Aorto-atrial fistula 10 days after dissection repair in giant cell arteritis.

Active aortitis caused by giant cell arteritis occurs more commonly than has been previously appreciated, and ascending aortic dissection may occur despite medical therapy, without a preexisting aneurysm or ectasia. We report a case of acute type A aortic dissection in a patient already treated for giant cell arteritis. The aortic root was left intact during the initial surgery, but was completely removed 10 days later after an early postoperative aorto-atrial fistula.

Primary isolated chronic chylopericardium.

Primary isolated chylopericardium is a rare entity. Its exact pathophysiology is still unknown. A case of chronic isolated primary pericardium diagnosed 12 years after the initial diagnosis of an asymptomatic pericardial effusion is reported.

Staged anesthesia for combined carotid and coronary artery revascularization: a different approach.

Objective: Combined coronary artery bypass graft (CABG) surgery and carotid endarterectomy (CEA) are performed in an attempt to reduce the risk of postoperative stroke after CABG surgery in patients with significant or symptomatic carotid artery stenosis. The choice between regional and general anesthesia for CEA is still under debate. Regional anesthesia offers an excellent monitoring technique of the neurologic status of the awake patient during carotid clamping.

Mitral valve repair or replacement in elderly people.

Purpose Of Review: Much has been published so far to describe and praise the benefits of mitral valve repair, and to compare it with valve replacement. Now, with mitral valve surgery in elderly people gaining greater acceptance worldwide, repair or replacement remains a controversial issue. This is especially true in the ageing population, in whom many of the complications associated with a mechanical valve can be avoided by using a bioprosthesis.

Postoperative intravenous iron used alone or in combination with low-dose erythropoietin is not effective for correction of anemia after cardiac surgery.

Objectives: The aim of this study was to examine whether intravenous iron III-hydroxide sucrose complex (IHSC) used alone was sufficient to provide rapid correction of anemia after cardiac surgery and whether additional stimulation of erythropoiesis is possible by means of a single low dose of recombinant-human erythropoietin (r-HuEPO) administration.

Design: Prospective, randomized, double-blind study.

Setting: The study was conducted in a university hospital.

Periareolar mediastinoscopy: a new technique.

Biopsy of anterior mediastinal or aortopulmonary nodes is usually accomplished through a left anterior mediastinostomy. Cosmetic concerns expressed by patients about scars in the neck or the upper chest led us to consider a new periareolar approach for mediastinoscopy. This technique has been used successfully in 10 patients.

Recurrence of left ventricular outflow tract obstruction after left anterior descending coronary artery revascularization in a patient with hypertrophic obstructive cardiomyopathy.

A patient with known hypertrophic obstructive cardiomyopathy presented with an anteroseptal myocardial infarction which resulted in the disappearance of his subaortic pressure gradient. Surgical revascularization of his left anterior descending coronary artery after the viability of his myocardium had been documented led to the recurrence of his left ventricular outflow tract obstruction and subaortic pressure gradient.

Aortic valve papillary fibroelastoma.

Cardiac papillary fibroelastomas are rare tumors of the heart and affect primarily the cardiac valves. These lesions are responsible for embolic accidents that clinically manifest as neurological and cardiovascular symptoms. We describe the case of a 40-yr-old woman who presented with a neurological deficit caused by a papillary tumor of the aortic valve.