Texas Heart Institute journal
-
Surgical valve replacement after infective endocarditis can result in local destructive paravalvular lesions. A 30-year-old woman with infective endocarditis underwent mitral valve replacement that was complicated postoperatively by 2 paravalvular leaks. ⋯ We discuss our patient's case and its relation to others in the relevant medical literature. To our knowledge, we are the first to describe the use of a percutaneous approach to close concomitant paravalvular leaks and a Gerbode defect.
-
Although biventricular heart failure has been successfully managed with dual continuous-flow ventricular assist devices, the long-term use of 2 mechanically dissimilar pumps has traditionally been discouraged. We present the case of a 52-year-old man whose treatment with a HeartMate II left ventricular assist device was complicated by right ventricular failure, necessitating the implantation of a long-term right ventricular assist device. ⋯ The patient was discharged from the hospital after routine postoperative care and dual-device training. This case shows that, despite logistical complexities, nonidentical continuous-flow device pairings can successfully provide long-term biventricular support.
-
Constrictive pericarditis is the final stage of a chronic inflammatory process characterized by fibrous thickening and calcification of the pericardium that impairs diastolic filling, reduces cardiac output, and ultimately leads to heart failure. Transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging each can reveal severe diastolic dysfunction and increased pericardial thickness. ⋯ Early pericardiectomy with complete decortication (if technically feasible) provides good symptomatic relief and is the treatment of choice for constrictive pericarditis, before severe constriction and myocardial atrophy occur. We describe our surgical approach to constrictive pericarditis, summarize our results in 93 patients, and provide a brief overview of the literature.