Journal of cardiac surgery
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Transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) with Amplatzer septal/duct occluder (ASO/ADO) is an established, safe, and efficient procedure with high success. However, device embolization remains a major complication requiring immediate intervention (either percutaneous or surgical) for retrieval and correction of the heart defect. The aim of this study is to share the experience of managing embolized ASO/ADO. ⋯ Careful consideration should be given to surgical or transcatheter closure of a heart defect. Life-threatening complications although rare can occur. Our experience strongly suggests that these devices should only be inserted in facilities where cardiac surgical support is immediately available.
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Case Reports
A modified technique of left ventricular restoration: endoventricular spiral plication.
We describe a modified technique of left ventricular restoration after anterior myocardial infarction, referred to as endoventricular spiral plication (ESP). This technique was designed for surgical ventricular restoration with a modified spiral stitch and no patch plasty. A continuous spiral stitch can reconstruct the left ventricular shape both at the short and long axis, and appropriate restoration can be achieved by adjusting the tension of the string and the degree of spiral rotation.
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Case Reports
Repair of an ascending aortic aneurysm using reduction aortoplasty in a Jehovah's Witness.
Reduction ascending aortoplasty has been advocated as a possible alternative to traditional graft replacement for treatment of aneurysms of the ascending aorta and root. We report a case of a 58-year-old Jehovah's Witness female, with a 5.5-cm ascending aortic aneurysm and critical aortic stenosis. She underwent aortic valve replacement and reduction aortoplasty buttressed with a Dacron graft. We reviewed the history and contemporary applications of this technique and concluded that aortic reduction with externally supported aortoplasty may represent a viable option to treat Jehovah's Witness patients with ascending aorta and root aneurysm.
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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disorder characterized by replacement of myocytes with adipose and fibrous tissue and often presents with ventricular arrhythmia, heart failure, and sudden death. This report describes a 67-year-old man with ARVC complicated with severe mitral regurgitation, dilated annulus of the tricuspid valve, and coronary artery-pulmonary artery fistula. Mitral valve repair, tricuspid valve annuloplasty, and ligation of the coronary artery-pulmonary artery fistula were performed. The postoperative course was uneventful, and the patient was discharged on postoperative day 15.
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A case of a 16-year-old female with tetralogy of Fallot and absent pulmonary valve is presented, who on coronary angiography and computerized tomography (CT) angiography had severe compression of the left main coronary artery by the dilated main pulmonary artery. The patient was successfully managed by surgical correction of the intracardiac defect, with right ventricular outflow tract reconstruction by the Contegra(®) bovine jugular vein conduit.