Journal of cardiac surgery
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Review Case Reports
Surgical technique of removal of inferior vena cava leiomyosarcoma extending into the right atrium without deep hypothermic circulatory arrest.
Leiomyosarcoma of the inferior vena cava is a rare tumor with potential for significant morbidity and mortality. Surgical extirpiration remains the optimal treatment choice. A case of caval leiomyosarcoma with right atrial extension is presented with management techniques and literature review. ⋯ Resection of extensive caval leiomyosarcoma allows the best chance of cure and is possible without DHCA. Perioperative planning and coordination and adherence to oncologic techniques is critical.
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Acute pulmonary embolism (PE) is a life-threatening disease which often results in death if not diagnosed early and treated aggressively. Despite all efforts at improving outcomes, there is no consensus on the management of acute severe PE. ⋯ Surgical pulmonary embolectomy should be considered early in the management of hemodynamically stable patients with PE who show evidence of RV dilation and/or failure, as it is associated with satisfactory outcomes. Conversely, pulmonary embolectomy has dismal results under salvage conditions. Revision of current guidelines for the surgical management of this condition may be warranted.
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Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.
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Review Case Reports
Total aortic arch replacement for the treatment of Kommerell's diverticulum in a Jehovah's Witness.
The treatment of Kommerell's diverticulum continues to evolve given advances in aortic surgery, cardiopulmonary bypass management, and endovascular techniques. This case report details the repair of a diverticulum of Kommerell in a Jehovah's witness with a right-sided aortic arch and reviews the surgical literature.
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We describe an unusual presentation of cardiac tamponade as superior vena cava syndrome post minimally invasive mitral valve repair. The tamponade was caused by local compression of junction between the right atrium and superior vena cava. This case illustrates the importance of using transesophageal echocardiogram in postoperative management of cardiac surgery patients.