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Predictors of major adverse events and complications after ventricular septal defects surgical closure in children less than 10 kg
The technical features of the diagnosis or treatment of coronary artery disease through the distal radial artery approach at the anatomical snuffbox compared with the conventional radial artery approach
Cardiac calcified amorphous tumor with mitral valve perforation: A case report
J Cardiol Cases. 2022 Jan 3;25(5):297-299. doi: 10.1016/j.jccase.2021.11.010. eCollection 2022 May.
ABSTRACT
Cardiac calcified amorphous tumors are rare non-neoplastic intracavitary masses. Herein, we report a case of a 75-year-old woman who presented with dyspnea on exertion and multiple cerebral infarctions 3 months prior. Transthoracic echocardiography showed severe mitral regurgitation from the posterior mitral leaflet with valve perforation and severe mitral annular calcification. In addition, we observed a 13 mm mobile high echogenic mass, suggesting healed infective endocarditis. The mass was successfully resected, and the mitral valve was replaced with a bovine pericardial patch for the decalcified annulus. Histopathological examination confirmed cardiac calcified amorphous tumor; the postoperative course was uneventful. Mitral valve replacement and annulus patch repair effectively prevented postoperative recurrent systemic embolization. <Learning objective: Calcified amorphous tumor (CAT) is a risk factor for systemic embolism. Cardiac CAT destroying the mitral valve tissue and causing mitral valvular disease have been scarcely reported. We present a case of cardiac CAT with mitral valve perforation and suspected systemic embolization, treated successfully through mitral valve replacement and calcified lesion coverage by surgical resection and patch repair.>.
PMID:35582074 | PMC:PMC9091504 | DOI:10.1016/j.jccase.2021.11.010
Complex Hybrid Repair of a Secondary Aortoenteric Fistula
Vasc Health Risk Manag. 2022 Apr 27;18:329-333. doi: 10.2147/VHRM.S363417. eCollection 2022.
ABSTRACT
BACKGROUND: Secondary aortoenteric fistula is a rare, highly morbid and often difficult to diagnose, cause of gastrointestinal bleeding. It is associated with prior aortic surgery or placement of a synthetic aortic graft. Our case features staged hybrid endovascular stent-grafting, graft excision, aortoplasty using a bovine pericardial patch, extra-anatomical bypass and complex bowel repair.
CASE REPORT: An 82-year-old man presented with gastrointestinal bleeding and Streptococcus Anginosus bacteraemia, with previous aorto-bi-iliac bypass surgery for left common iliac occlusive disease 15 years ago. Computed tomography angiography (CTA), gastroscopy, colonoscopy, capsule endoscopy and enteroscopy identified no bleeding source. Repeat CTA showed gas locules and stranding around the graft and the third part of the duodenum, concerning for fistulous communication. On the next day, a Zenith TX2 thoracic 28x80mm stent-graft was deployed into the infrarenal aorta. On laparotomy, a fistula was present between the Dacron graft and fourth part of the duodenum. The Dacron graft was excised, followed by aortic patching with bovine pericardium. A right-to-left femoral-femoral crossover graft was constructed. CT at one-month post-laparotomy showed no signs of perigraft endoleak and interval resolution of gas locules. He was transferred to a rehabilitation facility on the 34th post-operative day with a multidisciplinary follow-up arranged.
DISCUSSION: Aortoduodenal fistula is a challenging entity to diagnose and should be suspected in patients with GI bleeding and prior aortic surgery. Endovascular repair alone is a less invasive option but with higher re-infection and late failure rates. Liberal use of appropriate imaging modalities, a judicious repair strategy, long-term follow-up and multidisciplinary approach are critical for its management.
PMID:35510033 | PMC:PMC9058014 | DOI:10.2147/VHRM.S363417