Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Feb 2014
Case ReportsSystolic anterior motion of the mitral valve masked by general anesthesia.
Systolic anterior motion of the mitral valve is usually associated with hypertrophic obstructive cardiomyopathy that results in left ventricular outflow tract obstruction. This is sometimes treated by volume loading or negative inotropics such as beta blockers. We report a rare case of dynamic systolic anterior motion of the mitral valve, in which a beta blocker did not diminish but anesthetic agents masked intraoperatively. The patient underwent mitral valve replacement, and left ventricular outflow tract obstruction was successfully treated.
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Asian Cardiovasc Thorac Ann · Feb 2014
Case ReportsHeartWare left ventricular assist device thrombosis in aspirin non-responder.
Patient characteristics that increase the risk of continuous-flow left ventricular assist device thrombosis have not been well established. We report a case of HeartWare thrombosis in a patient with aspirin hyporesponsiveness, and discuss the role of platelet function testing in preventing this severe complication. There is a need for clinical trials determining optimal antiplatelet therapy in patients supported with left ventricular assist devices, and consensus regarding modification of antiplatelet therapy after device thrombosis.
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Asian Cardiovasc Thorac Ann · Feb 2014
Strategy to avoid patient-prosthesis mismatch: aortic root enlargement.
The choice of a valve with an effective orifice area matching the body surface area and providing efficient hemodynamics is an important factor affecting mortality and morbidity in patients undergoing aortic valve replacement. ⋯ Aortic root enlargement is a safe procedure. Therefore, cardiac surgeons should not be reluctant to enlarge the aortic root with an autologous pericardial patch to permit implantation of an adequate size of aortic valve prosthesis, with minimal additional aortic crossclamp time and no added cost.
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Asian Cardiovasc Thorac Ann · Feb 2014
Case ReportsConcomitant congenital heart defect repair and Nuss procedure for pectus excavatum.
The combination of complex congenital cardiac anomalies and pectus excavatum represents a technical challenge. Most concomitant repairs have been performed in adult patients. We report the uncomplicated concomitant repair of double-outlet right ventricle with absent pulmonary valve syndrome and the Nuss procedure for pectus excavatum in a 3-year-old child.