Robotic Redo Mitral Valve Replacement and Atrioventricular Groove Pseudoaneurysm Repair.

We report the use of robot-assisted right thoracotomy in the management of a patient who presented with acute-on-chronic congestive heart failure, associated with a contained atrioventricular dissection and 2 prior mitral valve replacements. Our patient had evidence of a contained rupture, as represented by preoperative cross-sectional imaging. The anatomic sequela from this was a ventricular pseudoaneurysm, which was likely survivable due to adhesions from prior operations buttressing the margins of the defect. Expansion of the pseudoaneurysm likely contributed to the dehiscence of the prosthesis. Our case illustrates an unprecedented resolution of a serious complication, managed effectively and efficiently by a robot-assisted procedure. With a successful outcome of totally endoscopic and robot-assisted repair, we demonstrate the versatility of minimally invasive techniques in addressing complicated anatomy as well as a surgical field scarred by multiple prior surgeries.

Imaging, Surgical, and Pathology Findings of a Myxoid Aortic Sarcoma: When Distal Embolization Uncovers a Bigger Problem.

Aortic sarcomas are a very rare condition typically characterized by a deceiving presentation. Making a correct diagnosis is based on the application of an algorithm which allows to identify the primary disease site and to obtain a tissue diagnosis. Surgical aortic resection with adjuvant therapy offers the best palliation, particularly in cases of well-differentiated tumors with no evidence of diffuse metastatic spread.