Anomalous origin of the left main artery from the pulmonary artery: Adult presentation with systemic collateral supply and giant right coronary artery aneurysm

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The double-orifice technique for mitral valve reconstruction: predictors of postoperative outcome

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Soft proton exchanged channel waveguides in congruent lithium tantalate for frequency doubling

We report on stable optical waveguides fabricated by soft-proton exchange in periodically-poled congruent lithium tantalate in the α-phase. The channel waveguides are characterized in the telecom wavelength range in terms of both linear properties and frequency doubling. The measurements yield a nonlinear coefficient of about 9.5pm/V, demonstrating that the nonlinear optical properties of lithium tantalate are left nearly unaltered by the process

A composed graft for subclavian artery reconstruction in case of redo surgery for aortic coarctation

We report the case of a 66-year-old woman admitted to the intensive care unit (ICU) for ongoing dyspnea and hemoptoe. She was operated upon in 1979 for aortic coarctation by the interposition of a 14 mm Dacron prosthesis from the left subclavian artery to descending aorta. Clinical evaluation performed over the years was normal with no signs of cardiac failure or prosthesis malfunctioning. The computed tomography scans (CT) showed a progressive increase of the descending aorta diameters and the onset of a pseudo-aneurysm of 50 mm in diameter. Patient was re-operated through a median sternotomy enlarged by a left thoracotomy and intra-operative findings revealed the pseudo-aneurysm originating from a dehiscence of the proximal suture. In order to allow a safe reconstruction of the dilated subclavian artery, a T-shaped composed graft was confectioned and then sutured to the descending aorta and the subclavian artery, respectively. Post-operative course was uneventful and three months CT scan showed a normal position of the composed graft

Bilateral pulmonary endarterectomy and Bentall procedure completed in one surgical session

We describe the performance, in one surgical session, of bilateral pulmonary endarterectomy and a button-technique Bentall operation in a 68-year-old man. The patient had chronic thromboembolic pulmonary hypertension and an ascending aortic aneurysm with moderate aortic regurgitation. The procedures were concurrently completed during short periods of systemic circulatory arrest, with antegrade cerebral perfusion maintained through the brachiocephalic artery at a flow rate of 10 mL/min/kg. The patient's cerebral perfusion was monitored with use of near-infrared spectroscopy, to prevent symmetric bilateral values from falling below 20% of the base value. The patient experienced no multiorgan failure or neurologic sequelae and, by the 6th postoperative day, improved from New York Heart Association functional class IV to class I.The reliable maintenance of continuous antegrade cerebral perfusion made the lengthy combined operation feasible, with low risk. The use of near-infrared spectroscopy enabled real-time monitoring of the patient's cerebral blood flow. Our experience shows the possibility of safely performing lengthy or multiple procedures in one surgical session

Integrated frequency shifter in periodically poled lithium tantalate waveguide

A frequency shifting device is fabricated and tested in a ferroelectric waveguide in a low-photorefractivity crystal. Periodic poling for quasi-phase-matching and channels for operation in the near-infrared C-band were obtained in congruent lithium tantalate, demonstrating for the first time both wave confinement and two-stage parametric conversion in such waveguides