Patent ductus arteriosus in a 67-year-old woman: late diagnosis and surgical closure.

An atypical clinical presentation, the diagnostic procedures and a novel surgical approach are described in a 67-year-old woman with a patent ductus arteriosus.

Two-dimensional real-time echocardiographic detection of a left ventricular aneurysm associated with mobile pedunculated thrombi.

A two-dimensional real-time echocardiographic study of a 51-year-old man with arterial emboli revealed an anterior wall aneurysm of the left ventricle containing mobile pedunculated masses. On the basis of this study alone, left ventricular aneurysmectomy and removal of a pedunculated thrombus were successfully performed.

Surgical experience of closure of ventricular septal defect with special reference to the transatrial approach.

One hundred patients underwent closure of ventricular septal defect (VSD) during the years 1964-1977. The right transventricular approach was used in 92, the left ventricular in one, the pulmonary artery in one and the transatrial in the remaining 18 patients. Six patients (5.

Retrograde (atrial) dislodgement of a Cross-Jones mitral valve occluder.

Fatal atrial dislodgement of a lenticular disc occurred seven years after surgery in a 54-year-old patient, who had had a mitral valve replacement with a Cross-Jones prosthesis, for ruptured chordae tendinae. A marked distortion of the titanium ring reinforced silicone rubber lens disc due to material wear was the cause of this complication. From the literature available to us, atrial dislodgement of a prosthetic mitral occluder has not been previously recorded.

Multiple pulmonary hamartomas; a case report and review of the literature.

Bilateral multiple hamartomas were found in a woman suspected of having metastatic malignancy of the lung. As extensive investigation for the primary tumour was unrevealing, a left exploratory thoracotomy and histological examination established the diagnosis. In view of the benign character of the tumours, local excision alone was performed.

Congenital atresia of the left main coronary artery ostium.

Three patients with the rare anomaly of congenital absence of the ostium of the left main coronary artery are presented. In two of the patients, aged 50 and 52 respectively, the diagnosis was established during selective coronary cineangiography for a severe anginal syndrome. The third patient, a 16-year-old-girl, underwent cardiac catheterization for investigation of a congenital heart malformation, when a single right coronary artery was demonstrated with absence of the main coronary artery ostium.

False aneurysm of the left ventricle. Surgical treatment.

The clinical and pathological features in three cases of false aneurysm of the left ventricle are reported. In two instances the condition developed after myocardial infarction, and in the third case a mycotic pseudoaneurysm developed after purulent pericarditis. All three patients were in intractable heart failure before urgent operation.

Type C double aortic arch. Double aortic arch with aberrant left subclavian artery.

Four infants with type C double aortic arch (double aortic arch with aberrant left subclavian artery) are discussed. The diagnosis was based on symptoms and signs of tracheoesophageal compression with a bilateral impression in the frontal plane of the esophagogram, as well as on early visualization of the aberrant left subclavian artery during counter-current right brachial angiography. Division of the atretic segment of the left arch and of the ligamentum arteriosum relieved the symptoms.

Squamous cell carcinoma associated with sarcoidosis in the lung.

A male patient, operated for squamous cell carcinoma of the lung, in whom sarcoidosis was discovered in the resected lung specimen, is reported. The increased association of sarcoidosis along with malignant diseases is discussed, as well as the various mechanisms probably responsible for this association.

Complete occlusion of the left main coronary artery: successful surgical management by myocardial revascularization.

Isolated total occlusion of the left main coronary artery was demonstrated on coronary cineangiography in a 50-year-old woman with a progressive anginal syndrome. Aortocoronary saphenous vein graft bypass was performed. Six weeks after operation the patient was free of symptoms and postoperative coronary angiography showed the graft to be patent.

Early and long-term effects on direct myocardial revascularization on cardiac function: a prospective study using multivariable physiological analysis.

Perioperative and late follow-up hemodynamic cardiovascular studies to assess the effects of direct myocardial revascularization on cardiac function objectively have been completed on 51 patients. Analysis of the data delineated three distinct groups basedon the patterns of their early postoperative recovery. Group I patients (12) had a hyperdynamic cardiovascular response to operation and returned to a normal physiological range of cardiac function within 24 hours.

Renal transplantation in children.

23 children aged 1--16 years of age have received renal transplantation during the years 1972-1975 at the Downstate Medical Center. Of 9 children transplanted from related donors, I died and 3 lost their kidney-2 were retransplanted; 1 lost the second graft. Of 14 children transplanted from cadaver donors, 2 died, and 3 lost their kidney.