1/491. Cardiocutaneous fistula.infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic evaluation, which established the diagnosis, the Teflon pledgets and fistulous tract were successfully surgically removed. Prompt diagnosis depends on a high index of suspicion. Eradication of infection requires excision of infected material, which must be planned on an individual basis.- - - - - - - - - - ranking = 1keywords = heart (Clic here for more details about this article) |
2/491. Integrated approach for revascularization in multivessel coronary artery disease and porcelain aorta.We report two cases in which combined beating heart revascularization of the left anterior descending artery (LAD) and percutaneous angioplasty of the non-LAD target arteries were adopted after the intraoperative detection of porcelain aorta and impossibility to complete surgical revascularization. This type of strategy preserves the benefits of surgical LAD grafting and complete revascularization and results in a simple and low-risk technical procedure in an otherwise challenging setting.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
3/491. Fatal cardiac beta2-microglobulin amyloidosis in patients on long-term hemodialysis.We report two long-term hemodialysis patients who developed severe congestive heart failure attributable to cardiac heavy amyloid deposition. Both patients became hypotensive during dialysis sessions, gradually making it difficult to continue hemodialysis, and they died of congestive heart failure. At autopsy, left ventricle walls in each case contained diffuse extensive deposits of amyloid. The distribution of amyloid was not localized to vessel walls but was widely disseminated throughout the left ventricle walls and replaced myocardial muscle fibers. Immunohistochemical examination showed positive staining for anti-human beta2-microglobulin antibody. We conclude that cardiac dialysis-related amyloidosis should also be considered in long-term hemodialysis patients with congestive heart failure as a life-threatening complication.- - - - - - - - - - ranking = 1.5keywords = heart (Clic here for more details about this article) |
4/491. Transesophageal echocardiography with a single-plane probe. Long-axis views of the heart from the apical (transgastric) approach.The literature suggests that during transesophageal echocardiography (TEE), a short-axis view can be obtained in the gastric position using a single-plane probe. Recently, we have found that a long-axis apical display of the heart can be achieved by placing the tip of the probe in the fundus of the stomach. In a 3-month period, we attempted to obtain this view in 54 consecutive patients. Twelve of the patients had TEE done under general anesthesia, while the other 42 patients had the procedure performed under sedation with midazolam at hospital bedside or as an outpatient. The long-axis transgastric view was obtained in 51 of the 54 patients (94%). The image quality was graded subjectively as good in 39 (72%) and fair in the other 12 patients (22%). This view helped to establish the diagnosis in eight patients (15%) and to increase the level of confidence about the accuracy of the diagnosis in 23 (43%) other patients. Four patients' findings are described. We conclude that the new long-axis transgastric view is easy to obtain, does not add much time to the usual TEE study, does not add to the low complication rate of TEE, and may help to interrogate the distal structures of the heart.- - - - - - - - - - ranking = 3keywords = heart (Clic here for more details about this article) |
5/491. Intraoperative echocardiography in cardiac emergencies.echocardiography has brought about a new modality of surgical decision making in open heart surgery. Especially in urgent and emergency surgery, echocardiography can provide decisive insight into the underlying pathophysiological processes, improved monitoring of cardiac function, as well as immediate quality control after the procedure. The importance of intraoperative echocardiography for the cardiac surgeon is illustrated in a number of selected case reports.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
6/491. Young-Simpson syndrome: further delineation of a distinct syndrome with congenital hypothyroidism, congenital heart defects, facial dysmorphism, and mental retardation.Young-Simpson syndrome is a rare congenital disorder, characterized by congenital hypothyroidism, congenital heart defects, facial dysmorphism, cryptorchidism in males, hypotonia, mental retardation, and postnatal growth retardation. We describe the cases of a 5-year-old boy and a 7-year-old girl with a similar constellation of symptoms and compared them with previously reported patients.- - - - - - - - - - ranking = 2.5keywords = heart (Clic here for more details about this article) |
7/491. Echocardiographic features of an unusual case of aortic valve endocarditis.In a patient with aortic valve endocarditis a myocardial abscess, complete heart block and acute aortic regurgitation developed. echocardiography gave evidence of large aortic valve vegetations, and at operation vegetations were found to have destroyed the right coronary cusp and part of the noncoronary cusp. Following surgery the patient recovered. echocardiography may prove to be a useful noninvasive technique to aid in the timing of surgical therapy in patients with valvular vegetations.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
8/491. Atrial thrombosis in cardiac amyloidosis: diagnostic contribution of transesophageal echocardiography.Few cases of atrial thrombosis detected by transesophageal echocardiography (TEE) in cardiac amyloidosis have been reported recently. We present the cases of 3 consecutive patients affected by AL-type cardiac amyloidosis, symptomatic for heart failure and in sinus rhythm. All patients had a cardiac restrictive pattern at Doppler examination. TEE showed left atrial thrombus in 2 patients and biatrial thrombi in 1 patient; conventional transthoracic echocardiography detected only 1 left atrial thrombus. Our experience confirms the association between cardiac amyloidosis and atrial thrombosis, even in sinus rhythm. TEE should be considered to assess thromboembolic risk in all cases of cardiac amyloidosis with severe diastolic dysfunction.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
9/491. Extrauterine pelvic arteriovenous malformation mimicking the clinical presentation of structural heart disease.A case is reported of an extrauterine pelvic arteriovenous malformation involving branches of the internal iliac arteries. cardiomegaly and a rough cardiac murmur were the clinical presentations mimicking a structural heart disease. A continuous bruit could only be detected by the diaphragm of the stethoscope applied firmly to the left lower abdomen. Multiple blood samplings from inferior vena cava, and iliac and femoral veins for determination of oxygen saturation may be necessary for suspected cases. However, selective arteriography remains the best method for diagnosing the presence, extent, and multiplicity of the lesions before surgery or percutaneous arterial embolization.- - - - - - - - - - ranking = 8.2564241189293keywords = heart disease, heart (Clic here for more details about this article) |
10/491. Acute cardiac herniation after radical pleuropneumonectomy.Acute cardiac herniation after radical pneumonectomy is extremely rare and is associated with an immediate mortality greater than 50%. We report a patient in whom cardiac herniation produced no signs or symptoms. The heart was returned to its correct position and the pericardial defect was repaired.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
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