Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology
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Cardiovasc. Pathol. · Jan 2016
Histologic examination of decellularized porcine intestinal submucosa extracellular matrix (CorMatrix) in pediatric congenital heart surgery.
CorMatrix is a decellularized porcine small intestinal submucosa extracellular matrix that has gained attention as a promising alternative to current materials used in cardiac repair. While animal models demonstrate integration of CorMatrix material with host tissue, the histologic characteristics of CorMatrix used in humans are less well-characterized. In this retrospective study, we report our experience with CorMatrix material used in pediatric congenital heart surgery and describe the histology of CorMatrix material and of surrounding native tissue in explanted specimens. ⋯ CorMatrix may be associated with a marked inflammatory response, including a foreign-body giant cell reaction and fibrosis of the surrounding native tissue. Degenerative changes of CorMatrix material are also seen in a majority of explanted specimens. No histologic differences were seen between patients with clinical evidence of graft failure versus patients requiring graft removal due to other factors. Additionally, no cases showed evidence of tissue integration or recellularization of patch material. Our overall clinical experience with CorMatrix demonstrates a favorable outcome for pediatric patients undergoing cardiac reconstructive surgery. However, there is no histologic evidence that CorMatrix acts as a scaffold for reconstitution of the native cardiovascular structures.
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Cardiovasc. Pathol. · Nov 2014
Review Case ReportsFibrosing mediastinitis due to Aspergillus with dominant cardiac involvement: report of two autopsy cases with review of literature.
Fibrosing mediastinitis (FM) is a rare condition characterized by extensive proliferation of fibrous tissue in the mediastinum resulting in mass like lesion. Histoplasma and Mycobacterium tuberculosis are the common infective causes of fibrosing mediastinitis, but Aspergillus infection is an extremely rare cause. Fibrosing mediastinitis due to Aspergillus usually occurs following Aspergillus bronchopneumonia. ⋯ Autopsy findings showed the granulomatous Aspergillus mediastinitis and extension into the heart with associated fibrosis. One case was proven to be due to Aspergillus flavus by fungal genomic sequencing. To the best of our knowledge, this is the first report of Aspergillus FM with pancarditis.
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Cardiovasc. Pathol. · Sep 2014
Case ReportsRight atrial thrombus arising from the junction of the right atrium and the inferior vena cava.
Cardiac tumors are a rare cause of recurrent syncope which are detected on echocardiography, computed tomographic scan, and/or magnetic resonance imaging. We present echocardiographic, anatomic, and histopathologic images of a cardiac tumor arising from the junction of the right atrium and the inferior vena cava in a young lady. ⋯ Cardiac thrombi can mimic appearances of a myxoma on echocardiogram. Delay in thrombus removal surgery can result in increased mortality as seen in our case.
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Cardiovasc. Pathol. · Jul 2014
Case ReportsA fatal case of atrioesophageal fistula following radiofrequency ablation of left atrium and pulmonary veins for atrial fibrillation.
Atrial fibrillation (AF) is associated with significant morbidity and mortality. Hemodynamic compromise and formation of thrombi within the fibrillating atrium or atrial appendage can occur. ⋯ Serious complications have been observed among patients who have undergone radiofrequency ablation, atrioesophageal fistula being a very rare example. This case describes a 43-year-old man who died after the development of an atrioesophageal fistula following radiofrequency ablation of the left atrium and pulmonary veins for treatment of AF.
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Cardiovasc. Pathol. · May 2014
ReviewStress cardiomyopathy: yet another type of neurocardiogenic injury: 'stress cardiomyopathy'.
Tako-tsubo syndrome pertains to rare acquired cardiomyopathies, characterized by left ventricular dyskinesia and symptomatology typical for acute myocardial infarction (AMI). Despite its low incidence and relatively benign course, stress cardiomyopathy should be thoroughly differentiated from AMI. The importance of tako-tsubo consists of the fact that its manifestation initially resembles AMI. ⋯ Stress cardiomyopathy reflects merely a single aspect of a much wider range of neurocardiogenic injury, which encompasses cardiac dysfunction associated with subarachnoid hemorrhage, intracranial hypertension and cerebral ischemia. Both psychological and physical insult to central nervous system may trigger a disastrous response of sympathetic nervous system, eventually leading to end-organ catecholamine-mediated damage. This review sought to delineate the phenomenon of tako-tsubo cardiomyopathy and deliver evidence for common pathophysiology of the broad spectrum of neurocardiogenic injury.