Cardiac Rupture Sutureless Repair

We retrospectively observed the long-term outcome of 40 patients with post-infarction cardiac ruptures repaired with a patch-and-glue technique, treated as an emergency between January 1997 and January 2019. In 32 patients, the cause of the rupture was late percutaneous revascularization. In patients with a poor ejection fraction, extracorporeal membrane oxygenation (ECMO) was used to unload the ventricle for a few days. A follow-up was made at 30 days, 6 months and long term with a mean follow-up of 11.5 ± 10.8 years. Kaplan–Meier curves were used to evaluate the long-term survival. The 30-day mortality was 12.5% (5/40 patients), in patients with very low ejection fraction and was not related to the cardiac rupture. There were no postoperative complications except for bleeding (7.5%), due to ECMO haematologic disorders. No bleeding through the rupture site was recorded. Overall mortality was 15% (6/40 patients) at a 6-month control, at late follow-up (11.5 ± 10.8 years) was 80% (32 patients), and the causes of death were not related to the rupture. We can affirm that a patch-and-glue technique is a safe and life-saving operation to treat cardiac ruptures. An early diagnosis and surgical treatment are crucial for a successful outcome

Unexpected limited chronic dissection of the ascending aorta

We report a rare case of a limited chronic dissection of the ascending aorta that was accidentally discovered at operation performed for severe aortic stenosis and moderate to severe dilatation of the ascending aorta. Preoperative investigations such as transoesophageal echocardiography and cardiac catheterization missed the diagnosis of dissection. Intraoperative findings included a 3.5 cm eccentric bulge of the ascending aorta and a 5 mm circular shaped intimal tear comunicating with a limited hematoma or small dissection of the media layer. (The rarety of the report is that the chronic dissection is limited to a small area (approximatively 3.5 × 2.5 cm) of the ascending aorta)

Papillary fibroelastoma, unusual cause of stroke in a young man: a case report

Abstract Background Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors. Case presentation We describe a rare case of a 28-Year-old man that while playing football, had a sudden onset of neurological deficit: aphasia, right hemiparesis and right facial numbness. Transthoracic echocardiography (TTE) showed a 10x10 mm mass attached to the anterior mitral valve leaflet. The patient was treated surgically for the prevention of further embolic complications. Histologic examination of the resected mass revealed a papillary fibroelastoma. It is the third most frequent primary cardiac tumor, after myxoma and fibroma, and the most common primary tumor of heart valves. Despite the benign nature of this tumor, it carries very high risk of embolic complications. The successful complete resection of the papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent. Conclusions Differential diagnosis of cardiac masses requires clinical informations, laboratory tests, blood cultures and appropriate use of imaging modalities. Papillary fibroelastoma is a potential cause of embolic stroke in the young. The prompt surgical excision of papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent