ABSTRACT
Cardiac surgery in patients aged 90 years or older is not common. We report 2 successful cases in nonagenarians. A 90-year-old man underwent the Bentall operation for aortic root aneurysm with moderate aortic valve regurgitation. A 91-year-old man underwent aortic valve replacement and single CABG (LITA to LCX) for severe aortic valve stenosis with single coronary artery disease. Their postoperative courses were uneventful. We emphasize that cardiac surgery in nonagenarians should not be withheld on the basis of age alone, but should be based on careful assessments of the relative medical risks and benefits, as well as the wishes of the patient and family.
ABSTRACT
Intrapericardial teratomas are unusual tumors that often cause cardiorespiratory distress and might be lethal in the newborn. We described a case of neonate who was successfully treated by emergency surgery. A 5-day-old female infant was referred for further evaluation of a fever and progressive cardiorespiratory distress. Chest X-ray showed a widened central silhouette. Echocardiogram and chest CT scanning demonstrated a 59×40mm mediastinal mass and the mass effect or massive pericardial effusion cause cardiac tamponade. After sternotomy, the tumor was found to have arisen from the anterior surface of the aortic root and 30ml of serosanguinous fluid were aspirated. The tumor was completely removed without any difficulty with cardiopulmonary bypass standby. The postoperative course was uneventful. Histologically, this tumor appeared to be a mature teratoma. The surgical resection was lifesaving.
ABSTRACT
A 13-year-old girl with asplenia syndrome who previously had undergone left subclavian-to-pulmonary artery shunt after removal of a cavopulmonary shunt with interposition of a short segment of the left superior vena cava was admitted for congestive heart failure. Angiography revealed aneurysmal dilatation of the left superior vena cava. Percutaneous coil embolization of the shunt was successfully performed and the venous aneurysm was diminished. Interposition of a venous component in systemic-to-pulmonary artery shunt should be avoided even after removing a cavopulmonary shunt.
ABSTRACT
In 4 children (2.4-10.9 y.o) with mitral valve regurgitation, prosthetic valve replacement was done using warm heart surgery. Three of them had previously received 1-3 times valve repair operations and the other one was accompanied by endocarditis. The condition of 3 children were in NYHA grade 4 and received dopamine preoperatively. At the esophageal temperature of 34 degree, aorta was cross clamped for 79-216min. with continuous coronary perfusion of 3ml/kg/min, however, no child showed postoperative low output syndrome, and the maximum use of dopamine was 2-6μg/kg/min and the CK-MB at 1POD was within the normal range in all cases. Warm heart surgery showed better myocardial protection for pediatric mitral valve replacement.