1/26. Orthotopic heart transplantation with concurrent aortic valve replacement and coronary artery bypass grafting.We report a case of successful orthotopic heart transplantation of a donor heart with normal ventricular function, 2-vessel coronary artery disease, and a bicuspid aortic valve, which required concurrent aortic valve replacement and coronary artery bypass grafting. In confronting the disparities in demand and supply, we must consider the so-called marginally acceptable heart for either critically ill recipients or those who may be disadvantaged on the waiting list.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/26. Concurrence of sarcoidosis and aortitis: case report and review of the literature.takayasu arteritis (TA) is a rare manifestation of systemic large vessel vasculitis which affects predominantly the aorta and its main branches, but often remains unrecognised owing to delayed diagnosis and non-characteristic clinical features. sarcoidosis, too, is a systemic inflammatory disease which can affect virtually any organ system. Reports about the coincidence of both diseases have appeared. The case presented here is characterised by a significant time lag between detection of TA and appearance of clinical signs of sarcoidosis. The woman, now 39 years old, had erythema nodosum, circumscript alopecia, and recurrent uveitis, which dated back to 1980 and was attributed to sarcoidosis. At least 12 years later aortic valve insufficiency with progressive cardiac failure developed. histology performed at the time of aortic valve prosthesis in 1997 disclosed a diagnosis of TA, which was confined to the aortic root. Incidentally, sarcoidosis was diagnosed in adjacent lymph nodes. A thorough check up failed to detect further manifestations of TA; thus, possibly, the patients had aortitis similar to, but not identical with, TA.Several related cases previously reported are discussed, suggesting that both diseases may be inherently related as they are characterised by certain non-specific, immunoinflammatory abnormalities. This case report suggests that the prevalence of TA, or related forms of arteritis, may be higher than expected and should be considered, especially in younger patients with non-characteristic cardiovascular symptoms and suspected systemic inflammatory disease. Moreover, the association with sarcoidosis in this and other previously described cases suggests that the two diseases may be related and that TA or TA-like vasculitis may even be a complication of sarcoidosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/26. Coronary arteriovenous fistula with annuloaortic ectasia and aortic regurgitation.cardiac catheterization in a 57-year-old man disclosed a left coronary artery-coronary sinus fistula with annuloaortic ectasia and severe aortic regurgitation. During surgery, the fistula vessel was exposed and clamped before infusing cardioplegic solution for cardiac arrest. The proximal orifice of the fistula was closed directly and the distal orifice doubly ligated. A modified Bentall's procedure was conducted without difficulty. The postoperative course was uneventful.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/26. Oblique aortic valve replacement and coronary artery bypass grafting for severely calcified narrow aortic root with unstable angina.We report an 84-year-old woman diagnosed with aortic stenosis and regurgitation with a severely calcified narrow aortic root and left main coronary artery trunk stenosis with triple-vessel coronary artery disease. Emergency aortic valve replacement and triple coronary artery bypass grafting were successful. The aortic annulus was small and heavily calcified, and the ascending aorta, the sinus of valsalva and the anterior leaflet of the mitral valve were severely calcified. A St. Jude Medical valve 19A (St. Jude Medical Inc., St. Paul, MN) was inserted obliquely along the noncoronary sinus. This technique is a useful alternative in cases where the patient's life is at risk in situations involving severe extensive calcification of a narrow aortic root.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/26. Simultaneous surgery for ischemic heart disease, type A aortic dissection and abdominal aneurysm.The patient was a 72-year-old male with three-vessel coronary artery disease, chronic dissecting aneurysm of the ascending aorta with moderate aortic regurgitation, and abdominal aortic aneurysm 7 cm in diameter. Because staged procedure seemed to exacerbate the risk due to the remaining lesion, simultaneous procedures (double coronary artery bypass, aortic root remodeling, tube replacement of the ascending aorta and Y-graft replacement of the abdominal aneurysm) were performed. The patient recovered completely without any serious complication.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/26. wiskott-aldrich syndrome, vasculitis and critical aortic dilatation.wiskott-aldrich syndrome is a rare X-linked disorder, comprising the triad eczema, thrombocytopenia and progressive immunodeficiency. The prognosis has been poor in the past but is now improving with therapeutic options including splenectomy and bone marrow transplantation. We report the case of a 21-year-old male with an established diagnosis of wiskott-aldrich syndrome, who developed aortic root dilatation with severe aortic regurgitation requiring aortic valve and root replacement. histology confirmed a destructive, full-thickness, chronic aortitis. CONCLUSION: As treatment and prognosis improve, large vessel vasculitis may become an increasingly recognized late complication of this syndrome, which now extends into adult practice.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/26. Single coronary artery with aortic regurgitation.An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3 aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/26. Transesophageal and transpharyngeal ultrasound demonstration of reversed diastolic flow in aortic arch branches and neck vessels in severe aortic regurgitation.In the current study, we describe an adult patient with torrential aortic regurgitation due to an aortic dissection flap interfering with aortic cusp motion, in whom a transesophageal echocardiogram with the probe positioned in the upper esophagus and transpharyngeal ultrasound examination demonstrated prominent reversed flow throughout diastole in the left subclavian, left vertebral, left common carotid, and left internal carotid arteries. Another unique finding was the demonstration of aortic valve leaflets held in the fully opened position in diastole by the dissection flap as it prolapsed into the left ventricular outflow tract, dramatically documenting the mechanism of torrential aortic regurgitation in this patient.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
9/26. Aortic valve replacement in a patient with Takayasu's disease without cross-clamping the calcified ascending aorta.The case of a 42-year-old female requiring surgical management of aortic regurgitation, secondary to Takayasu's disease, with a co-existing heavily calcified ascending aorta is described. In order to address aortic valve surgery with such calcific disease affecting the ascending aorta and peripheral vessels, we present a simple and safe technique that allows aortic valve replacement using a vascular intra-aortic occlusion catheter.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/26. Traumatic innominate artery disruption and aortic valve rupture.Rapid deceleration injury causing blunt thoracic trauma can result in injury to the thoracic aorta. rupture of the aortic isthmus is the most common presentation; however, injury can occur more proximally in the arch vessels or the aortic root. We present an unusual case of simultaneous innominate artery disruption with aortic valve rupture after a motor vehicle accident, and we discuss issues surrounding the diagnosis and operative management of this rare, but life-threatening condition.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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