Cor Triatriatum with Ankylosing SpondylitisAnkilozan

Cor triatriatum is a rare congenital defect that one of the atrial chambers especially left atrium, is divided into two by a fibromuscular membranee. Ankylosing spondylitis is a chronic systemic inflammatory rheumatic disorder that cardiovascular involvement can be seen. 27-year-old woman, who has been followed for ankylosings pondylitis searched for cardiac involvement, Cor triatriatum was diagnosed with echocardiography and diagnosis was confirmed with MRI and CT angiography. Membrane was resected surgically under cardiopulmonary bypass with cardioplegic arrest. Patient was discharged from the hospital with recovery. In conclusion, patient with ankylosing spondylitis must be searched for cardiac involvement

Successful coronary artery bypass grafting in a patient with bilateral internal carotid artery occlusion: a case report

The best management regimen for patients with coronary artery disease requiring surgery and bilateral total internal carotid artery occlusion remains controversial. A 61-year-old male patient presented with unstable angina pectoris. His medical history revealed that he had a cerebrovascular accident 11 years ago. On physical examination, he had dysarthria and monoparesis on the right upper extremity. Coronary and carotid angiography revealed critical coronary artery stenosis and total occlusion of bilateral internal carotid arteries, total occlusion of the right vertebral artery and 40% stenosis of the left proximal vertebral artery. After general intravenous fentanyl anesthesia, low dose heparin was administered, and coronary artery bypass grafting (CABG) was performed under off-pump beating heart condition. Systolic blood pressure was maintained above 120 mmHg to preserve cerebral blood flow during the operation. The postoperative course was uneventful and the patient was discharged in the 7(th) day postoperatively. If CABG is mandatory in patients having high cerebrovascular risk, off-pump CABG could be performed to reduce the stroke risk

Residual postmyocardial infarction ventricular septal defect repair through right atrium with right thoracotomy on beating heart technique

Background and Aim: The incidence of residual opening after repair of postmyocardial infarction ventricular septal defect (VSD) was reported to be 10% to 25%. Redo surgery with remedian sternotomy is more complex than primary surgery and is consequently associated with higher mortality and morbidity due to the myocardial and patent coronary grafts injury during pericardial dissection. Methods: A 59-year-old female patient had coronary artery bypass grafting and closure of post myocardial infarction ventricular septal defect with patch 10 months earlier in a different cardiac center. She was admitted to the hospital for severe congestive heart failure. Results: She was operated because of the residual opening after repair of post myocardial infarction ventricular septal defect. Post myocardial infarction ventricular septal defect closure was performed through the right atrium by on-pump beating heart technique via the right thoracotomy. Conclusions: Closure of post myocardial infarction ventricular septal defect with this technique offers an alternative and safe approach to repair of the residual VSD when the coronary bypass grafts are patent

Surgical approach to giant pseudoaneurysm of the left ventricle

Left ventricular pseudoaneurysm is a rare, but life-threatening complication occurring after acute myocardial infarction. Early diagnosis and surgery are critical for the patients' recovery. An 80-year-old man was admitted to hospital with severe dyspnea. Coronary angiography and ventriculography showed a giant left ventricular pseudoaneurysm. Surgical approach to pseudoaneurysm was made through the mitral valve and directly from the aneurysmal sac. Defect was closed by Dacron patch. Postoperative period was uneventful and patient was discharged from hospital seven days after surgery

Mitral valve replacement with the beating heart technique in a patient with previous bypass graft from ascending to descending aorta due to aortic coarctation

Background and Aim: Conventional mitral valve replacement (MVR) is carried out under cardioplegic arrest with cross-clamping of the ascending aorta during cardiopulmonary bypass. In this case, MVR was performed with on-pump beating heart technique without cross-clamping the aorta because of the diffuse adhesion around the ascending aorta, and tube graft presence between ascending and descending aortas. Methods: A 47-year-old female patient had aorto-aortic bypass graft from ascending aorta to descending aorta with median sternotomy and left thoracotomy in single stage because of aortic coarctation 2 years ago in our cardiac center. She was admitted to the hospital with palpitation and dyspnea on mild exertion. Transthoracic echocardiography revealed 4th degree mitral insufficiency. Results: MVR was carried out through remedian sternotomy with on-pump beating heart technique without cross-clamping the aorta. Conclusions: MVR with on-pump beating heart technique offers a safe approach when excessive dissection is required to place cross-clamp on the ascending aorta