Cardiac herniation after left intrapericardial pneumonectomy.

Postoperative cardiac herniation is a rare fatal complication that requires urgent surgical reduction and closure of the pericardial defect. Cardiac herniation occurred 8 h after a left intrapericardial pneumonectomy. Although the patient was completely asymptomatic, acute hemodynamic failure with electrocardiographic changes occurred. Chest radiographs were not helpful in showing cardiac herniation. The patient was immediately brought back to the operating room. Cardiac herniation was found to be caused by a pericardial defect, and the heart was strangulated at the atrioventricular groove level. The heart was repositioned, but hemodynamic instability inherent to ischemic strangulation lesions persisted despite extracorporeal membrane oxygenation.

A case of huge solitary fibrous tumor with hypoglycemia.

We report the case of a 64-year-old man with a huge solitary fibrous pleural tumor who presented with breathlessness and recurrent severe symptomatic hypoglycemia. The tumor was safely removed in toto via a median sternotomy. The patient had an uneventful postoperative recovery and no recurrent hypoglycemia.

Modified medial nephropexy for treatment of the anterior nutcracker syndrome.

We report the case of a 15-year-old male, presenting with recurrent gross hematuria complicated by acute anemia. Cystoscopy showed little bleeding from the left ureteral orifice. Diagnosis of left renal vein compression at the aortomesenteric space was established through color Doppler ultrasonography and computed tomographic angiography. Therapeutic attitude was interventionist in our case, performing successful management with modified medial nephropexy, with a retroperitoneal approch. To the best of our knowledge, we report the second case of left medial nephropexy for treatment of the anterior nutcracker syndrome. The first case of modified medial nephropexy was done by lowering the left renal vein from its initial position in the aortomesenteric angle through a restrict retroperitoneal approach.

Primitive cardiac sarcomas: about 2 cases.

BACKGROUND: the cardiac sarcomas, although very rare, represent the quasi-totality of the primitive sly tumors of the heart AIM: it is about a retrospective study of two cases of cardiac sarcomas operated in Sahloul university hospital of Sousse. CASES: it is about a woman and a man: The respective ages were 22 and 45 years. The clinical pattern of the patients was polymorphic and the diagnosis put by cardiac echography. Both patients had a surgical resection and a chemotherapy. Both patients died in 13 and 18 months after the diagnosis. CONCLUSION: because of the extreme rarity of the cardiac sarcomas, there is no precise therapeutic strategy. The only consensus concerns the surgery as soon as the diagnosis of cardiac tumor is put. The prognosis of these tumors is extremely redoubtable with a survival which does not exceed 2 years after the beginning of the symptomatology.

[Cor triatriatum: of six operated patients report]. / Coeur triatrial: a propos de 6 cas opérés.

Six cases of cortriatriatum operated between January 1990 and April 2004. Their ages ranged from 3 months to 22 years. Associated lesions are present in 4 patients. They consisted mostly of interatrial defects. The echocardiography has been considered the procedure of choice for the diagnosis. Results of surgery were excellent for all patients with a mean follow up of 5 years.

[Congenital abdominal infrarenal aortic aneurysm in infants: 2 case reports and literature review]. / Anevrysme congenital de l'aorte abdominale sous-renale chez le nourrisson: cas cliniques et revue de la littérature.

Abdominal aortic aneurysm is extremely rare in infant and is generally due to infection, umbilical artery catheterization, vasculitis, connective tissue diseases and tuberous sclerosis. At the absence of these evident causes, it is a congenital primary aortic aneurysm which is exceedingly rare and only a few cases have of which have been reported. Here we report two cases of aortic wall reconstruction done by a Gore tex patch. The immediate result is excellent with a reestablishment of the femoral pulse and an excellent Doppler control. The problem which we may face in the future is probably the aortic out come with this Gore tex patch a continaons follow up of these patients is necessary.

[Chronic aortic regurgitation with left ventricular dysfonction]. / Insuffisance aortique avec dysfonction ventriculaire gauche.

We studied fifty one patients (40 men and 11 women) under going valve replacement from 1990 to 2002 for aortic regurgitation and had left ventricular dysfunction. 45% patients were in class III or IV of New York Heart Association (NYHA). All patients were investigated by echocardiography (left ventricular ejection fraction [LVEF] < 50%) - Peroperative mortality was 5.8% due to myocardial failure. 81.4% of survivors were followed duering a mean period of 24 months (rangis from 3 to 67 months) after valve replacement.

[Cardio-pericardial hydatid cyst. Report of 19 cases]. / Les kystes hydatiques cardio-pericardiques. A propos de 19 observations.

From May 1991 to July 2003, 19 patients (9 men and 10 women), of 30 years average age were operated in our department service for surgical cure of cardio-pericardial hydatid cysts. The TEE constitutes the examination of choice in the cardio-pericardial diagnosis of hydatid cyst. The surgery under CPB is the technique of choice, we practiced used 15 times. The left ventricular localization is most frequent. We deplore only death into post-operative immediate. The post-operative was course simple at the majority of our patients. 17 patients could be controlled remotely of the intervention with 35.5 months an average passing. We deplore 2 late deaths. No relapse was observed.