Journal of cardiac surgery
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Case Reports
Interventricular septal rupture after transcatheter aortic valve implantation: surgical and perioperative management.
Transcatheter aortic valve implantation (TAVI) is associated with various complications, usually related to valve positioning or prosthesis delivery. We report the rare complication of an iatrogenic ventricular septal defect, secondary to aortic annulus disruption after TAVI-transfemoral procedure, generating a significant left-to-right shunt and cardiac failure. Open surgical procedures under cardiopulmonary bypass remain the best option for this lethal complication.
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We report a 62-year-old female who required surgery for severe mitral regurgitation. Under robotic assistance, the valve was repaired by transection of the fibrous bridge, implantation of four neo-chordaes to the anterior leaflet, commissuroplasty of the posterolateral commissure, and annuloplasty.
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Patient-prosthesis mismatch has been identified as a risk factor for mortality after aortic valve replacement and for structural valve deterioration (SVD) in patients receiving a bioprosthetic aortic valve. The aim of the present study was to compare the incidence of aortic valve bioprosthesis replacement for SVD in patients with mismatch to a population without mismatch. ⋯ Patients suffering from mismatch were twice as likely to undergo reoperation for aortic bioprosthesis replacement for SVD than those without mismatch.
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Constrictive pericarditis has multiple etiologies and can lead to disabling symptoms and severe heart failure with poor quality of life. Surgical pericardiectomy is the cornerstone of management. All patients undergoing pericardiectomy at our institution were reviewed with the goal of analyzing preoperative and intraoperative factors that may be associated with long-term outcomes. ⋯ Pericardiectomy can be performed with low mortality and immediate improvement in hemodynamics. Those patients with compromised cardiac output, abnormal hepatic or renal function, or with previous radiation therapy have reduced long-term survival.
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Mitral valve operations are increasingly performed through minimally invasive approaches such as the right anterior minithoracotomy. To facilitate exposure with this technique, a diaphragmatic suture may be implemented. We describe a liver laceration caused by the diaphragmatic suture in minithoracotomy mitral repair and its successful nonoperative management with arterial embolization.