A Tricuspid Valve Mass Attached to Papillary Muscle

BACKGROUND: Cardiac myxoma is the most common benign heart tumor which can arise in any of the cardiac chambers, valves or related great veins. Diagnosis of a myxoma arising from the tricuspid valve apparatus is exceptional. We present a rare case of myxoma in a tricuspid valve attached to papillary muscle.CASE DETAILS: A 45-year-old man was referred to our center for the evaluation dyspnea and chest pain. During work-up by transthoracic echocardiography (TTE), a mass was found on the corda tendinea of the anterior papillary muscle of the tricuspid valve. Coronary angiography revealed normal coronary artery. During open heart surgery, an oval and non-pedunculated mass was detected on tricuspid corda tendinea and resected. Pathological examination revealed the presence of a myxoma.CONCLUSION: This experience illustrates a rare case of myxoma which originated from tricuspid corda tendinea, diagnosed by echocardiography, suggesting fibroelastoma. However, the mass was not clear enough but dyspnea and sign and symptom of probably embolization to lung urged us to treat it surgically. No complications attributable to the mass developed in the postoperative course. In the first year of follow-up, non-recurrence of the mass was detected on TEE, and the patient was asymptomatic.KEYWORDS: Myxoma, Papillary muscle, Tricuspid valv

Combination of cardiac and carotid glomus tumour: a rare case report

The most common tumour of the heart is myxoma but paraganglioma (also called glomus tumour in extracardiac sites) in the cardiac position is the rarest of them. While this tumour accounts for 0.8% of all primary benign tumours, the combination of both neoplasms is an exceedingly rare occurrence. Herein, we present a case of combined carotid glomus tumour and left atrial paraganglioma tumour in which respiratory distress was the presenting symptom of cardiac type but carotid tumour was asymptomatic. The case underwent a two-step resection of the neck and cardiac mass with an uncomplicated postoperative course and in the 1year follow-up, no recurrence of tumour in both sites was found on physical exam and imaging studies

Cardiocutaneous fistula secondary to left ventricular pseudo-aneurysm rupture

Cardiocutaneous fistula (CF) is a potentially serious and catastrophic complication. Infection the suture line after left ventricular aneurysm repair, presenting with the CF. We present an unusual case of CF due to staphylococcus infection 6 months after repair of a myocardial rupture secondary to dehiscence repair

Traumatic Hemolytic Anemia after Valve Surgery: a Case Report

Hemolytic anemia is an uncommon complication after mitral valve repair. We present a case of a 55-year-old man who presented with post-operative hemolytic anemia after mitral valve repair with prosthetic ring. The hemolytic anemia improved after the patient had the prosthetic ring removed and the valve replaced by a prosthetic mitral valve. However, the post-operative course of the redo operation was complicated by acute renal failure and respiratory dysfunction, but the hemolytic anemia was finally abolished and the patient was discharged 20 days post-operatively in good condition.

In-hospital outcome of patients undergoing off-pump coronary artery bypass graft with and without coronary endarterectomy

Background: Coronary endarterectomy (CE) can be used in patients with diffused coronary artery disease (CAD) as an adjunct technique to coronary artery bypass grafting (CABG) for complete revascularization. Because the impact of CE has been debated, hospital outcomes are of concern. Objectives: The aim of the current study is to compare hospital outcomes of patients undergoing off-pump CABG with and without CE. Methods: We performed a retrospective analysis of data on patients undergoing CABG and CE between 2011 and 2012 by a single surgeon using off-pump technique. Patients were divided into CABG and CABG + CE groups. Preoperative, perioperative, and postoperative data were collected from the data bank. Results: CABG was performed in 478 patients, of whom 69 had a CE. Hospital mortality was 0.7% in CABG and 0% in CABG + CE group (P > 0.05). The duration of stay in the intensive care unit (ICU) was 37.23 ± 0.88 hours in the CABG group and 51.31 ± 5.59 hours in the CABG + CE group (P = 0.015). Logistic regression confirms that CE is one of the factors affecting longer ICU stay. Blood transfusion was 324.71±22 milliliters in the CABG group and 650.62±110 milliliters in the CABG + CE group (P = 0.001). There were no significant differences between myocardial infarction (MI) rate, arrhythmia, intra-aortic balloon pump insertion, or low cardiac output between the two groups. Conclusions: The current study demonstrates that the results of CE are acceptable with respect to hospital outcome. CE as an adjunct to CABG offers a valuable surgical option for patients in whom complete revascularization cannot be obtained. With careful selection of patients, a well-judged and well-executed surgical technique, and good postoperative care, excellent results can be obtained

Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction

Introduction: Heart failure is a major hazard for public health. Despite recent advance in medical therapy, there is not enough information on the outcome of off-pump coronary artery bypass (OPCAB) and medical therapy on the patients with severe ventricular dysfunction and triple-vessel (CAD). This study aimed to compare treatment outcomes and mortality rate in patients undergoing off-pump coronary artery bypass (OPCAB) surgery and medical therapy who presented with severe ventricular dysfunction and triple-vessel coronary artery disease (CAD). Materials and Methods: This retrospective cohort study was conducted on patients with severe ventricular dysfunction and triple-vessel CAD during 2010-2011 in the Imam Ali Hospital of Kermanshah University of Medical Science. Patients were divided into two groups of medical therapy (group one) and OPCAB (group two). Follow-up data were collected after 30 months. Survival estimation was performed using Kaplan-Meier survival analysis and Cox regression model. Results: Of the 276 enrolled patients, 139(50.4%) underwent group one and 137(49.6%) group two. Study groups were homogenous in baseline characteristics, with the exception of hyperlipidemia (P=0.005). A significant difference was observed in cardiac mortality rates between the study groups (hazard ratio: 0.260; 95% confidence interval: 0.105-0.644; P=0.004). However, no significant difference was observed between the groups regarding the frequency of admission due to decompensate heart failure (P=0.17). In addition, the rate of admission due to acute coronary syndrome (ACS) in the first group was higher than the second group, significantly (P=0.001). Level of ejection fraction (EF) had a significant increase after coronary artery bypass graft (CABG) (28.50) compared to the preoperative stage (27.59) (P=0.042). However, no significant increase in the level of EF was observed in the first group before and after medical therapy (27.28 and 27.20, respectively) (P=0.83). Conclusion: According to the results of this study, the mortality rate associated with OPCAB was lower compared to medical therapy, ACS and EF enhancement in patients with triple-vessel CAD and severe ventricular dysfunction

The association of age and gender with risk factors of noncommunicable diseases among employees in West of Iran

Background: The relationships that age and gender share with risk factors (RFs) of noncommunicable diseases (NCDs) were assessed among a large-scale employ in Western Iran. Methods: In this epidemiologic cross-sectional study, 7129 employees from Kermanshah Province were assessed using a census method in 2012. Data on RFs of NCD were collected using a standard questionnaire. Demographic information, diet, physical activity, tobacco use, and history of hypertension, history of diabetes, cardiovascular diseases, osteoporosis, and cancer were studied. Results: The proportion of ≥ 5 servings of fruits and vegetables consumption per day was lower in higher ages (P = 0.001), and this proportion was greater in females than males (72.1% vs. 47.8%;P< 0.0001). Tobacco use was more in higher ages and was higher among males than females (13.3% vs. 0.6%;P< 0.0001). Overweight and obesity prevalence increased in higher ages and was more prominent among males than females (67.8% vs. 55.3%;P< 0.0001). Overall, the prevalence of having 3–5 RFs was greater among those with ≥ 55 years and among males than females (20.4% vs. 6.6%;P< 0.0001). Conclusions: The prevalence of major RFs of NCDs was greater among older persons and male participants. More preventive programs such as health education on employees of Kermanshah are recommended