Cardiac Arrhythmias in Patient with Isolated Persistent Left Superior Vena Cava.

We report here the case of a 47-year-old male presented with atypical chest pain, fatigue and arrhythmias that was found to have persistent left superior vena cava. The clinical exam was normal. Twelve leads ECG showed sinus rhythm of 70 beats/min, QRS axis of 90 degree and right bundle branch block. Transthoracic echocardiography revealed left ventricular hypertrophy, a large coronary sinus and mild pulmonary hypertension. Saline contrast echocardiography was performed and micro-bubbles were visible first into the coronary sinus and then passed through the right atrium. Multislice computed tomography confirmed the presence of persistent left superior vein cava and the site of drainage into the right atrium via a large coronary sinus. Right superior vein cava was absent. In this case report, we emphasize the importance of full assessment in patient with persistent left superior vena cava.

Edwards Intuity Aortic Bioprosthesis in Patient with Bicuspid Aortic Valve.

Bicuspid aortic valve (BAV) is generally considered to be a contraindication to sutureless aortic valve replacement (AVR). Implantation of the Edwards Intuity aortic bioprosthesis is an innovative approach associated with superior hemodynamic performance, significantly reduced myocardial ischaemia and cardiopulmonary bypass times and proves to be suitable for type 1 and 2 of bicuspid aortic valves replacement. We report a case of successful AVR using a fast deployment bioprosthesis,the Edwards Intuity Valve System, in a 67-year-old woman with a bicuspid aortic valve and concomitant severe aortic stenosis.