Cardiac myxoma with high standardized uptake value of FDG-PET-CT in the right ventricular outflow tract.

Background: Cardiac myxoma rarely occurs in the right ventricle, and as is a benign disease, it rarely shows high positivity on 18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT).

Case Presentation: We present herein the case of a 77-year-old woman who was found to have a heart murmur during a routine health checkup. Further examination revealed a 27-mm tumor in the right ventricular outflow tract (RVOT) and moderate aortic valve stenosis.

Circular Shunt: A Loop Not to Be Ignored.

A circular shunt, initially described by Shone et al. in 1962, refers to abnormal blood recirculation through complete intracardiac or intra- and extracardiac communications, bypassing the capillary beds. This pathophysiological condition is most commonly associated with complex congenital heart defects, such as Ebstein's malformation, pulmonary atresia, Gerbode defect, and so on.

Hemodynamic evaluation of the pulmonary arteries and aorta using 4D flow cardiac MRI in children and young adults with dextro-transposition of the great arteries after the arterial switch operation.

Background: Pulmonary artery stenosis, neoaortic dilatation, and neoaortic valve insufficiency are among the most frequent complications of the arterial switch operation for repair of dextro-transposition of the great arteries (d-TGA). It remains difficult to predict which patients will require great arterial reintervention.

Objective: We aimed to characterize hemodynamics within the great arteries using 4D flow MRI in patients with d-TGA after the arterial switch operation.

The Ross procedure for recurrently failed aortic valve procedures.

The Ross procedure provides young patients with unrepairable aortic valve disease with a living pulmonary autograft that confers significant survival benefit and improved quality of life. However, the procedure is complicated, and surgeons can be reluctant to offer it as a solution, especially in complex re-operative scenarios. We present a young patient with symptomatic, severe aortic insufficiency who had undergone two failed aortic valve procedures for congenital bicuspid aortic valve disease within the prior year.

Incidence and Outcomes of Revision Bronchoscopies Following Bronchoscopic Lung Volume Reduction (BLVR).

Background: Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure used to reduce shortness of breath and improve functionality in some patients with emphysema. While BLVR is often effective for improving dyspnea by causing target lobe atelectasis, the treatment effect can sometimes be lost. This study reviews the incidence of revision bronchoscopies in patients who lost or never achieved target lobe atelectasis following BLVR.

"Martin Mattress": Surgical Technique for Achieving Hemostasis in Redo Aortic Root Operations.

A 71-year-old gentleman with prior bioprosthetic aortic valve replacement was admitted with aortic valve dehiscence and an aortic root abscess. He underwent reoperative sternotomy, aortic root, mitral valve, and hemiarch replacement. To augment hemostasis, we implanted the "Martin Mattress"-a pericardial patch sutured to the fibrous ridge within the innominate vein, superior vena cava, right atrium, right ventricular outflow tract, and pulmonary artery-which is preferred to modified Cabrol fistula techniques in infectious root pathology.

Cardiac magnetic resonance imaging in repaired tetralogy of Fallot: A longitudinal midterm follow-up study.

Background: Biventricular dysfunction is frequent in patients with repaired tetralogy of Fallot, necessitating routine imaging to monitor for worsening conditions and determine whether procedures like pulmonary valve replacement (PVR) are needed. This study aimed to highlight the parameters of cardiac magnetic resonance imaging (CMR) and their association with adverse outcomes in the midterm follow-up of these patients.

Methods: This longitudinal study recruited all patients with a history of tetralogy of Fallot total correction (TFTC) who had two CMR images at a minimum three-month interval at Rajaie Center from 2007 through 2017.

Complete surgical correction of tetralogy of Fallot with Ebstein's anomaly.

Association of Ebstein's anomaly of tricuspid valve (TV) with tetralogy of Fallot (TOF) is extremely rare. Their coexistence is unique as they modify each other's physiology. We report a case of a girl child having this rare combination along with Diamond-Blackfan syndrome awaiting a bone marrow transplant.

Transcatheter pulmonary valve implantation with custom-made 35-mm Myval™ transcatheter heart valve.

Transcatheter pulmonary valve implantation (TPVI) is the standard of care in patients with repaired tetralogy of Fallot (rTOF) presenting with right ventricular outflow tract (RVOT) dysfunction. However, the feasibility of TPVI is limited by the high cost and nonavailability of larger-sized valves for dilated native RVOT of rTOF patients. We report the first successful TPVI with a custom-made 35 mm balloon-expandable valve (Myval™) in a 30-year-old rTOF patient with severe pulmonary regurgitation and RV dysfunction.

Pediatric cardiac interventions: Innovations from India.

India, owing to its population structure, faces an enormous burden of children born with congenital heart disease (CHD). Systematic challenges such as limited public health infrastructure, a shortage of trained specialists, and high out-of-pocket expenditures hinder uniform access to comprehensive CHD care. Despite these limitations, Indian pediatric cardiologists have delivered innovative and often cost-effective solutions to challenging clinical problems.

Prognostic Implications of Right Ventricular Dysfunction in Severe Degenerative Mitral Regurgitation.

Background: The prevalence and impact of right ventricular dysfunction (RVD) in degenerative mitral regurgitation (DMR) is unknown. We aimed to determine whether RVD assessed by echocardiography in routine clinical practice is independently associated with mortality in patients with DMR.

Methods And Results: We used data from the MIDA-Q (Mitral Regurgitation International DAtabase-Quantitative) registry, which included patients with isolated DMR due to mitral valve prolapse from January 2003 to January 2020 from 5 tertiary centers across North America, Europe, and the Middle East.

Interventional Treatment of Acute Right Ventricular Outflow Tract Infectious Endocarditis: A Bridge to Surgical or Percutaneous Pulmonary Valve Replacement.

Background: Infective endocarditis (IE) poses significant risks following percutaneous pulmonary valve implantation (PPVI) or surgical replacement (PVR).

Aims: This study evaluates the effectiveness of emergency percutaneous treatment in stabilizing patients with severe right ventricular dysfunction or obstructive cardiac shock, allowing for delayed surgical or percutaneous valve replacement.

Methods: This retrospective study examines 16 patients (age 19.

Complete Clinical Recovery Following Surgical Excision of Extensive Primary Cardiac Sarcoma.

Primary cardiac tumors are rare, most of them being benign. Most malignant cardiac tumors are sarcomas, with the most important therapeutic option being surgery, along with perioperative chemo- and radiotherapy. Here, we present a case of a 67-year-old female patient with no prior medical condition, who presented with primary cardiac sarcoma and extensive tumor growth in the pulmonary artery.

Pulmonary hypertension as a prognostic marker in low-flow low-gradient aortic stenosis: Insights from invasive hemodynamics and post-TAVR outcomes.

Introduction: Pulmonary hypertension (PH) is a common and significant comorbidity in patients with low-flow low-gradient (LF-LG) aortic stenosis, impacting prognosis after transcatheter aortic valve replacement (TAVR). Non-invasive tools often fail to capture PH's full clinical impact due to inherent limitations. This study evaluates the prognostic significance of PH measured invasively and explores its implications on post-TAVR outcomes.

Optimal site of pacemaker lead implantation for persistent atrial standstill guided by electroanatomical mapping following a cox-maze procedure: a case report.

Background: Atrial standstill is characterized by the absence of atrial activity. We report a case of a patient with extensive atrial fibrosis who underwent electrophysiologic study (EPS) and electroanatomical mapping (EAM) to identify surviving atrial sites amenable for pacemaker lead implantation.

Case Summary: A 72-year-old man with persistent atrial fibrillation (AF) and atrial functional mitral regurgitation/tricuspid regurgitation (MR/TR) underwent a Cox-Maze surgery, mitral and tricuspid valve repair, and biatrial plication.

Pregnancy Outcomes in Women with Biventricular Circulation and a Systemic Right Ventricle: A Systematic Review.

Pregnancy in women with biventricular circulation and a systemic right ventricle (sRV) is considered high risk, with limited data available on pregnancy outcomes. This study aimed to investigate pregnancy outcomes in this population. A systematic review was conducted using four major electronic databases.

The Value of Repeat 5-HIAA Measurements as a Predictor of Carcinoid Heart Disease: A Prospective 5-Year Follow-Up Study in Patients with Small Intestinal Neuroendocrine Tumors.

Small intestinal neuroendocrine tumors (SI-NETs) are characterized by carcinoid syndrome and carcinoid heart disease (CHD). The aim of the present study was to identify early risk markers for carcinoid heart disease and survival in a prospective median-term follow-up setting. We measured 5-HIAA and cumulative 5-HIAA exposure (Cum-5-HIAA) based on repeated measurements, proBNP, vascular function, hepatic tumor load, and transthoracic echocardiography (TTE) at baseline and during the median 5-year follow-up.

Utility of an Echocardiographic Machine Learning Model to Predict Outcomes in ICCU Patients.

Introduction: The risk stratification at admission in ICCU (intensive cardiac care unit) is crucial and remains challenging.

Objectives: We aimed to investigate the accuracy of a machine learning (ML)-model based on initial transthoracic echocardiography (TTE) to predict in-hospital major adverse events (MAEs) in a broad spectrum of patients admitted to ICCU.

Methods: All consecutive patients hospitalised in ICCUs with a complete TTE performed within the first 24 hours of admission were included in this prospective multicenter study (39 centers).

Neo-aortic valve replacement in arterial switch operation in a 9-year-old child.

The surgical management of d-transposition of the great arteries (dTGA), ventricular septal defect (VSD), and left ventricular outflow tract obstruction (LVOTO) poses intricate challenges, demanding tailored surgical interventions. This case report elucidates a patient involving a 9-year-old child with dTGA, VSD, and LVOTO with a dysplastic pulmonary valve with adequate annulus who underwent neo-aortic valve replacement with a mechanical prosthesis, arterial switch, and VSD closure. The recovery of the patient was uneventful and follow-up echocardiogram and clinical evaluation at 18 months have remained satisfactory.

Pulmonary valve replacement and left pulmonary arterioplasty in repaired tetralogy of Fallot through left vertical axillary thoracotomy.

Different surgical approaches have been described for pulmonary valve replacement in patients with pulmonary regurgitation post tetralogy of Fallot repair-repeat median sternotomy, left anterior or antero-lateral thoracotomy, and left posterolateral thoracotomy. Every approach has its merits and drawbacks. In this case report, we describe a technique of pulmonary valve replacement and left pulmonary arterioplasty through left vertical axillary thoracotomy.

Novel technique of monocuspid reconstruction of pulmonary valve in children requiring transannular patch for right ventricular outflow tract relief during tetralogy of Fallot surgery.

Unlabelled: Tetralogy of Fallot (TOF) repair involves the placement of a transannular patch (TAP) to relieve right ventricular outflow tract (RVOT) obstruction. TAP results in free pulmonary regurgitation (PR) after surgery. PR is responsible for most of the long-term complications in patients with operated TOF.

Intimal sarcoma of the aortic valve and ascending aorta: a case report.

Background: Intimal sarcomas are rare tumors that typically affect the major vessels, such as the pulmonary artery and aorta, and are associated with a particularly poor prognosis. Intimal sarcomas found in the aorta are most commonly located in the abdominal section between the celiac artery and the iliac bifurcation. The descending aorta is involved in 30% of cases, while involvement of the ascending aorta is rare.

A Case of Infective Endocarditis Following Bone Marrow Transplantation for Myelodysplastic Syndrome.

A 63-year-old man was diagnosed with myelodysplastic syndrome (MDS) at the age of 62 by the hematology department. The patient underwent four cycles of azacitidine (AZA) therapy, followed by successful bone marrow transplantation (BMT). Subsequently, he was hospitalized twice for graft-versus-host disease (GVHD).

Impact of Right Ventricular to Pulmonary Artery Coupling on Survival Following Indirect Mitral Annuloplasty.

Background: Right ventricular-to-pulmonary artery (RV-PA) coupling is an important predictor of long-term survival following transcatheter edge-to-edge repair. However, its impact on survival in patients undergoing indirect mitral annuloplasty is unknown. The study aimed to assess the impact of baseline RV-PA coupling on survival following indirect mitral annuloplasty in heart failure patients.

Preoperative inspiratory muscle training improves lung function prior to elective heart valve surgery and reduces postoperative lung function impairment and pulmonary complications: a randomised trial.

Question: What is the effect of 3 days of preoperative inspiratory muscle training (IMT) on lung function prior to heart valve surgery and on postoperative lung function and pulmonary complications compared with sham and no IMT?

Design: A three-arm, multicentre, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment of some outcomes.

Participants: This study included 228 adults scheduled for heart valve surgery.

Interventions: The IMT group received 3 days of IMT at 30% maximal inspiratory pressure, the sham IMT group received the same but at 10% maximal inspiratory pressure and the control group received no IMT.