A knot-pusher technique with hand-tying precision through a mini-thoracotomy.

This study documents the application of a knot-pusher technique via a mini-thoracotomy with the traditional one-handed knot-tying rationale using an existing long-shaft knot-pushing device. This technique achieved the typical hand-tying precision and secured tight knots in minimally invasive cardiac surgery.

Extensive aortic root endocarditis caused ventricular septal rupture.

A 79-year-old man was referred to us for severe cardiac decompensation. Chest radiography showed severe pulmonary edema, and transesophageal echocardiography revealed extensive vegetations on all aortic valve leaflets with severe aortic valve regurgitation, heterogeneous cavities adjacent to the aortic annulus, and ventricular septal rupture into the right-ventricular outflow tract. After extensive debridement of the aortic root (including the infected ventricular septum), the ventricular septum and aortic root were reconstructed using autologous and bovine pericardial patches, and a bioprosthetic stented valve was placed.

Four-dimensional geometric assessment of tricuspid annulus movement in early functional tricuspid regurgitation patients indicates decreased longitudinal flexibility.

Objectives: Functional tricuspid regurgitation (FTR) is generally caused by the dilation of the tricuspid annulus (TA) and the tethering of tricuspid leaflets; however, it also occurs in patients without dilatation of the TA. The aim of this study was to develop and to use a four-dimensional tracking system, utilizing cardiac magnetic resonance imaging (MRI), and to assess TA flexibility in patients with early FTR without right ventricle dilation as a preliminary investigation for the mechanism of early FTR.

Methods: The structure and movement of the TA were examined in 20 healthy subjects and 19 FTR patients whose right ventricle was not dilated.

Cerebral hemorrhage after mitral valve replacement in a patient with active infective endocarditis during the acute phase of a cerebellar infarction: a case report.

A 60-year-old woman presented with a high fever (39°C or higher). Transthoracic echocardiography revealed a large and mobile vegetation on the anterior mitral leaflet with moderate mitral regurgitation. Computed tomography revealed a cerebellar infarction.

Redo an aortic valve replacement for bioprosthetic valve destruction in a patient developing Streptococcus bacteremia three years after the initial operation.

A 66-year-old man with a bioprosthetic aortic valve developed Streptococcus bacteremia and was treated with antibiotics. He responded well to this therapy, and no evidence of bioprosthetic valve endocarditis (BVE) was detected at this time. One-and-a-half years after the antibiotic therapy for bacteremia, the patient was referred to our department with a diagnosis of acute cardiac failure.