Résumé
Coronary sinus ostial atresia (CSOA) with persistent left superior vena cava (LSVC) in the absence of an unroofed coronary sinus is a benign and rare anomaly that may be taken lightly in most instances. However, if overlooked in patients undergoing univentricular heart repair such as bidirectional Glenn or Fontan-type surgery, fatal surgical outcomes may occur due to coronary venous drainage failure. We report a case of CSOA with a persistent LSVC that was managed through coronary sinus rerouting during a total cavopulmonary connection, and provide a review of the literature regarding this rare anomaly.
Sujets)
Humains , Sinus coronaire , Drainage , Procédure de Fontan , Coeur , Anastomose cavopulmonaire , Veine cave supérieureRésumé
No abstract available.
Sujets)
Faux anévrisme , Ventricules cardiaques , Infarctus du myocardeRésumé
We detected two cases of right atrial angiosarcoma that had a similar appearance on imaging studies. Although the surgical findings were similar for the two patients, one had a clear resection margin, while the other had tumor cells in the resection margin on frozen biopsy. We suggest that preoperative data on magnetic resonance imaging and computed tomography in patients with angiosarcomas may not predict the exact extent of surgical resection or prognostic outcomes.
Sujets)
Humains , Biopsie , Tumeurs du coeur , Hémangiosarcome , Imagerie par résonance magnétiqueRésumé
BACKGROUND: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases. MATERIALS AND METHODS: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups' baseline characteristics, a propensity score analysis was performed. RESULTS: After adjustment, there were no significant differences in the two groups' baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group (176.0+/-49.5 minutes) than the sternotomy group (150.0+/-51.9 minutes). There were no significant differences (p=0.31) in the two groups' rate of reoperation for bleeding (MICS=6 vs. sternotomy= 2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were 87.4+/-8.1% in the MICS group and 89.6+/-5.8% in the sternotomy group (p=0.92). Freedom from late AF at 2 years was 86.8+/-6.2% in the MICS group and 85.0+/-6.9% in the sternotomy group (p=0.86). CONCLUSION: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.
Sujets)
Humains , Fibrillation auriculaire , Pontage cardiopulmonaire , Survie sans rechute , Liberté , Hémorragie , Valve atrioventriculaire gauche , Score de propension , Réintervention , Sternotomie , Chirurgie thoraciqueRésumé
A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.
Sujets)
Humains , Adulte d'âge moyen , Douleur thoracique , Sténose pathologique , Vaisseaux coronaires , Dyspnée , Échocardiographie , Études de suivi , Défaillance cardiaque , Infarctus , Valve atrioventriculaire gauche , Insuffisance mitrale , Infarctus du myocarde , Patients en consultation externe , Muscles papillaires , EndoprothèsesRésumé
A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.