Repair of left ventricular aneurysm with acellular dermis graft: A case report.

We report the use of a novel graft material in cardiac surgery, acellular human dermis graft, to repair a left ventricular aneurysm in a patient undergoing surgical ventricular restoration. We also describe the postoperative magnetic resonance imaging characteristics of the dermis graft. We conclude that acellular dermis graft has material handling properties that allow it to be used in left ventricular aneurysm repair. On magnetic resonance imaging, there is no gadolinium enhancement of the graft and the graft is akinetic.

Pericardial hemangioma taking origin from the posterior wall of the left atrium.

We present a rare case of a pericardial hemangioma taking origin from the posterior wall of the left atrium and compressing the surrounding structures. Contrast cardiac magnetic resonance imaging preoperatively established the diagnosis, and computed tomographic findings helped in the management of this patient.

Prediction of Homograft Aortic Valve Size by Transthoracic and Transesophageal Two-Dimensional Echocardiography.

To avoid the problem of patient valve mismatch we assessed the reliability of echocardiographic measurements in selecting an appropriate-sized homograft aortic valve. Preoperative transthoracic echocardiography (TTE) was performed in 26 consecutive patients undergoing aortic valve replacement with a cryopreserved human homograft; 19 of the patients also had intraoperative transesophageal echocardiography (TTE). The diameters of left ventricular outflow tract (LVOT), aortic annulus, sinuses of Valsalva, and ascending aorta were measured by the same technique in all patients. There was a strong correlation between LVOT diameter measured by intraoperative TEE and homograft aortic valve size selected by the surgeon (r = 0.91, P < 0.001). A good correlation was also found between LVOT measured by preoperative TTE and the homograft valve size (r = 0.82, P = 0.001). The correlation between the homograft aortic valve size and the diameter of aortic annulus was less optimal; the correlation was poor for the diameter of aorta measured at the level of the sinuses of Valsalva and ascending aorta. Measurement of the LVOT diameter by intraoperative TEE and preoperative TTE is reliable and clinically useful for the preparation of homograft aortic valves and selection of proper size, particularly in those patients undergoing repeat aortic valve replacement, with heavily calcified aortic valve or with ascending aortic aneurysm.