A failed case of percutaneous septal closure of fenestrated atrial septal defect

A patient presenting with a history of palpitation and exertional dyspnea was initially diagnosed with two separate secundum-type atrial septal defects by transesophageal echocardiography. Subsequent transesophageal echocardiography, after failure of closure with two separate closure devices, showed another defect and an ongoing left to right shunt. During surgery, more defects were observed. The defects were successfully repaired using pericardial patch without incident. (Cardiol J 2011; 18, 1: 92-93

Surgical treatment of aortic valve endocarditis: a 26-year experience

Objective: We have retrospectively analyzed the results of the operations made for aortic valve endocarditis in a single center in 26 years. Methods: From June 1985 to January 2011, 174 patients were operated for aortic valve endocarditis. One hundred and thirty-eight (79.3%) patients were male and the mean age was 39.3±14.4 (9-77) years. Twenty-seven (15.5%) patients had prosthetic valve endocarditis. The mean duration of follow-up was 7.3±4.2 years (0.1-18.2) adding up to a total of 1030.8 patient/years. Results: Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%). In-hospital mortality occurred in 27 (15.5%) cases. Postoperatively, 25 (14.4%) patients had low cardiac output and 17 (9.8%) heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up. Conclusion: Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low

Influence of Tribulus terrestris extract on lipid profile and endothelial structure in developing atherosclerotic lesions in the aorta of rabbits on a high-cholesterol diet

The aim of this study was to investigate the pleotropic effects of an extract of a traditional herb, Tribulus terrestris (TT), on the lipid profile and vascular endothelium of the abdominal aorta in New Zealand rabbits fed a cholesterol-rich diet. Eighteen rabbits were randomly divided into three groups (n=6 for each). One experimental group (EG-I) was given a cholesterol-rich diet, a second experimental group (EG-II) was treated with TT following a cholesterol-rich diet, and a control group (CG) was fed a standard diet. Blood samples were collected on day 0 and then at weeks 4 and 12 to determine total serum cholesterol (TC), high density lipid-cholesterol (HDL-C), low density lipid-cholesterol (LDL-C) and triglyceride (TG) levels. Tissues were collected from the abdominal aorta for immunohistochemistry and transmission and scanning electron microscopy. In EG-II, the serum lipid profile was significantly lower than that of EG-I at week 12 with a reduction of TC: 65%; LDL-C: 66%; HDL-C: 64%; TG: 55%. Ultrastructural analysis revealed that endothelial damage was more prominent in EG-I compared to EG-II. The ruptured endothelial linings and damaged cellular surfaces increased in EG-I compared to EG-II. Our data indicate that dietary intake of TT can significantly lower serum lipid profiles, decrease endothelial cellular surface damage and rupture and may partially repair the endothelial dysfunction resulting from hyperlipidemia. © 2008 Elsevier GmbH. All rights reserved

The effects of Eicosapentaenoic acid on the endothelium of the carotid artery of rabbits on a high-cholesterol diet

The preventive and therapeutic effects ofEicosapentaenoic acid (EPA) on diet-inducedhyperlipidemia in rabbits have been investigated.Eighteen New Zealand rabbits were randomly dividedinto three groups of 6 subjects each; experimental group-I (EG-I) was administered a cholesterol rich diet,experimental group-II (EG-II) was treated with EPA(300 mg/kg/d) following a cholesterol-rich diet and thecontrol group (CG) had a standard diet. Blood sampleswere collected at day 0 and at the 4th and 12th weeks ofEG-II to obtain serum levels of total cholesterol (TC),high density lipid-cholesterol (HDL-C), low densitylipid-cholesterol (LDL-C) and triglyceride (TG). Fromeach group tissue samples were collected from thecarotid artery for immunohistochemistry and electronmicroscopy. Our results showed that EPA couldsignificantly lower (p<0.001) serum TC, LDL-C, HDL-C and TG levels with a reduction of 35%; 55%; 44% and51%, respectively. Scanning and transmission electronmicroscopy results revealed that endothelial damage wasmore prominent in EG-I when compared to EG-II. Theruptured endothelial lining and damaged cellular surfacewas increased in EG-I when compared to EG-II.Ultrastructural observations showed that after EPAtreatment, the degeneration and cellular surface damageon the endothelium were also decreased. These biochemical and ultrastructural results suggestthat EPA is a potential drug which significantly lowersthe serum lipid profile and partially repairs endothelialdysfunction due to hyperlipidemi

Axillary artery cannulation in ascending aortic pathologies

Conclusion: The axillary artery is a safe route for arterial cannulation, and the axillary route does not cause an increase in postoperative mortality and morbidity