Triple valve surgery with triple aorto-coronary bypass and endarterectomy of the right coronary artery.

This paper presents the case report of a 50-year-old woman with a triple valve lesion of rheumatic origin and ischemic coronary disease. The patient underwent successful simultaneous triple valve surgery; the aortic and mitral valves were replaced by mechanical prostheses, and the tricuspid valve was repaired by annuloplasty, together with three aorto-coronary bypasses and endarterectomy of the right coronary artery. The peri- and postoperative courses were uneventful and the patient was discharged from hospital in good clinical condition 12 days after surgery.

[Late postoperative complications after primary treatment of aortic coarctation]. / Neskoré pooperacné komplikácie po primárnom riesení koarktácie aorty.

During the period between 1963 and 1988, 343 patients were operated due to aortic coarctation. 14 patients (4%) were necessarily reoperated for late postoperative complications. In 3 cases (0.8%) reoperation was indicated due to the development of aneurysm in the region of primary operation of aortic coarctation. The development of aneurysm is prevalently predisposed by Vosschulte's indirect aortoplastic operation by the use of a synthetic patch. In the remaining 11 patients (3.2%) the reoperation was indicated owing to the development of recoarctation. Today recoarctation concerns children which were operated under the age of two. The most important moment favourable for the recoarctation development is the secondary constriction of the repaired region in consequence of the coarctation listel fibroid tissue and owing to the incapability of the anastomosis to grow. The perspective rests on using new suture material and combined techniques. Late postoperative complications which follow operations performed due to aorta coarctation remarkably augment the peri and postoperative mortality. Three cases out of the given group of 14 patients terminated by exitus (21%). Hence, it is necessary to remove all moments of predisposition creating a condition favourable for the development of recoarctation and aneurysm. (Tab 2, Fig. 1, Ref. 14.).

[Atrial septal defects: the importance of peroperative morphometric evaluation of defects]. / Defekty predsienového septa: význam peroperacného morfometrického hodnotenia defektov.

The authors analyze the results of preoperative morphometry of atrial septal defects. They compare the area of the defect and the septal area in different types of defects. Based on the thus obtained relative value, they select either suture of the defect or its correction by means of a patch. They emphasize that during correction defects deformations and reduction of the septal area must be avoided. They do not admit the possibility that the suture of the defect is exposed to traction. Ostium secundum defects the area of which is greater than 40% of the septal area are suited for correction by means of a patch. An important indicator is the transverse dimension of the defect and of the septum. This relation determines the grade of deformity during an inadequately selected suture and the presence of traction mechanisms in the area of the suture and cardiac skeleton. The authors recommend more frequent use of patches also in ostium secundum defects in the cranial lateral and distal part of the atrial defect.