1/39. Simultaneous repair of cardiovascular disorders and pectus deformity in a patient with Sprintzen-Goldberg syndrome: A case report.We report a 12-year-old girl with Sprintzen-Goldberg syndrome (SGS) who was complicated with annuloaortic ectasia with aortic regurgitation, mitral valve prolapse with mitral regurgitation, and a severe pectus excavatum. In this patient, aortic root replacement, mitral valve replacement, and sternal elevation were simultaneously performed, and a version of Ravitch's procedure that was technically modified to support the sternum was used for sternal elevation. This modified sternal elevation technique gave excellent operative exposure, and maintained chest wall stability after the operation.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/39. Transformation of mitral valve prolapse to dynamic left ventricular outflow tract obstruction and back again in a patient with acute transient myocardial depression.We describe an unusual case of transient resolution of preexisting mitral valve (MV) prolapse during acute cardiac dysfunction and the development of dynamic left ventricular (LV) outflow tract obstruction. The patient presented with lightheadedness, chest pain, and compromised hemodynamic status. echocardiography revealed akinesis and deformation of the LV anterior wall and apex, hyperdynamic activity in the bases, anterior MV leaflet systolic anterior motion without prolapse, and a dynamic outflow tract gradient. Myocardial function fully recovered over 1 month. Repeat ultrasonography showed posterior MV leaflet prolapse and no anterior MV leaflet systolic anterior motion. Elongated MV leaflets may have contributed to dynamic outflow tract obstruction and life-threatening hemodynamic compromise during LV conformational change.- - - - - - - - - - ranking = 33.666261713623keywords = chest pain, chest, pain (Clic here for more details about this article) |
3/39. Severe incisional pain and long thoracic nerve injury after port-access minimally invasive mitral valve surgery.The authors describe the occurrence of severe postoperative pain and long thoracic nerve injury after Port-Access minimally invasive mitral valve surgery. The potential for these events and the impact on postoperative hospitalization and rehabilitation are emphasized.- - - - - - - - - - ranking = 0.66079179512225keywords = pain (Clic here for more details about this article) |
4/39. mitral valve prolapse with pulmonary haemosiderosis and severe anaemia: cause or association?A 12 years boy presented with the history of pallor for one month. Two days before hospitalisation he developed fever, cough, shortness of breath. He had past history of such episode.On examination, his heart rate was found to be 120/minute, respiratory rate 40/minute and moderate anaemia was detected. Scattered creptus was audible over mid and lower lung fields and a soft systolic murmur was auscultated at apex. On investigations, Hb was found as 4.6 g/dl and HbF was less than 2%. plasma Hb was 5 g/dl. Straight x-ray chest showed bilateral patchy opacities over mid and lower zones. His sputum was found to be blood stained and prompted the possibility of blood loss occurring in the lungs, which was confirmed by demonstrating haemosiderin laden macrophages on three consecutive sputum specimens. echocardiography revealed a systolic displacement of mitral valve leaflets into the left atrium with co-optation superior to the plane of mitral annulus. Doppler study showed a minimal late systolic regurgitation. It was decided to treat the case as idiopathic pulmonary haemosiderosis. oxygen inhalation, hypertonic saline nebulisation, i.v. hydrocortisone, packed cell transfusion followed by oral prednisolone improved the patient's condition. After 3 months of discontinuing prednisolone, he remained asymptomatic. Here one case of pulmonary haemosiderosis characterised by abnormal accumulation of haemosiderin in the lungs following repeated alveolar haemorrhages with the presence of mitral valve prolapse is reported.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
5/39. Isolated congenital ventricular septal aneurysm in an adult--a case report.Congenital ventricular septal aneurysm without ventricular septal defect is a very rare condition. We describe the clinical features of an adult case and the literature was reviewed. A 54-year-old woman experienced intermittent palpitation with rapid heart beating sensation for several years. The duration was only several seconds. There was neither congestive heart failure nor syncope history. physical examination revealed mid-systolic click with grade II/VI systolic murmur at apical area. echocardiography disclosed mitral valve prolapse with mild mitral regurgitation. A ventricular septal aneurysm bulging into right ventricle was found incidentally. Transesophageal echocardiographic and cardiac angiographic pictures of ventricular septal aneurysm were demonstrated. Since the patient was relatively asymptomatic, no surgical intervention was advised.- - - - - - - - - - ranking = 0.018874610393795keywords = area (Clic here for more details about this article) |
6/39. Multiple embolism in a female patient with infective endocarditis. low back pain and hematuria as the initial clinical manifestations.A 59-year-old female patient with mitral valve prolapse and a previous history of lumbosacral spondyloarthrosis and lumbar disk hernia had an episode of infective endocarditis due to streptococcus viridans, which evolved with peripheral embolism to the left kidney, spleen, and left iliac artery, and intraventricular cerebral hemorrhage. Her clinical manifestations were low back pain and hematuria, which were initially attributed to an osteoarticular condition. Infective endocarditis is a severe polymorphic disease with multiple clinical manifestations and it should always be included in the differential diagnosis by clinicians.- - - - - - - - - - ranking = 0.66079179512225keywords = pain (Clic here for more details about this article) |
7/39. A unique case of reducing body myopathy.The clinical, electromyographic, and histologic characteristics of a 17-year-old girl with reducing body myopathy are described. She is, to our knowledge, the oldest reported case and the only patient described with severe mitral valve prolapse and scoliosis. electromyography demonstrated spontaneous positive sharp waves and fibrillation potentials with many low-amplitude, short, polyphasic motor unit potentials. The right deltoid muscle was characterized by focal areas with large fibers associated with increased endomysial connective tissue and "split" fibers. Purple-gray sarcoplasmic masses stained with trichrome were PAS-negative, appeared as "empty" spaces with both ATPase and NADH-TR, and stained darkly with menadione NBT. The features described expand the clinical presentation of this myopathy, and may lead to a better understanding of its etiology.- - - - - - - - - - ranking = 0.018874610393795keywords = area (Clic here for more details about this article) |
8/39. Surgical treatment of commissural prolapse: case report and review of the options.Repair of commissural prolapse associated with chordal rupture may represent a challenging problem for the cardiac surgeon. The case of a patient with chronic mitral regurgitation and prolapse of the posterior commissural area associated with chordal rupture is presented. A technique was proposed that involved partial resection of the degenerative leaflet segment, plication of the posterior annulus and chordal transfer to create a neocommissure. An analysis of the options available for surgical treatment of commissural prolapse is included.- - - - - - - - - - ranking = 0.018874610393795keywords = area (Clic here for more details about this article) |
9/39. Hepatocellular adenomatosis is a rare entity that may mimic other hepatocellular lesions.A 14-year-old girl presented to her pediatrician with right lower quadrant pain that progressed to right upper quadrant pain with radiation to her back. Her past medical history included mitral valve prolapse, and she had no history of oral contraceptive use. Abdominal computed tomography revealed a liver mass and multiple smaller areas of low attenuation, too small to characterize. The clinical and radiographic features were suggestive of hepatocellular adenoma, and she underwent a left hepatic lobectomy. The liver contained one 4.2 cm nodule and multiple (10 to 20) smaller nodules that were well-demarcated from the adjacent liver parenchyma. All lesions were histologically hepatocellular adenomas and, therefore, she was diagnosed with hepatocellular adenomatosis. This case is unique because of the small number of cases of hepatocellular adenomatosis diagnosed in teenagers, and little long-term follow-up.- - - - - - - - - - ranking = 0.28319132844269keywords = pain, area (Clic here for more details about this article) |
10/39. Reexamining contraindications for minimally invasive mitral valve surgery.Historically, contraindications to minimally invasive or robotic mitral valve surgery have included prior mastectomy, thoracic reconstruction, or chest radiation. However, we believe that by granting flexibility in the choice of skin incision site while performing careful dissection, surgeons can provide these patients the outstanding results afforded by a minithoracotomy. We present a patient who had undergone a prior mastectomy and radiation treatment in whom we performed a minimally invasive mitral valve repair through a right-sided minithoracotomy using the previous mastectomy incision.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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