Surgical resection of a cardiac lipoma of the right ventricle.

Cardiac lipomas are rare, benign, encapsulated tumors which predominantly appear outside of the heart and less frequently inside the cardiac chambers. We describe a case of a right ventricular cardiac lipoma in a 72-year-old female patient who presented with palpitations. Surgical considerations, diagnostic modalities, and up-to-date literature are also presented and discussed.

Eighteen years of clinical experience with a modification of the Bentall button technique for total root replacement.

BACKGROUND: We retrospectively reviewed our experience with the modified Bentall procedure and evaluated the short- and long-term results over a period of 18 years. METHODS: Between 1999 and 2017, 89 patients with a mean age of 57.3±13.9 years underwent the modified Bentall operation with a slight modification for the correction of aortic root disease. RESULTS: The operative mortality was 1.1% while the overall early mortality rate, defined as death within 30 days of initial hospitalization, was 2.2% (2/89). Logistic regression analysis revealed that increased Euroscore and aortic cross-clamp times were associated with greater likelihood for complications. The overall survival rates for the 89 patients (including deaths occurred at the initial hospitalization) were 93.0% (SE =3.0%) at 6 months, 93.0% (SE =3.0%) at 1 year, 89% (SE =5.0%) at 5 years and 73.0% (SE =5.0%) at 10, 15 and 18 years. Multiple Cox regression analysis for survival identified that increased aortic cross-clamp time, increased age, having a concomitant cardiac procedure and increased NYHA Class were associated with greater hazard. Left ventricular remodeling was assessed by means of echocardiography preoperatively and 1, 3, 6 and 12 months postoperatively. CONCLUSIONS: According to our experience, the Bentall procedure is a safe procedure, provides optimal long-term survival and can still be regarded as the gold standard procedure for aortic root replacement.

Intrapericardial bronchogenic cyst found incidentally during open heart surgery.

Bronchogenic cysts are embryological remnants occurring as developmental abnormalities of the primary foregut. The most common locations of these cysts are the mediastinum, lung parenchyma, and inferior pulmonary ligament. An intrapericardial location is an extremely rare finding. We describe the case of a 76-year-old man with aortic valve stenosis and coronary artery disease, in whom an intrapericardial bronchogenic cyst was found incidentally during the open heart procedure.

Stented within a stentless aortic valve. A simple surgical solution for the replacement of a stentless aortic bioprosthesis.

Stentless aortic bioprostheses are designed to offer better hemodynamics, less mechanical stress to the leaflets and as a result less degeneration. Although encouraging results are reported, little evidence has been published regarding reoperations of stentless valves. We are reporting a case of a structural valve dysfunction of an O'Brien-Angell stentless prosthesis, which could not be extracted during reoperation without damaging the aortic root. We are presenting a simple, quick and effective surgical solution, the surgical 'valve within a valve' technique for the avoidance of a redo complex root procedure.