour. This tumour constitutes about 10-15% of all primary cardiac tumours. We report here a case of CPF of an anomalous mitral valve chorda.

Postendocarditis mitral valve aneurysm.

Mitral valve aneurysm is defined as a localized, thin-walled, saccular bulge of the mitral leaflet toward the left atrium. In this study, we report a case of mitral aneurysm of the posterior leaflet (scallop P3) secondary to primary mitral endocarditis in a patient who underwent prosthetic aortic valve replacement and coronary artery bypass graft.

A stitch in time saves nine: closing the hole after removal of the aortic root cannula.

Background: On completion of the surgical procedure the hole in the ascending aorta has to be closed after withdrawal of the aortic root cannula. The aorta is usually pinched by a double transversal stitch or it is crumpled by a purse string suture. Nevertheless, hemostasis is difficult to obtain because closure is done under recovered pressure.

A rare case of anterior chest closure only with omental flap after devastating mediastinitis: case report.

We describe a case of 73-year-old patient who has been operated in emergency on triple coronary artery bypass graft (CABG), which was complicated with respiratory insufficiency and devastating mediastinitis. The anterior mediastinum was closed with an omental flap that was allowed to epithelize spontaneously. The patient was discharged after 110 days.

New device for saphenous vein-to-aorta proximal anastomosis without side-clamping.

Background: Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy.

Safe wrapping of the borderline dilated ascending aorta during aortic valve replacement.

Background: Techniques of reduction aortoplasty are widely published in the literature with conflicting results. External support seems to be an important factor in preventing recurrence but, in some cases, this technique caused erosion of the aorta because of the wrinkles the prosthesis creates in the rear side of the aorta.

Case Presentation: A 73 year old patient with aortic valve stenosis and borderline dilated ascending aorta had aortic valve replacement and simple wrapping without aortoplasty.

Left ventricle remodelling by double-patch sandwich technique.

Background: The sandwich double-patch technique was adopted as an alternative method for reconstruction of the left ventricle after excision of postinfarction dysfunctional myocardium to solve technical problems due to the thick edges of the ventricular wall.

Methods: Over a 5-year period, 12 of 21 patients with postinfarction antero-apical left ventricular aneurysm had thick wall edges after wall excision. It was due to akinetic muscular thick tissue in 6 cases, while in the other 6 with classic fibrous aneurysm, thick edges remained after the cut of the border zone.

[Cardiac surgery in octogenarians: a five-year experience].

Background: Cardiac surgery in octogenarians is increasing in industrialized countries and therefore represents a growing population. The aim of this study was to evaluate characteristics and outcomes of octogenarian patients undergoing cardiac surgery.

Methods: We reviewed all consecutive octogenarians operated on during the last 5 years.

Transatrial approach of acquired posterior ventricular septal rupture and double orifice technique in tricuspid valve repair.

We present a successful transatrial repair of ventricular septal rupture and tricuspid valve reconstruction, using the "edge-to-edge" technique, as a serious complication of a posterior myocardial infarction in an 83-year-old woman.

Myocardial revascularization using branches of the left internal mammary artery.

To increase the number of arterial grafts in patients with multivessel coronary disease, we have used branches of the left internal mammary artery (LIMA) as bypass grafts. From March 1990 to June 1993, 15 patients (13 males and 2 females) aged 38 to 65 years (mean 57 +/- 8), received a total of 30 LIMA branch anastomoses. The two terminal branches were used to perform a "Y" graft to the left anterior descending coronary artery territory in 13 patients.

Mechanical support for decompression of the left ventricle in repair of ischemic cardiac rupture.

Acute cardiac rupture is often a lethal complication of transmural myocardial infarction. A case of successfully treated left ventricular free wall rupture is described. Preoperative hemodynamic stabilization was achieved by intraaortic balloon counterpulsation.

[Surgical treatment of postinfarctual left ventricular aneurysm (author's transl)].

Ventricular aneurysm is a frequent complication of myocardial infarction, but its diagnostic and prognostic implications are not fully defined. A surgical series of 66 ventricular resections for symptomatic left ventricular aneurysm is analyzed. Pts.

[Surgical complications of pacemaker implantation (author's transl)].

During the period 1966-1977, 705 pacemaker implantations with transvenous endocardial electrode and 369 substitutions of generators were carried out, besides 275 operations treating some complications after implantation were required. The most frequent complications were: endocardial electrode dislocation (9.4%), lesion caused by decubitus (7.

[The administration of an association of sodium nitroprusside and adrenaline in cardiac surgery (author's transl)].

In 223 operations of cardiovascular surgery, myocardial performance was supported, after the interruption of cardiopulmonary bypass, by means of a combined and strictly controlled administration of a pure vasodilator drug (sodium nitroprusside) and of an inotropic agent (epinephrine). The reduction of afterload achieved by the former, the increase of contractility and heart rate induced by the latter, the coronary dilator effect of both, associated with an adequate maintaining of preload proved to be rapidly effective. This appeared to be particularly true in patients with overt left ventricular failure after valve replacement and/or myocardial revascularization procedures.