Texas Heart Institute journal
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Herein, we describe the design of a perfusion system for a complex cardiovascular reoperation in an 11-kg Jehovah's Witness patient. The goal of safe, transfusion-free surgery was achieved chiefly by minimizing the priming volume of the cardiopulmonary bypass circuit to 200 mL while providing adequate flow and standard safety features.
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We present a case of transient left ventricular outflow tract obstruction after mitral valve replacement with a high-profile bioprosthesis; only the posterior native mitral valve leaflet was preserved. A 76-year-old woman was admitted to our institution with pulmonary edema. Two weeks earlier, she had undergone mitral valve replacement at our hospital due to severe mitral stenosis and 2+ mitral regurgitation complicated by cardiac failure and atrial fibrillation. ⋯ Doppler echocardiography revealed a peak 64-mmHg gradient between the septum and the strut of the bioprosthesis. The patient was successfully treated medically. This case indicates that the risk of left ventricular outflow tract obstruction after bioprosthetic mitral valve replacement is not always eliminated by removal of the anterior mitral valve leaflet when the posterior mitral leaflet is preserved.
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The clinical presentation of myocarditis is variable and often mimics myocardial infarction. The diagnosis of acute myocarditis is frequently empiric, and is made on the basis of the clinical presentation, electrocardiographic changes, elevated cardiac enzymes, and lack of epicardial coronary artery disease. ⋯ We present the case of a young woman who presented with chest pain and dramatic anteroseptal ST-segment elevation on electrocardiography. The diagnosis of acute myocarditis was eventually confirmed with use of cardiac magnetic resonance imaging.
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Case Reports
Successful surgical treatment of massive pulmonary embolism after coronary bypass surgery.
Acute massive pulmonary embolism after cardiac surgery is very rare. Although accurate diagnosis and rapid treatment are crucial to a successful outcome, there is no standard treatment option. ⋯ Open pulmonary embolectomy may be the best choice for treating these patients. This report describes our use of emergency pulmonary embolectomy along with cardiopulmonary bypass as an effective therapeutic approach in 2 cases of massive pulmonary embolism that occurred after on-pump coronary artery bypass grafting.