Papillary Fibroelastoma Incidentally Found on Left Atrial Wall During Minimally Invasive Aortic Valve Replacement

A 60-year-old man was about to undergo minimally invasive aortic valve replacement when transesophageal echocardiography revealed an intracardiac mass on the left atrial free wall. Multimodal images from 5 months earlier had shown no mass. We converted the procedure to open surgery. The excised mass resembled a cardiac myxoma but was determined to be a papillary fibroelastoma. This case illustrates that papillary fibroelastomas can form and grow rapidly, warranting alertness for their unexpected discovery before and during cardiac surgical procedures

Transfemoral TAVR by the Houston Methodist TAVR Team

<div><div><div>Transcatheter aortic valve replacement (TAVR) is changing the landscape of the treatment of structural heart disease. There are now more TAVRs than isolated surgical AVRs done in the USA. The authors believe it is crucial for cardiac surgeons to be full partners in this procedure. To do so, surgeons need to understand the valves and the technical aspects of their use. This video introduces the cardiac surgeon to transfemoral TAVR as done by the TAVR team at Houston Methodist in Texas, USA.</div><div>Disclosure: Dr Reardon is the national surgical primary investigator for the Medtronic SURTAVI and low risk trials, and he is a consultant for Medtronic and Boston Scientific.<br></div><div>Learn more: https://www.ctsnet.org/article/transfemoral-tavr-houston-methodist-tavr-team</div></div></div

Intraoperative surgical sealant application during cardiac defect repair

Bleeding can occur as a sequela to cardiac surgery. Surgical products-such as conventional sutures and clips, and somewhat less conventional sealants-have been developed to prevent this event. Among these, CoSeal is a sealant used at our institution; here we report the cases of 2 patients in whom CoSeal was used successfully as either a supplement or an alternative to suture repair. This sealant was found to be useful in attaining hemostasis both in high-pressure ventricular repair and in the rupture of a friable coronary sinus adjacent to vital structures (in this instance, a left circumflex coronary artery)

The danger of wearing an anorak

Campaigns to reduce road traffic accidents have paid little attention to the way headgear could interfere with vision. Binocular visual field measurement was undertaken in six healthy volunteers wearing four different types of anorak. All four anoraks greatly reduced the horizontal and superior field of vision. The anorak producing the worst reduction resulted in a width of vision of 99° and only 15° of vision above eye level, versus 167° and 52° respectively without an anorak. Anorak wearers should turn their heads to look sideways before crossing the road