Huge left ventricular aneurysm in a minimally symptomatic 11-year-old boy.

An 11-year-old boy presented with mild shortness of breath and tachycardia and was diagnosed with a huge left ventricular aneurysm ruptured in a secondary pseudoaneurysm. This report highlights the complementary use of echocardiography and cardiac magnetic resonance imaging in the preoperative assessment of this anomaly.

Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes.

Objective: Valve repair for aortic insufficiency requires a tailored surgical approach determined by the leaflet and aortic disease. Over the past decade, we have developed a functional classification of AI, which guides repair strategy and can predict outcome. In this study, we analyze our experience with a systematic approach to aortic valve repair.

Repair of aortic valve cusp prolapse.

Aortic valve preservation and repair is emerging as a feasible and attractive alternative to aortic valve replacement in young patients with aortic valve insufficiency. Cusp pathology requiring repair is present in up to 50% of patients undergoing aortic valve repair or valve preserving surgery and may occur in isolation or in conjunction with ascending aortic disease. Diagnosis of cusp prolapse can usually be made on preoperative echocardiography and is confirmed on surgical inspection.

Ross operation in the adult: long-term outcomes after root replacement and inclusion techniques.

Background: Dilatation of the pulmonary autograft is a major concern after root replacement for the Ross operation. The inclusion technique would avoid this drawback, but few data are available on the long-term results of this technique. We retrospectively analyze long-term results of both techniques.

Comparison of bilateral internal thoracic artery revascularization using in situ or Y graft configurations: a prospective randomized clinical, functional, and angiographic midterm evaluation.

Background: Bilateral internal thoracic arteries (BITA) demonstrated superiority over other grafts to the left coronary system in terms of patency and survival benefit. Several BITA configurations are proposed for left-sided myocardial revascularization, but the ideal BITA assemblage is still unidentified.

Methods And Results: From 03/2003 to 08/2006, 1297 consecutive patients underwent isolated bypass surgery in our institution.

Comparison of saphenous vein graft versus right gastroepiploic artery to revascularize the right coronary artery: a prospective randomized clinical, functional, and angiographic midterm evaluation.

Objective: Despite its theoretic advantage over saphenous vein grafts, the right gastroepiploic artery graft has not been accepted as the ideal conduit to revascularize the right coronary artery. We therefore prospectively randomized these 2 grafts types to compare their clinical, functional, and angiographic evolution at 6 months and 3 years.

Methods: From 2003 to 2006, 1397 consecutive patients underwent isolated revascularization at the University of Louvain Medical School.

Repair of aortic leaflet prolapse: a ten-year experience.

Objective: Leaflet plication (PL), triangular resection (TR), resuspension with running suture of Gore-Tex (GTx) and extension with autologous pericardial patch (PP) are different techniques to repair aortic leaflet prolapse (LP) for aortic insufficiency (AI). In this study, we report and compare the early and mid-term results of these techniques for aortic valve repair.

Methods: From 1996 to 2006, 298 patients underwent elective aortic valve (AV) repair.

Partial tear of the quadriceps tendon in a child.

We present a case of partial rupture of the quadriceps tendon in an 8-year-old girl. This is one of the youngest patients reported with a quadriceps tendon rupture, an entity seen predominantly in middle-aged people. The strength of the muscle tendon unit in a child makes tendon injuries extremely unusual as compared to apophyseal avulsions.

Angiographic predictors of 6-month patency of bypass grafts implanted to the right coronary artery a prospective randomized comparison of gastroepiploic artery and saphenous vein grafts.

Objectives: The purpose of this study was to define the pre-operative angiographic variables that could influence graft patency and flow pattern.

Background: Saphenous vein grafts (SVG) and pedicled right gastroepiploic artery (RGEA) grafts are routinely used to revascularize the right coronary artery (RCA). Little is known about the predictive value of objective pre-operative angiographic parameters on the 6-month graft patency and on the interest of these parameters to select the optimal graft material in individual cases.

Algorithm for primary closure in sternal wound infection: a single institution 10-year experience.

Objectives: To evaluate a simple treatment algorithm in sternal wound infection (SWI) allowing for primary closure and to describe the different surgical techniques and their associated morbidity and mortality.

Methods: A retrospective analysis of all patients operated on between 1996 and 2004 in a single tertiary care institution. All epidemiological and surgical data were prospectively collected in our database.

Acid deprotection of covalently immobilized peptide probes on glass slides for peptide microarrays.

Protein microarray technology has shown great advancements in the field of biomedical research and diagnosis, it allows to study and understand protein activities and protein - ligand interactions (e.g. detection of antigen-autoantibody interaction in autoimmune diseases.

Radiologic evaluation of chronic foot pain.

Chronic foot pain is a common and often disabling clinical complaint that can interfere with a patient's routine activities. Despite careful and detailed clinical history and physical examination, providing an accurate diagnosis is often difficult because chronic foot pain has a broad spectrum of potential causes. Therefore, imaging studies play a key role in diagnosis and management.

Functional anatomy of aortic regurgitation: accuracy, prediction of surgical repairability, and outcome implications of transesophageal echocardiography.

Background: For patients with aortic regurgitation (AR), aortic valve sparing or repair surgery is an attractive alternative to valve replacement. In this setting, accurate preoperative delineation of aortic valve pathology and potential repairability is of paramount importance. The aim of the present study was to assess the diagnostic value of preoperative transesophageal echocardiography (TEE) in defining the mechanisms of AR, as identified by surgical inspection, and in predicting repairability, by using the final surgical approach as reference.

Role of magnetic resonance imaging in musculoskeletal trauma.

The unique ability of magnetic resonance (MR) imaging to visualize injuries of bone, cartilage, bone marrow, and supporting soft tissue structure makes it ideally suited for the evaluation of musculoskeletal trauma. Magnetic resonance imaging also offers exquisitely detailed anatomical information on the musculoskeletal system. The widespread availability of MR imaging and the constantly improving technology make it the imaging modality of choice for the patients with a musculoskeletal trauma.

Reduced mortality in high-risk coronary patients operated off pump with preoperative intraaortic balloon counterpulsation.

Background: Preoperative intraaortic balloon pump (IABP) counterpulsation has better outcomes compared with perioperative or postoperative insertion in critical patients, and off-pump surgical procedures have been advocated to reduce mortality in high-risk patients. However, some surgeons are reluctant to perform beating heart operations in specific patient subgroups, including those with unstable angina or patients with low ejection fraction, because of their possible perioperative hemodynamic instability.

Methods: We evaluated combined beating heart procedures and preoperative IABP in selected high-risk patients and compared our results with the predictive European System for Cardiac Operative Risk Evaluation (EuroSCORE) model.

Occult fractures of extremities.

Recent advances in cross-sectional imaging, particularly in CT and MR imaging, have given these modalities a prominent role in the diagnosis of fractures of the extremities. This article describes the clinical application and imaging features of cross-sectional imaging (CT and MR imaging) in the evaluation of patients who have occult fractures of the extremities. Although CT or MR imaging is not typically required for evaluation of acute fractures, these modalities could be helpful in the evaluation of the occult osseous injuries in which radiographic findings are equivocal or inconclusive.

Imaging of the acetabulum in the era of multidetector computed tomography.

Acetabular fractures are often complex injuries and the result of high-energy trauma with associated injuries. Understanding and classification of these rare injuries using radiography can be difficult and are much facilitated by the addition of computed tomography (CT). The purpose of this paper is to briefly review some of the underlying physical principles and technical factors for multidetector CT (MDCT) and to describe its use and imaging findings in the evaluation of acetabular fractures.

Sleeve fracture at the superior pole of the patella.

We present a sleeve fracture at the superior pole of the patella in a 12-year-old boy. Sleeve fractures at the inferior pole of the patella have been well described in the orthopedic and radiologic literature. However, a similar injury at the superior pole of the patella is relatively rare.

Satisfaction of search in multitrauma patients: severity of detected fractures.

Rationale And Objectives: Satisfaction of search (SOS) occurs when an abnormality is missed because another abnormality has been detected. This research studied whether the severity of a detected fracture determines whether subsequent fractures are overlooked.

Materials And Methods: Each of 70 simulated multitrauma patients presented examinations of three anatomic areas.

Tricuspidation of quadricuspid aortic valve: case reports.

Quadricuspid aortic valve in adulthood is a rare pathology which often leads to aortic valve regurgitation that requires surgical treatment. Herein are described two patients with severe regurgitation on a quadricuspid aortic valve and with dilated left ventricle, who where successfully repaired using a technique of tricuspidation of the valve at the level of the abnormal commissure. In each patient, the repair was stabilized and leaflet coaptation increased by subcommissural annuloplasty stitches at the level of the three commissures.

A single fracture in the ring of vertebrae below the atlas: report of four cases.

A single fracture of the ring of a vertebra is a rare injury of the spine. In this report, we present five single fractures of the posterior ring of the cervical spine below the atlas from four patients after motor vehicle accidents. Initial radiographs failed to show any of these fractures; all were detected by computed tomography.

The Ross procedure: clinical and echocardiographic follow-up in 219 consecutive patients.

Background: The replacement of the diseased aortic valve with a pulmonary autograft has been shown to provide excellent hemodynamic results and to be associated with low morbidity and mortality rates.

Methods: From 1991 to 2005, 219 patients undergoing the Ross operation were identified. All patients underwent transthoracic echocardiography at discharge and were scheduled for a yearly study thereafter.

A single fracture in the atlas ring: report of two cases and a review of the literature.

Atlas fractures commonly present more than two breaks in its ring structure because of the unique anatomy and the mechanism of injury. The incidence of a single break in the atlas ring is exceedingly rare. However, we encountered two cases of a single fracture of the atlas.