Traumatic Atrial Septal Defect Repair via Primary Endovascular Suture Method: Case Report and Operative Technique.

We report a case of a 20-year-old male with no prior medical history who was found to have an atrial septal defect on echocardiography following a motor vehicle accident (MVA). The patient underwent primary percutaneous defect closure using the NobleStitch EL (Heartstitch, Fountain Valley, California) cardiovascular suturing system with intra-operative Doppler echocardiogram showing no residual shunt or color flow. There were no operative complications. At five months follow-up, the patient reported no symptoms from the procedure. In the case of traumatic atrial septal defect repair, the NobleStitch EL system may be utilized as an alternative to open heart surgery.

Pulmonary Artery Root Replacement for Leiomyosarcoma: A Viable Thoracic Oncovascular Operation.

Leiomyosarcoma of the pulmonary artery is a rare but potentially fatal disease. Due to its rarity, the treatment algorithm is not well-established. While there may be a role for both chemotherapy and radiotherapy, surgical management is the most definitive method. Unfortunately, when the disease process is advanced, surgery may not be curative. However, it may still be a palliative treatment option. In this case report, we present a patient who suffered from respiratory symptoms that were initially attributed to pulmonary embolism (PE). However, upon the diagnosis of pulmonary artery leiomyosarcoma (PAL), surgery intervention was undertaken and resulted in an improved quality of life for the patient.

Transcatheter Occlusion of a Patent Ductus Arteriosus for a Symptomatic Left-to-Right Shunt.

Congenital diaphragmatic hernias (CDH) can induce life-threatening pulmonary hypertension and right heart failure. The patent ductus arteriosus (PDA) is often maintained in CDH to allow for decompression into the systemic circulation. However, if the PDA becomes hemodynamically significant, PDA closure may be indicated. Traditional methods rely on pharmacological closure. In this report, we document a rare transcatheter closure of a hemodynamically significant PDA.

Palpitations and a Left Ventricular Mass: An Odd Presentation of Left Dominant Arrhythmogenic Cardiomyopathy.

A 20-year-old woman presented with palpitations. Echocardiography demonstrated a left ventricular mass involving the posterolateral apical wall and protruding into the ventricular cavity. Evaluation with magnetic resonance imaging (MRI) suggested fatty consistency with all edges well defined except the medial, which was ill defined, raising concern for an invasive liposarcoma. Open core needle biopsy demonstrated mature adipocytes infiltrating the myocardium with extensive interstitial fibrosis. The diagnosis was left-dominant arrhythmogenic cardiomyopathy. Two-year MRI follow-up demonstrates no change in size. This case illustrates the use and limits of cardiac MRI and the value of open cardiac biopsy in diagnosis.