J Cardiovasc Surg
-
Mitral aneurysm is commonly associated with infectious endocarditis of the aortic valve. In rare instances, it is associated with other underlying inflammatory or metabolic disorders. A 62-year-old man with mitral valve insufficiency with moderate aortic valve insufficiency underwent operation. ⋯ There was no evidence of infection in the mitral valve and the aortic valve. The mitral valve was repaired, the aortic valve replaced, and Cox Maze procedure added. A rare combination of mitral and aortic valve lesions without endocarditis suggested that mechanical stress alone may induce mitral valve aneurysm.
-
The purpose of this article is to present a very rare case of Stanford type A acute aortic dissection featuring a swinging motion of the cylinder-shaped intimal flap through the aortic valve. The patient was a 62-year-old male suffering from severe cardiogenic shock. A transthoracic echocardiogram revealed aortic dissection and severe aortic regurgitation. ⋯ We conclude that this movement of the intimal flap should be regarded as one of the most serious complications leading rapidly to cardiogenic shock. From a surgical point of view, it is most important to prevent myocardial ischemia during cardiopulmonary bypass especially in cases in which ventricular fibrillation has occurred. We describe the ways to prevent myocardial ischemia in this rare situation.
-
Comparative Study Clinical Trial
Primary closure of deep sternal wound infection following open heart surgery: a safe operation?
Deep median sternotomy wound infection is a significant source of morbidity and mortality after cardiac operations. Management of an infected median sternotomy incision is a subject of controversy. The aim of this study was to assess our experience with primary closure without any irrigation system for infected deep median sternotomy wound. ⋯ Mediastinitis after cardiac surgical procedures remains a devastating complication. Primary closure without irrigation-suction system should only be considered in selected patients.
-
Comparative Study
"Mosaic" medtronic bioprosthetic valve replacement clinical results and hemodynamical performance.
We report the mid-term results of a prospective trial of a new bioprosthetic valve. The Mosaic bioprosthesis consists of porcine aortic valve that has been cross linked ed in glutaraldehyde solution under zero-pressure fixation and treated with alpha amino oleic acid to reduce the potential for calcification. ⋯ The valve was user friendly. The early results are very satisfactory. Echocardiography measurements after aortic valve replacement are showing very marked late postoperative remodelling of left ventricle. After mitral valve replacement there were exceptionally low transvalvular gradients, no left ventricle outflow tract obstruction.
-
Although rare, aortobronchial fistula complicates thoracic aortic surgery. Correct diagnosis and the infectious nature of the lesion are the most important conditions to define, for the following best therapy. ⋯ In the case of infection our policy is homograft replacement. Computed tomography, being able to make diagnosis, should be performed as the initial technique.