1/8. Persistent left superior vena cava: case report and literature review.A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of a vessel that is present as a counterpart of normal right-sided superior vena cava (SVC) in early embryological development but normally disappears later. Although it can be easily diagnosed by the characteristic chest radiographic appearance of a pulmonary artery catheter (PAC) passed through it after being inserted into the left subclavian or jugular vein, its diagnosis is usually missed by the presence of normal (right) SVC and the passage of the catheter on the right side. Its diagnosis can be confirmed by many noninvasive and invasive tests, or it is incidentally diagnosed at thoracic surgery or autopsy. If it is not associated with other congenital cardiac anomalies, it is usually asymptomatic and hemodynamically insignificant. However, PLSVC has important clinical implications in certain situations. In this article, we describe a patient with bilateral SVC (a normal right SVC and a PLSVC) identified by a PAC in the PLSVC and the pacemaker wires in the right SVC. In addition, we review the literature on prevalence, embryological development, diagnosis, and clinical implications of PLSVC.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/8. Beraprost sodium-induced hypotension in two patients after cardiac surgery.Two episodes of hypotension caused by oral beraprost sodium administration following cardiac surgery are described. The first case was a 67-year-old female who underwent concomitant surgery for mitral valve replacement, tricuspid annuloplasty, and a radiofrequency maze procedure for atrial fibrillation. The second case was a 45-year-old female who underwent 4-vessel coronary artery bypass grafting associated with endarterectomy in the right coronary artery. Beraprost sodium was administered for the treatment of residual pulmonary hypertension in the first case, and was initiated as an antiplatelet agent following coronary endarterectomy in the second case. hypotension occurred at approximately one hour after beraprost sodium administration in both cases. Careful observation to prevent this adverse effect is critical after the administration of beraprost sodium, especially in patients who have undergone cardiac surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/8. Surgical approach to corrected transposition of the great vessels and situs inversus [I, D, D] with ventricular septal defect and systemic atrioventricular valve regurgitation.Successful surgical repair of a 4-year-old boy with situs inversus [I, D, D] and corrected transposition of the great vessels (TGV) as well as hemodynamically significant ventricular septal defect (VSD), systemic atrioventricular (tricuspid) valve regurgitation, and atrial septal defect is described. Unique technical aspects of VSD and tricuspid valve repair in association with corrected TGV and situs solitus or inversus are discussed and clarified.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
4/8. Corrected transposition of the great vessels associated with an obscured ventricular septal defect due to an abnormal systemic atrioventricular valve (report of a case and surgical considerations).A case of corrected transposition associated with atrial septal defect, obscured ventricular septal defect, mild pulmonary valvar stenosis, severe systemic atrioventricular valve regurgitation and complete heart block is described. Closure of an atrial septal defect and a ventricular septal defect was carried out through a left atriotomy. Systemic atrioventricular valve replacement with a 27 mm. Hancock porcine valve was performed through the same approach. A permanent Demand rechargeable pulse generator unit with myocardial unipolar electrode lead was implanted. In the presence of complete heart block, a beating heart was not mandatory while repairing the ventricular septal defect. This enabled us to employ the hypothermic cardioplegic technique which greatly facilitated the surgical repair. Despite the multiplicity and magnitude of the anomalies, gratifying results were obtained. The surgical approach and technical precautions are discussed.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
5/8. Transesophageal echocardiography combined with magnetic resonance imaging for detecting venous anomalies in dextrocardia. A case report.A fifty-six-year-old woman was admitted to Osaka Rosai hospital because of dyspnea, chills, and fatigue. The patient was diagnosed by transthoracic echocardiography as having congestive heart failure due to severe biatrioventricular valve regurgitation, and cardiac surgery was proposed. Preoperative transesophageal echocardiography (TEE) revealed a dilatation of the coronary sinus (CS), a right-sided hemiazygos vein (R-AZ), and another great vessel lying between the CS and the R-AZ. magnetic resonance imaging (MRI) was also performed, and this showed a persistent right superior vena cava (PRSVC) entering the left atrium via the dilatated CS. However, the site of connection between the R-AZ and the PRSVC could not be detected by MRI because of inadequate slice acquisition. Each method has its limitations, particularly with regard to visualizing the extracardiac vascular system. Therefore, the authors demonstrated that the combination of TEE and MRI might be more useful than each alone, and the combination is as a valuable method as digital subtraction angiography for the diagnosis of extracardiac venous anomalies.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/8. Bilateral corkscrew episcleral veins from tricuspid incompetence.PURPOSE: To use color Doppler imaging in examining a patient with clinically diagnosed low-flow carotid-cavernous sinus fistula and a history of rheumatic heart disease. METHOD: The flow characteristics of the orbital vessels and the internal jugular veins were studied with a 7.0-MHz transducer. RESULTS: Episodic arterialization and reversal of blood flow was demonstrated in both superior ophthalmic veins. This similar waveform was also seen in both jugular veins. CONCLUSION: The presence of tricuspid regurgitation and pulmonary hypertension caused increased episcleral venous pressure and the corkscrew appearance, which is more commonly associated with carotid-cavernous sinus fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/8. chest pain and bilateral atrioventricular valve prolapse with normal coronary arteries in isolated corrected transposition of the great vessels. Clinical, angiographic and metabolic features.A man evaluated for disabling chest pain was found to have isolated anatomically corrected transposition of the great vessels. angiography demonstrated right and left atrioventricular (A-V) valve prolapse and normal coronary arteries. Atrial pacing produced chest pain, ischemic electrocardiographic changes, abnormal myocardial lactate metabolism and marked elevation of the left ventricular end-diastolic pressure; all of these changes returned to normal on termination of pacing. The association of corrected transposition and bilateral A-V valve prolapse and the possible causes of myocardial ischemia in this patient are discussed.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
8/8. hemoptysis from an emphysematous bulla developing after open-heart surgery: report of a case.We present herein the case of a 62-year-old woman with an emphysematous bulla who developed intractable hemoptysis 16 days after undergoing mitral and aortic valve replacement with tricuspid annuloplasty. A bronchoscopic examination with balloon occlusion of the bronchial lumen revealed that the blood source was the right middle lobe bronchus. A computed tomographic (CT) scan of the chest subsequently demonstrated a blood-filled emphysematous bulla in the right middle lobe. A right middle lobectomy was performed and the bulla was observed to be swollen with clotted blood. The respiratory tract bleeding stopped immediately after the lobectomy. Pathohistological examinations suggested that disruption of the pulmonary vessels in the wall of the bulla had caused the respiratory tract bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |