Persistent left superior vena cava is a rare but well-recognised condition. We describe a case of persistent left superior vena cava draining directly into the left atrium, with a fixed anatomical right-to-left shunt and paradoxical embolic events causing recurrent brain abscess. Surgical ligation was curative.

: Traumatic internal carotid artery dissection (CAD) has a potentially grave outcome. Anticoagulant therapy may be ineffective or contraindicated; surgery impractical. We present our experience with endovascular stenting in CAD patients. : From 2004 to 2011, 23 patients with angiographically proven traumatic CAD underwent endovascular stent-assisted arterial reconstruction based on ...

Coronary stent thrombosis is a rare event leading to ST segment elevation myocardial infarction and death. Although early thrombosis of drug-eluting and bare metal stents is relatively frequent, simultaneous thrombosis of bare metal coronary stents has rarely been reported. Here, we present a case of simultaneous subacute thrombosis of two ...

A 73-year-old man was admitted for evaluation of sudden onset of dizziness, bilateral shoulder pain, and brachial diplegia. Neurological examination revealed severe bilateral weakness of the triceps brachii, wrist flexor, and wrist extensor muscles. There was no paresis of the lower limbs. His gait was ataxic. Pinprick and temperature sensations ...

Background. The pulmonary artery catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow ...

A 35-year-old man presented with simultaneous occurrence of subarachnoid hemorrhage (SAH) and cerebral infarction (CI) caused by anterior cerebral artery (ACA) dissection. He complained of sudden onset of left frontal headache and his symptoms progressed to consciousness disturbance and right hemiparesis. Computed tomography and magnetic resonance imaging demonstrated SAH localized ...

Coronary artery fistulae (CAF) are rare forms of congenital heart disease with an incidence of one in 50 000 live births. The authors present the case of an asymptomatic neonate with a precordial murmur. Pre and postductal saturations, blood pressure and ECG were normal. Echocardiography revealed a large right coronary ...

A model of brain ischemia induced by staged ligation of the left and right common carotid arteries has been developed in experiments on rats. The use to this model led to reduction of animal mortality. On days 2-5 after the second ligature, the animals lost weight, the level of their ...

OBJECTIVE: Posteroinferior cerebellar artery (PICA) aneurysms are uncommon and have not been well investigated previously. We report our series of 29 ruptured PICA aneurysms with surgical treatment along with the description of the surgical anatomy of the PICA to the lower cranial nerves in cadaveric specimen. METHODS: All patients with ...

BACKGROUND: Surgical results for functional univentricular heart with total anomalous pulmonary venous connection (TAPVC) have been unsatisfactory to date. METHODS: During a 25-year period until December 2009, 207 TAPVC patients underwent surgical repair at our institute, including 56 with a univentricular heart. The 10-year survival rate was 51.1% with univentricular ...

Although there is still a role for conventional sternotomy for aortic valve replacement, minimally invasive techniques are increasing in popularity and may benefit the patient with shorter postoperative course, less morbidity, and decreased overall cost. Additionally, transcatheter procedures have recently shown promising results in high-risk patients. This article provides an ...

Tetralogy of Fallot is characterized by a ventricular septal defect, a large, overriding aorta, subpulmonic stenosis, and right ventricular hypertrophy. These lesions can be associated with abnormal development of the pulmonary vasculature. This can include peripheral pulmonic stenosis, discontinuous pulmonary arteries, anomalous pulmonary venous return, and the development of aortopulmonary ...

Abstract  Entrapment and detachment of guidewire fractures during percutaneous coronary intervention (PCI) are very rare, but can lead to life-threatening complications such as embolization, thrombus formation, and perforation. Surgical extraction of the remnant fragments is recommended if the percutaneous retrieval is not possible. We present a case of remnant guidewire ...

Mitral valve repair is considered the procedure of choice for correcting mitral regurgitation in myxomatous disease, providing long-term results that are superior to those with valve replacement. The use of artificial chordae to replace elongated or ruptured chordae responsible for mitral valve prolapse and severe mitral regurgitation has been the ...

Chronic arterial embolism of the lower extremities, the unusual cause of critical limb ischemia (CLI), is not well recognized in the medical practice. To study the clinical problem of chronic arterial embolism in the aspects of the clinical characteristics and treatment outcomes. Between January 2000 and December 2004, 411 consecutive ...

Optimal perfusion strategies for extensive aortic resection in patients with mega-aortic syndromes include: tailored myocardial preservation, antegrade cerebral perfusion, controlled hypothermia and selective organ perfusion. Typically, the aortic arch resection and elephant trunk procedure are performed under hypothermic circulatory arrest with myocardial and cerebral protection. However, mesenteric and systemic ischemia ...

Portal vein aneurysms (PVA) are a rare vascular anomaly of the portal system, representing fewer than 3% of all venous aneurysms, with only 150 known cases since first reported in l956 by Barzilai and Kleckner. PVA can be divided into 2 categories: extrahepatic and intrahepatic with acquired and congenital etiologies. ...

Central venous stenosis or occlusion occurs in 11-50% of hemodialysis patients with prior subclavian vein cannulation and ipsilateral fistula or shunt. Most patients are asymptomatic but some require treatment to reduce the risk of thrombosis and improve inadequate hemodialysis pressure. In these cases, endovascular intervention, including ballooning and stenting, is ...

Primary pulmonary artery leiomyosarcoma is a rare tumor that can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. In this report, we present a case of a 58-year-old woman initially diagnosed with chronic thromboembolic pulmonary disease, but who was later found to have pulmonary artery leiomyosarcoma. A complete mass ...

Injury to the vertebral artery during anterior cervical discectomy is rare but potentially fatal. We report a case of cerebellar infarction after endovascular embolization for iatrogenic vertebral artery injury at C5-C6 during an anterior cervical discectomy and fusion. A 61-year-old man had an intraoperative injury of the right vertebral artery ...

Purpose: Cerebral infarction secondary to septic embolism is a lethal complication of infective endocarditis. However, its effective treatment has not been well defined in the previous literature. Case Report: We presented a patient suffering from right middle cerebral artery (MCA) embolism with left hemiplegia and infective endocarditis, who was once ...

The morphology of coronary aneurysm sets a predisposing factor to thrombus formation. However, the blood stasis caused by the change in flow may not be enough to cause thromboembolic events.

Hyperthyroidism has many characteristic manifestations of various organ systems. Cardiovascular effects are frequent in these patients. A less known complication of hyperthyroidism is reversible right-sided heart failure and pulmonary hypertension. In the patient presented, the symptoms of atrial fibrillation and right-sided heart failure were the first manifestations of hyperthyroidism. Doppler ...

In the 30 years since Norwood described the palliative procedure for hypoplastic left heart syndrome (HLHS), many modifications have been described which have increased the survival rate of children born with this lesion. We describe further modifications which result in reduced cardiopulmonary bypass time, no cooling or circulatory arrest time, ...

A 28-year-old man presented with acute onset of chest pain. Transthoracic echocardiography confirmed an aneurysm of the sinus of Valsalva dissecting into the interventricular septum. During the next 12 h, the aneurysm enlarged to involve the entire interventricular septum, and the patient developed features of cardiac tamponade. He underwent successful ...

Coronary computed tomographic angiography (CCTA) has emerged as a novel noninvasive method for the evaluation of not only coronary artery stenosis but also arterial wall and plaque features. Recent developments in CCTA technology enable the simultaneous assessment of coronary stenosis, atherosclerotic plaque characteristics, physiologic significance of lesion-specific ischemia, and cardiac ...

To report the use of neuroelectrophysiologic monitoring to alter the course in aneurysm surgery to minimize postoperative infarction and bypass-related adverse events. Two patients with large middle cerebral artery (MCA) aneurysms were admitted to the authors' hospital. Direct clipping seemed to be difficult, and postoperative paralysis was not rare in ...

An isolated, spontaneous, ruptured aneurysm of the replaced left hepatic artery (LHA) arising from the left gastric artery, in a 72-year-old female, leading to haemorrhagic shock treated by surgical ligation is reported. To our best knowledge, this is the second case report of a ruptured hepatic artery aneurysm in this ...

We report a case of an aneurysm-like finding of MCA with severe atherosclerosis on standard radiological evaluation, which led us to plan surgical clipping. In particular, patients, whose modalities usually performed for preoperative assessment of cerebral aneurysms, such as DSA, 3D CTA and MRA, are insufficient.

Abstract  Inflammatory aortic aneurysms (IAAs) are rare and located mainly in the infra-renal abdominal aorta. The ascending aorta has been typically spared from this process. We report on two cases of ascending aortic inflammatory aneurysms and describe the available literature on this rare entity. (J Card Surg 2011;**:1-5).

In this report, we present a case of a 68-year-old male who developed extensive, devastating prosthetic valve endocarditis (PVE) several months following aortic valve replacement with a tissue valve St. Jude Epic Supra. He was successfully treated with a complex surgical procedure. In the discussion, we focus on the issues ...

Treatment of ruptured internal carotid artery anterior wall (ICAW) aneurysms presents a surgical challenge because limitations and difficulties are encountered with either clipping or endovascular treatment. The present study examined clinical outcomes after aneurysmal trapping followed by radial artery grafting for management of these difficult lesions. Radial artery grafting was ...

We present a seldom seen case of Takotsubo cardiomyopathy (TCM) with concurrent obstructive coronary artery disease (OCAD) and its first case surgical experience. We propose that TCM and OCAD can coexist and that the presence of OCAD should not be an exclusion criterion for the diagnosis of TCM.

A 41-year-old man presented to the ED with severe vertigo 2 days after a grappling injury while training in mixed martial arts. Imaging revealed a cerebellar infarct with complete occlusion of the right vertebral artery secondary to dissection. Management options are discussed as is the ongoing controversy regarding the safety of ...

Purpose: Mycotic aortic aneurysms are rare but are associated with high morbidity and mortality due to their propensity for rupture. Traditional therapy consists of open surgical repair with resection and aortic reconstruction or extra-anatomic bypass combined with long-term antibiotic therapy. Case report: An 85-year-old male with persistent bacteremia was found ...

An ischemic foot can be developed by acute arterial occlusion. Given proper treatment within critical time, the patient can avoid foot amputation and death. Early proper diagnosis and treatment by family physician at the initial clinical interviewing is important in saving the affected leg and the life. Thrombosis and embolism ...

The aim of the present study was to assess a new technique of surgical microscope-based indocyanine green (ICG) videoangiography (VAG) to confirm the patency of the anterior communicating artery (AcomA) after clipping AcomA aneurysms. Aneurysmal clipping of five cases of unruptured, broad-neck AcomA aneurysm was performed using the Carl Zeiss ...

To assess the safety and efficacy of transcatheter closure of residual ductal flow after initial surgical ligation of the arterial duct. Between June 2005 and December 2009, transcatheter occlusion of residual postsurgical ductus arteriosus was performed in six children. The mean patient age was 10±5.5 years; mean post-procedural time since ...

OMNEX (Ethicon, Inc.; Somerville, NJ) is a cyanoacrylate-based synthetic surgical sealant. To date, the use of OMNEX has only been described in a limited number of vascular surgery procedures. We present the cases of two patients who underwent successful extracorporeal renal artery aneurysm repair with the aid of OMNEX sealant. ...

A 40-year-old man was admitted to our hospital with dyspnea and atypical chest pain. Left ventricle (LV) apico-lateral wall aneurysm and right coronary artery aneurysm were found. We could find no etiological reason for this condition. Surgical treatment was considered but the patient refused. In this report, we describe an ...

Endovascular popliteal artery aneurysm repair has emerged recently as a feasible alternative to standard surgical repair. However, the evidence from the literature is still limited, with only case reports, case series and one small randomized trial. Currently, the available data suggests that stent-grafts should be used in patients at very ...

The management of the free-floating thrombus (FFT) is difficult, and it is unclear whether surgical or medical treatment is superior. The common carotid artery is rarely involved. An 80-year-old woman presented with right hand weakness and syncope. Ultrasound showed the presence of FFT in the left common carotid artery. A ...

Surgical repair of ascending aortic disease involving the aortic root most commonly involves the direct ana stomosis of the coronary ostia to the composite aortic graft. Occasionally, when direct aortocoronary ana stomosis is not safe or technically challenging--such as in cases of extreme aortic dilatation, calcification and reoperations--the Cabrol technique ...

Symptomatic compression of the renal artery by the diaphragmatic crus is a rare disorder. To our knowledge, renal artery compression by the diaphragmatic crus complicated with poststenosis aneurysm has not been reported. We present the case of a 28-year-old man with refractory hypertension. Extrinsic compression of the bilateral renal arteries ...

The bicuspid aortic valve is a common congenital heart disease characterised by inequality of cusp size, a central raphe, and smooth cusp margins even in diseased valves. It may progress and become calcified, leading to varying degrees of aortic valve disorders, such as stenosis, regurgitation, or combined, which may eventually ...

Abstract  Type A aortic dissection (TAAD) can be complicated by myocardial ischemia due to extension of the dissection into coronary artery or by extrinsic compression of a coronary artery by the false lumen. We present the successful surgical management of a hemodynamically unstable patient with acute aortic dissection with ongoing ...

We describe the case of a 45-year-old man with a unique constellation of supra-aortic artery aneurysms detected by chest X-ray during work-up for chronic cough. During his diagnostic work-up, the patient suffered an embolic stroke likely secondary to disrupted plaque originating in an aneurysmal right vertebral artery. Endovascular repair was ...

Please cite this paper as: Christophe P, Raj N, Alejandra M, Gwenael F, Joseph N, Jacques D, Arjun J. Systematic (complete) para-aortic lymphadenectomy: description of a novel surgical classification with technical and anatomical considerations. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03171.x. The clinical indications for a complete para-aortic lymphadenectomy in the surgical management ...

The combination of absent pulmonary valve syndrome with coarctation of aorta is extremely uncommon and pathogenetically intriguing. This unusual association, which defies popular theories of pathogenesis of coarctation, may need to be looked at in the light of the current concepts regarding the morphogenesis of ventricular outflow tracts and aortic ...

OBJECTIVES: This study observed midterm results of vascular ring connectors in surgery for aortic dissection. METHODS: Vascular ring connectors were used as stents in vascular grafts to achieve quick, sutureless anastomoses. Tapes were used to secure ringed vascular grafts from outside the aorta. RESULTS: From November 2007 to February 2011, ...