Left-ventricular inflow obstruction due to a dilated coronary sinus mimicking cor triatriatum

Persistence of the left superior vena cava with drainage to the coronary sinus is a common congenital anomaly. We report an infant with such a malformation associated with marked enlargement of the coronary sinus, which produced partial supramitral obstruction and consequently impairment to the left-ventricular inflow. The patient pre-sented with cardiac failure in infancy and features mimicking cor triatriatum. Surgical relief of the supramitral obstruction resulted in immediate reversal of the pulmonary hypertension, with clinical improvement. This rare entity, only once previously reported, is an unusual cause of pulmonary hypertension in infancy.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Surgical treatment of coronary artery fistula with aneurysm

Two operations for coronary artery aneurysm with fistula are reported. This rare congenital malformation can be associated with acute and chronic complications. Surgical treatment is generally recommended. The surgical strategy remains controversial and is discussed. Retrograde cardioplegic cardiac arrest and retrograde dissection of the fistula are favoured. Conservative treatment of the dilated coronary segments was adopted. In both cases, the postoperative course was uneventful and no residual shunts were diagnosed at postoperative echocardiography.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Early coronary sinus reroofing using the left atrial baffle

Surgical correction of unroofed coronary sinus, left superior vena cava, dextrocardia, and situs solitus in a 4-month-old infant consisted of reroofing the coronary sinus by means of a left atrial flap while redirecting the left superior vena cava to the right atrium. Excellent access to the left side of the left atrium was afforded by the associated dextrocardia.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Implantation of an Absorb bioresorbable vascular scaffold in the stenotic aortopulmonary collateral artery of a young child with Alagille syndrome

Stent implantation in children can be problematic due to the possibility of growth incapacity and difficulties during later surgery. For these reasons, bioresorbable stents may be a good alternative to conventional stents. We report our experience with implantation of an Absorb bioresorbable stent in the stenotic major aortopulmonary collateral artery (MAPCA) of a 1-year-old girl born with pulmonary atresia with ventricular septal defect.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Ventricular Septal Defect Closure in Taussig-Bing Heart: The "Pulmonic Rule"

Accurate ventricular septal defect patch sizing and tailoring remain challenging in many surgical procedures. Surgical exposure frequently limits complete visualization of the ventricular septal defect. Moreover, examination of the heart cavity under cardioplegic arrest may lead to skewed appreciation of the ventricular septal defect caliber and shape. Here we describe a simple and safe surgical tip to predict the size and shape of the ventricular septal defect patch in Taussig-Bing malformation before starting extracorporeal circulation. The patch should be circular with a diameter equal to the under pressure, proximal, pulmonary artery diameter. © 2009 The Society of Thoracic Surgeons.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Redo valve surgery nowadays: What have we learned?

Re-operative valvular surgery is common nowadays. Increased mortality and morbidity are generally associated. Re-operations in cardiac surgery are technically more difficult because of adhesions and a more advanced cardiac status of the patient. Results reported 20 years ago carried a high mortality risk. Experience and technological evolution have produced a substantial reduction in postoperative mortality nowadays. The present review focuses on historical results of redo valve surgery, risks factors for postoperative mortality, technical progress and surgical strategies contributing to better results.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Ventricular septal defect closure in tetralogy of Fallot: The aortic rule

Ventricular septal defect (VSD) closure is an important part of the surgical repair of tetralogy of Fallot and related anomalies. Visual appreciation of the VSD size (either transinfundibular or transatrial) can be misleading. My colleagues and I describe a simple and precise way to predict the size and shape of the VSD patch before extracorporeal circulation: the patch should be circular with a diameter identical to that of the mid ascending aorta. © 2004 by The Society of Thoracic Surgeons.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The calcium channel blocker nifedipine fails to inhibit leucocyte elastase release during cardiopulmonary bypass

Circulating concentrations of leucocyte elastase were measured in 16 adult patients undergoing cardiopulmonary bypass (CPB) with a flat-sheet membrane oxygenator. Eight patients (Group I) received the calcium channel blocker nifedipine (9 μg · kg-1 · h-1) during CPB. Eight patients (Group II) did not receive any calcium channel blocker during surgery and served as the control group. Elastase concentrations were measured at 7 time points: 2 before, 2 during, and 3 after CPB. The bypass procedure was associated with elevation in elastase concentrations (P<0.001). Comparing to baseline values elastase concentrations were significantly elevated (P<0.05) 60 min after the start of CPB and on all measurements done after CPB. Elastase concentrations correlated with the duration of CPB (rs=0.76, P<0.001), and were not influenced by nifedipine infusion as revealed by comparing the two groups. This study demonstrates moderate elastase release during CPB with a flat-sheet membrane oxygenator and fails to confirm inhibition of elastase release by nifedipine infusion during CPB.SCOPUS: ar.jFLWNAinfo:eu-repo/semantics/publishe

Cavopulmonary connection after repair of pulmonary vein stenoses

We report a case of heterotaxia with single-ventricle physiology undergoing successively pulmonary artery banding (PAB) at 8 months of age, repair of pulmonary vein (PV) stenoses at 15 months of age, and a fenestrated total cavopulmonary connection (TCPC) combined with repair of a regurgitant common atrioventricular (AV) valve and a Damus-Stansel operation for a restrictive subaortic ventricle at 5 years of age, followed by percutaneous closure of the fenestration. The child is now 10 years old and is, to the best of our knowledge, the only reported long-term survivor of a Fontan type procedure done after repair of PV stenoses. © 2001 by The Society of Thoracic Surgeons.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Traitement chirurgical des cardiopathies du sujet âgé.

We have reviewed hospital mortality and morbidity with cardiac surgery under cardiopulmonary bypass in patients over 75 years, operated during a 5 years period. It is at the expense of a sometimes difficult selection process in favour of patients with a potentially curable cardiac disease as their only problem, and despite substantially increased mortality and morbidity, that the operated elderly can have excellent probability to normalise both life expectancy and quality of life.English AbstractJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe