Journal of cardiac surgery
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Case Reports
Gerbode defect with Staphylococcus lugdunensis native tricuspid valve infective endocarditis.
Coagulase-negative staphylococci are generally not considered to be very virulent; they are an uncommon cause of native valve endocarditis. Staphylococcus lugdunensis is an important exception and causes more severe infections, clinically mimicking S. aureus. We present a case of direct Gerbode defect associated with S. lugdunensis native valve infective endocarditis (IE) requiring cardiac surgery.
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Anomalies of the pulmonary venous drainage vary widely in their anatomic spectrum and clinical presentation. We describe an unusual case of supra-cardiac total anomalous pulmonary venous connection (TAPVC), where the pulmonary veins drained directly in the posterior aspect of proximal right superior vena cava (SVC) through separate ostia. The veins were re-routed with a patch to the left atrium via the secundum atrial septal defect (ASD). The continuity between distal SVC and right atrium was re-established by re-implanting the SVC to the right atrial appendage (Warden Procedure).
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Case Reports
Staged repair of pentalogy of Cantrell with ectopia cordis and ventricular septal defect.
Pentalogy of Cantrell is a rare congenital anomaly characterized by a combination of severe defects in the middle of the chest and abdomen including intracardiac defects. Survival rate after cardiac surgery is extremely low. We present a successful staged complete repair of an omphalocele, a ventricular septal defect and a sternal defect in a case of pentalogy of Cantrell.
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This is a case of aortic valve endocarditis and leaflet perforation caused by Staphylococcus lugdunensis successfully treated with aortic valve replacement and antibiotics. We believe that the patient's endocarditis may be related to the vasectomy he underwent two months prior to presentation, as S. lugdunensis is an integral component of normal skin flora of the lower abdomen and groin. We also suggest that whenever this organism is found in patients with endocarditis, early surgical treatment of the infected valve should be considered, as S. lugdunensis is an aggressive and virulent coagulase-negative staphylococcus.
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Comparative Study
Have changes in ECMO technology impacted outcomes in adult patients developing postcardiotomy cardiogenic shock?
Extracorporeal membrane oxygenation (ECMO) technology has undergone several advancements over the last decade. We sought to compare current ECMO technology to older ones to determine how these technological improvements have impacted outcomes in patients suffering from postcardiotomy cardiogenic shock (PCS). Between 2005 and 2010, 49 patients received ECMO as support for PCS following elective cardiac surgery. ⋯ Similar trends were detected in hospital survival (Gp 1 = 27.3%, Gp 2 = 27.3%, and Gp 3 = 33.3%). Technology did impact oxygenator durability with Gp 1 requiring seven (63.6%) oxygenator exchanges compared to zero (0.0%) in Gp 2 and two (7.4%) in Gp 1. While advancements in ECMO technology have resulted in improved oxygenator durability, outcomes in patients requiring such support for PCS continue to be poor.