Journal of cardiac surgery
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Case Reports
Echocardiographic diagnosis and surgical closure of coronary sinus type of atrial septal defect.
Coronary sinus type of atrial septal defect (ASD CS) is a rare cardiac anomaly and is rarely diagnosed by only transthoracic echocardiography prior to surgical operation. We now describe a technique to treat this defect with the aid of two-dimensional echocardiography, which prevents trauma to the conduction system and maintains drainage from the coronary sinus into the right atrium (RA).
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Case Reports
Repair of left atrial-esophageal fistula following percutaneous radiofrequency ablation for atrial fibrillation.
Atrial-esophageal fistula is a rare but often fatal complication of percutaneous radiofrequency ablation for atrial fibrillation. We present a patient who was diagnosed with this complication in a delayed fashion and successfully treated with primary repair via left thoracotomy. The details of the surgical approach are discussed.
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Comparative Study
Omission of a prior Glenn anastomosis is a risk factor for prolonged pleural drainage after the fenestrated extracardiac conduit Fontan procedure.
Factors related to prolonged pleural drainage after the Fontan operation have not been clearly defined. We investigated perioperative variables to establish factors predicting operative morbidity including prolonged chest tube drainage. Also, we pursued the fate of the fenestration during the follow-up period. ⋯ Previous bidirectional cavopulmonary shunt and shortened aortic cross-clamp time may reduce postoperative morbidity including prolonged chest tube drainage and mechanical ventilator support after the fenestrated extracardiac conduit Fontan procedure.
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Comparative Study
Timely use of a CentriMag heart assist device improves survival in postcardiotomy cardiogenic shock.
Postcardiotomy cardiogenic shock (PCS) is often fatal despite inotropic and circulatory support. We compared our experience with the CentriMag left ventricular assist device (LVAD) for patients with PCS at two time periods: in the operating room (OR) after unsuccessful weaning from cardiopulmonary bypass (CPB) and after transfer to the intensive care unit (ICU). ⋯ In patients with PCS, timely placement of a CentriMag LVAD may increase the chance of eventual recovery.
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Papillary fibroelastoma (PFE) is a benign primary tumor of the heart usually originating from the heart valves. Nonvalvular fibroelastomas are rare, and reported cases have presented either incidentally or with cerebral embolic phenomena; none have reported recurrent anginal symptoms. We are reporting a case of a 53-year-old female with history of significant radiation exposure to the chest in the past, who presented with recurrent chest pain and was found to have left atrial nonvalvular PFE managed with surgical excision.