A giant pericardial cyst.

Pericardial cysts are rare, benign, congenital anomalies. Most are asymptomatic and are found incidentally on chest radiographs. Some may cause symptoms and complications. Giant pericardial cysts are even more rare, and few reports on their natural history, presentation and management are available. This report describes a giant pericardial cyst that exerted pressure on the heart and lungs and was excised surgically. Subsequently, the patient has been asymptomatic for nine years and appears to be in complete remission.

Detection of human herpesvirus 6 DNA but not human herpesvirus 7 or 8 DNA in atherosclerotic and nonatherosclerotic vascular tissues.

INTRODUCTION: Various viral infections are thought to play a role in the development of atherosclerosis. A number of studies suggest that certain viruses from the Herpesviridae family in particular may lead to atherosclerosis. METHODS: We investigated the presence of human herpesvirus 6 (HHV-6), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8) DNA in carotid, iliac, and coronary artery specimens obtained from a group of adult autopsy cases by means of polymerase chain reaction (PCR) analysis and nested PCR techniques. A 28-subject study group with at least type IV atherosclerosis and a 25-subject control group with no visible atherosclerosis were enrolled. RESULTS: HHV-6 DNA was found in the carotid artery specimen of 1 subject with atherosclerosis, in an iliac artery specimen of another subject, and in the iliac artery specimen of one of the control subjects. HHV-7 or HHV-8 DNA was not found in either the atherosclerosis or control cases. CONCLUSIONS: This study is the first to demonstrate the presence of HHV-6 in atherosclerotic vascular tissues. HHV-7 and HHV-8 were not found in atherosclerotic tissues; however, further research on broader study groups and with different protocols is needed to determine whether these viruses play a role in the formation of atherosclerosis.

Investigation of Chlamydia pneumoniae DNA, chlamydial lipopolisaccharide antigens, and Helicobacter pylori DNA in atherosclerotic plaques of patients with aortoiliac occlusive disease.

BACKGROUND AND INTRODUCTION: It has been suggested that chronic infections may have a role in both the initiation and progression of atherosclerosis. While the majority of available data are focused on coronary artery disease, our aim was to investigate the presence of Chlamydia pneumoniae and Helicobacter pylori in samples from aortoiliac occlusive disease. METHODS: Aorta-iliac atherectomy specimens were collected under sterile conditions from 21 patients (19 male, 2 female) undergoing surgery for aortoiliac occlusive disease. Seventeen macroscopically healthy vessels (12 internal mammary arteries, 3 radial arteries, prepared for coronary artery bypass graft, and 2 traumatic artery specimens, one of which was a superficial femoral artery and the other was a radial artery) were used as control. Blood samples for serological assays were obtained immediately before surgery. The polymerase chain reaction (PCR) was employed to search for H. pylori and C. pneumoniae DNA in atherosclerotic plaques and healthy vessel samples. Group-specific chlamydial lipopolysaccharide (LPS) antigens in atherosclerotic plaques and in healthy vessel samples and serum IgG antibodies to chlamydial LPS were determined by using a commercially available enzyme-linked immunosorbent assay (ELISA). Antibodies to H. pylori were also tested in all cases by means of an in-house ELISA. RESULTS: Chlamydial LPS and DNA were detected in 6 of 21 (28.57%) atherosclerotic lesions using ELISA or PCR, respectively. There was no evidence of H. pylori DNA in any plaque specimens. All cases in which C. pneumoniae DNA was positive were also seropositive for antichlamydial LPS. Neither C. pneumoniae DNA nor antigen nor H. pylori DNA was found in the macroscopically healthy samples. CONCLUSION: Our results suggest that C. pneumoniae but not, as proposed, H. pylori may be involved in the pathogenesis of aortoiliac atherosclerosis.

Damage to coronary arteries during mitral valve surgery.

BACKGROUND: The rheumatic cardiac valve diseases are one of the most important heart problems in Turkey. In mitral valve surgery, the relationship between the anulus fibrosus sinister and the coronary arteries is extremely critical for the postoperative life of the patient. METHODS: The study was performed with human adult hearts. The aim of this study of 50 hearts was to understand the existing correlations between the mitral annulus and the coronary arteries. We determined the right or left dominance or codominance of the anulus fibrosus sinister on each heart and stu died the relationship of the mitral annulus to the circumflex coronary artery (CCA) and the left posterior descending coronary artery. RESULTS: The distances of the anulus fibrosus sinister from the CCA and interventricularis posterior arteries w e re measured with a flexible ruler. In 19 of 50 cases, the distance of the coronary artery from the annulus was 3 mm at 23 different points, 2 mm at 8 different points, and 1 mm at 2 different points. CONCLUSIONS: In mitral valve surgery, damage to the CCA can occur, especially in patients with left coronary dominance or codominance in which the CCA is running in the atrioventricular groove very close to the mitral annulus. Therefore, this study emphasizes the importance of knowing the coronary artery anatomy preoperatively.