Thoracic and Cardiovascular Surgeon Reports最新文献

Background: Congenital heart disease, repaired or unrepaired, requires lifelong follow-up. Carcinoid disease, rheumatic heart disease, and infective endocarditis can damage all four cardiac valves. Multiple valve replacement has a poor outcome.

Case description: A 23-year-old male underwent single-stage quadruple valve (mechanical [mitral and aortic] and bioprosthetic [tricuspid and pulmonary]) replacement due to rheumatic carditis and surgical complications. Over 8 years of follow-up, he is asymptomatic, has no prosthetic valve-related complications, and has improved cardiac function.

Conclusion: Single-stage quadruple valve replacement with mechanical and bioprosthetic valves has a good long-term outcome. To the best of our knowledge, this is the longest follow-up study from India.

Background: Vertebral artery fenestration (VAF) is a rare anatomical variation of the vertebral artery that may affect the safety of clinical surgeries and interventional treatments. Although ultrasound is widely used to assess neck vessels, its application in diagnosing VAF has not been extensively investigated.

Case description: This article reports a case of an 82-year-old male patient who was diagnosed with VAF following a neck vessel ultrasound examination prompted by poor blood sugar control. The ultrasound revealed an abnormal course of the left vertebral artery, leading to the diagnosis of VAF.

Conclusion: Ultrasound, with its noninvasive nature and real-time imaging capabilities, is a valuable initial screening tool for diagnosing VAF. Despite its limitations, its ability to identify vascular anomalies such as VAF highlights its critical role in early detection, potentially improving patient outcomes and guiding clinical decision-making.

Background  Minimally invasive lateral thoracotomies may cause severe postoperative pain and discomfort. We describe an intraoperative intercostal cryo-neuronal pain block as one possibility for postoperative pain relief. Case description  A 63-year-old male patient underwent minimally invasive mitral valve repair. To reduce postoperative pain, an intercostal cryo-neuronal ablation was performed. The consecutive course was pain-free. Conclusion  Intraoperative cryo-neuronal nerve block may be a standard procedure during minimally invasive cardiac surgery.

Background  Cardiac myxomas are the most common primary cardiac neoplasms. Case Description  We present a case of a middle-aged lady with cardiac myxoma in her left atrium awaiting semi-elective surgery. During the preoperative period, the patient presented emergently with acute bilateral lower limb ischemia. This lady was fortunate to have these emboli fired towards a tissue with ischemia tolerance capacity. If these emboli had been directed toward the central nervous system, this patient would have experienced devastating complications and even death. Conclusion  This presentation opens the debate on the timing of surgical intervention in myxoma patients.

Dilated cardiomyopathy (DCM) is one of the main causes for end-stage heart failure. Until the transplantation, left ventricular assist devices (LVAD) have become an established treatment. We report a case of a 66-year-old patient with ischemic and DCM and suspected aortic ulcer formation. LVAD was implanted in the same session with a supracoronary aortic replacement. Bilateral cannulation of the subclavian arteries omitted the need of circulatory arrest and proximal aortic cross-clamping. Pneumonia-associated decarboxylation failure prolonged the postoperative intensive care period. The patient was finally discharged home on the 115 ^th postoperative day.

The risk of patent ductus arteriosus infective endarteritis (PDA-IE) has significantly reduced since the introduction of antibiotics and surgical or interventional treatment strategies. However, diagnosis and adequate, timely management of PDA-IE remains challenging. We present the case of a 9-year-old girl with PDA-IE, illustrating our strategy to minimize complications in pediatric patients.

Surgery for Bentall's endocarditis poses challenges because the infection spreads to the aortic valve annulus, leading to an annular abscess that necessitates reconstruction. We present a straightforward miniskirt Bentall procedure using an annular pericardial patch to treat Bentall's endocarditis with an annular abscess. After removing the former composite graft and debriding the aortic root and annulus, we created a miniskirt-composite graft using a mechanical or bioprosthetic valve, a straight or Valsalva graft, and an annular bovine pericardial patch with a valve prosthetic sizer. The miniskirt-composite graft, along with the underlying annular pericardial patch, was implanted using a double-layered suture technique.

Symptoms of papillary fibroelastomas are often related to thromboembolic events but are rarely caused by a mechanical impairment of blood supply by the tumor itself. We describe a case of a papillary fibroelastoma in a 91-year-old female patient leading to a cardiac arrest through intermittent occlusion of the left coronary artery.

We report two cases of rare invasive tumors presenting with transvenous and intracardiac extensions. In one instance, an unusual invasive thymoma type A penetrated into the heart chamber; the other case was an extension of a myxoma into the right atrium that was associated with superior vena cava syndrome. Our interest was stimulated by the rarity of these clinicopathological observations and the unusual clinical features of diagnostic and therapeutic methods presented by these cases.