Cardiopulmonary bypass circuits with surface-bonded heparin in combination with low-dose heparinisation can be used in cardiac surgery when reduction in systemic heparinisation is required.
Cardiopulmonary bypass circuits with surface-bonded heparin in combination with low-dose heparinisation can be used in cardiac surgery when reduction in systemic heparinisation is required.
We report the successful removal of a large right atrial haemangioma associated with multiple liver haemangiomas. Preoperative echocardiography showed a large right atrial mass, and computerised tomography revealed lesions in the liver. A preoperative diagnosis of malignant cardiac tumour and liver secondaries was made. However, the tumour was benign. This case emphasises the need to obtain a definitive histologic diagnosis preoperatively, if possible, before rejecting a patient for surgery, and to be aware that benign lesions can be multifocal.
Although the concept of sequential segmental analysis is now widely accepted for description of congenitally malformed hearts, some aspects remain controversial. Our concepts have changed little since our initial descriptions, although we have improved the words we use to describe anatomic features. In this review, we give an outline of the steps needed, prerequisites for application of the steps, and the limited anatomic possibilities available at each step. We emphasise that our analysis of the atrial chambers, following the so-called morphologic method, uses the arrangement of the junctional morphology between the atrial appendages and the venous components of the atriums as the arbiter of morphological rightness and leftness. At the atrioventricular junctions, separate analysis of the connections of the muscle masses from the arrangements of chambers within the ventricular mass clarifies controversies concerning the “univentricular” heart. At the ventriculo-arterial junction, we focus on the need to identify a solitary arterial trunk, together with the fact that precise junctional morphology is conditioned by the semilunar attachments of the leaflets of the arterial valves. We argue that application of these principles will distinguish between those controversies which are semantic as opposed to those reflecting persisting scientific disagreements.
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