Journal of cardiac surgery
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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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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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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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The use of carbon dioxide (CO(2)) insufflation into the pericardial well has become widespread, and in some units routine. The rationale behind this practice is the fact that CO(2) is more soluble than air leading to fewer gaseous microemboli entering the bloodstream and being transferred to the brain or heart. ⋯ Although CO(2) insufflation is generally a safe procedure there are case reports of significant complications. The aim of this systematic review is to analyze the current evidence for this practice.
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We report our experience with a five-year-old child with d-transposition of great arteries (d-TGA), ventricular septal defect (VSD), and severe pulmonary arterial hypertension (PAH). A fenestrated unidirectional-valved patch was used to close the VSD and a standard arterial witch operation (ASO) was performed. Difficulties in assessment of operability and the choice of procedures in such patients are briefly discussed.