Atypical and unusual atrial myxoma

A successfully excised right atrial myxoma arising from the suprahepatic segment of the inferior vena cava associated with asplenia, cutaneous manifestations, and iron deficiency anemia is reported. This report documents the unusual origin of myxoma, along with asplenia. A thorough review of the literature revealed only one other patient with right atrial myxoma originating from the suprahepatic inferior vena cava. Nevertheless, the literature contains no report of any other patient with asplenia associated with atrial myxoma

Low-dose aprotinin in cardiac operations

Patients with heart disease are frequently maintained on a regimen of aspirin. During cardiac surgery aspirin-induced platelet dysfunction increases the risk of bleeding.The files of 82 patients who had undergone open-heart surgery were selected to study the efficacy of the low-dose [2 million KIU] aprotinin regimen in decreasing blood loss and transfusion requirements for patients receiving aspirin. Patients were divided into three groups: Group 1 includes those who received neither aspirin nor aprotinin [n = 41], Group 2, received both aspirin and aprotinin [n = 27] and Group 3, did not receive aprotinin despite aspirin intake [n = 14]. Primary out-come measures in this study were total volume of blood loss [postoperative chest tube drainage] and volume of transfusions during hospitalization. Patients treated with aprotinin [Group 2] had significantly lower total blood loss [359 ml versus 527 ml and 628 ml in Group 1 and Group 3, p < 0.05], rates of bleeding [17.2 ml/hr versus 25.7 and 30.4 ml/hr in groups 1 and 3 respectively]. A significant difference was also found when comparing the volume of blood transfusions [224.4 ml versus 262.4 and 537.5 ml] and prevalence of transfusion [33.3% versus 36.6% and 64.3%].Low-dose aprotinin significantly reduces blood loss and blood transfusions in patients receiving aspirin who undergo cardiac operations

Surgical experience with congenital fixed subaortic stenosis at the American university of Beirut medical center

Twenty-two cases of subaortic stenosis were operated upon at the American University of Beirut Medical Center [AUBMC] from1980 till 1987, and were follow-up for 3to78 months [average 38months], eighteen patients had a discrete subaortic membrane [group I] and 4 patients had a fibromuscular tunnel stenosis [group II]. The operative approach was transaortic under hypothermic cardioplegic myocardial arrest. No operative and no late death occurred. Two patients presented 4and 6months later with recurring symptoms and significant residual gradients in the left ventricular out flow tract, both have been controlled on medical treatment. The mean pre-operative gradients in groups I and II were 99.5 mm Hg and 110 mm Hg respectively; these dropped to 12.8 mm Hg and15mm Hg following correction. Five patients had associated aortic valve Insufficiency two patients a ventricular septal detect, one had a patent ductus arteriosus and another had an aneurysm of the sinus of valsalva together with aortic valve insufficiency. A review of the literature is included