1/111. 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 = aneurysm (Clic here for more details about this article) |
2/111. An unusual combination of cardiovascular surgical disorders.A 53-year-year-old man presented with aortic regurgitation, subvalvular and supravalvular aortic stenoses, and aneurysms involving the ascending aorta, the arch, and the innominate, right subclavian, and left common carotid arteries. Surgery consisted of resection of the obstructive lesions, replacement of the aortic valve, graft replacement of the ascending aorta, and the arch resection of innominate and subclavian artery aneurysms and reconstruction with a side limb to which the right carotid artery was anastomosed. The patient has remained asymptomatic with full employment.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
3/111. Intraoperative left ventricular perforation with false aneurysm formation.Two cases of perforation of the left ventricle during mitral valve replacement are described. In the first case there was perforation at the site of papillary muscle excision and this was recognized and successfully treated. However, a true ventricular aneurysm developed at the repair site. One month after operation rupture of the left ventricle occurred at a second and separate site on the posterior aspect of the atrioventricular ring. This resulted in a false aneurysm which produced a pansystolic murmur mimicking mitral regurgitation. Both the true and the false aneurysm were successfully repaired. In the second case perforation occurred on the posterior aspect of the atrioventricular ring and was successfully repaired. However, a false ventricular aneurysm developed and ruptured into the left atrium producing severe, but silent, mitral regurgitation. This was recognized and successfully repaired. The implications of these cases are discussed.- - - - - - - - - - ranking = 4keywords = aneurysm (Clic here for more details about this article) |
4/111. Post-infarction cardiac rupture.Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.- - - - - - - - - - ranking = 1.4704682249132keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/111. Aorto-right ventricular fistula: a late complication of aortic valve replacement.We report the case of a patient who was found to have an aorto-right ventricular fistula 17 years after receiving a Bjork-Shiley prosthetic aortic valve. A pseudoaneurysm had formed at the aortotomy suture line, and it had extended into the interventricular septum and had eventually opened into the right ventricle. Using transesophageal echocardiography, we identified the defect in the ascending aorta, and a left-to-right shunt. aortography was used to confirm these findings. The pseudoaneurysm was successfully resected and the ascending aorta was replaced with a Dacron graft. To the best of our knowledge, no similar late complication of aortic valve replacement has been reported in the medical literature.- - - - - - - - - - ranking = 2.9409364498265keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
6/111. Identification of cardiac masses and abnormal blood flow patterns with harmonic power Doppler contrast echocardiography.Power Doppler is an ultrasound technique that color-encodes the change in amplitude of the ultrasound signal, which reflects changes in the position of scatterers between ultrasound pulses. Power Doppler can be used with echocardiographic contrast agents in a harmonic imaging mode to opacify a cardiac chamber. The opacification of a cardiac chamber can aid in visualizing the silhouette of intracardiac masses and displaying blood flow patterns. Four cases are presented that demonstrate the use of harmonic power Doppler to aid in the identification of a left ventricular apical thrombus, a left atrial thrombus, and a left ventricular pseudoaneurysm.- - - - - - - - - - ranking = 1.4704682249132keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/111. salmonella infection of a ventricular aneurysm with mural thrombus.We describe a case of salmonella infection of a left ventricular aneurysm with a mural thrombus and review 12 cases described in the literature. This entity should be looked for in any patient with persistent or relapsing salmonella bacteremia in whom an intracardiac thrombus is demonstrated. Nuclear imaging may help in the diagnosis. A combined medical and surgical approach should be aggressively pursued because patients who do not undergo an aneurysmectomy are unlikely to survive.- - - - - - - - - - ranking = 3keywords = aneurysm (Clic here for more details about this article) |
8/111. Ventriculotomy and resection for left ventricular thrombus infection with salmonella.We report the case of a patient with a left ventricular thrombus infected by salmonella. The diagnosis was suspected from a gallium scan demonstrating an intense activity in the lower left parasternal area. A transesophageal echocardiogram confirmed a calcified left ventricular aneurysm with a mural thrombus containing pus and heterogeneous material. The patient underwent a successful left ventricular aneurysmectomy, thrombectomy and endocardial resection under cardiopulmonary bypass which brought the infection under control.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
9/111. Diverticulosis of the left ventricle.Nine patients, 4--60 years old, had single or multiple left ventricular outpouchings, best seen during diastole, and believed to represent congenital diverticula. The 14 diverticula, 5--28 mm long, were either along the diaphragmatic or anterior ventricular wall. Only one patient had his diverticulum surgically removed; the wall was lined by thick endocardium surrounded by normal myocardium. The lesions did not produce local or systemic complications. All patients had normal chest radiographs. The material suggests that left ventricular diverticula not associated with midline anomalies are perhaps not very rare and should be distinguished from cardiac aneurysm.- - - - - - - - - - ranking = 0.5keywords = aneurysm (Clic here for more details about this article) |
10/111. Coronary artery-left ventricle fistula complicating balloon angioplasty--a case report.The authors describe a coronary artery fistula complicated balloon angioplasty. The proximal left anterior descending coronary artery was dilated, but a septal branch was occluded by thrombus. angioplasty was used on the septal branch, but a pseudoaneurysm communicating with the left ventricle occurred. Follow-up angiography revealed spontaneous closure of the fistula.- - - - - - - - - - ranking = 1.4704682249132keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
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