Disección intramiocárdica del ventrículo izquierdo y ruptura del septum interventricular posinfarto de miocardio. Reporte de caso

Left Ventricular Intramyocardial Dissecting Hematoma

Composite reconstruction of right ventricle and tricuspid valve for cardiac angiosarcoma

Case of a Large Dissecting Intramyocardial Hematoma Treated Conservatively

Congenic nonobese diabetic mouse strains fail to confirm linkage of a marginal zone B lymphocyte phentoype to the Idd11 locus on chromosome 4-Response.

8 Postoperative interventricular septal haematoma following tetralogy of fallot repair and perimembranous ventricular septal defect repair

75-Year-Old Man With Chest Pain and Dyspnea

There are three major mechanical complications of acute myocardial infarction: rupture of the left ventricular free wall, rupture of the interventricular septum, and development of mitral regurgitation. Each of these complications is associated with extremely high mortality. Reviewing the scientific literature, we found descriptions of sporadic cases of both of those complications combined. We report an unusual case of simultaneous rupture of free wall and interventricular septum.

Falso aneurisma de la aorta ascendente 3 meses después de un reemplazo valvular aórtico

Mitral valve rupture secondary to ischemic papillary muscle necrosis is rare in the contemporary era due to improved revascularization techniques. However, when it does occur, prompt diagnosis and urgent surgical intervention can be lifesaving. A 69-year-old male with morbid obesity, hypothyroidism, and a family history of coronary artery disease presented to the hospital with chest pain and dyspnea that began five hours prior. He had an acute infero-postero-lateral myocardial infarction due to total occlusion of the left circumflex artery that was revascularized with the deployment of a drug-eluting stent. Two days after the myocardial infarction, the patient had an episode of ventricular tachycardia. He subsequently went into respiratory distress from flash pulmonary edema and developed cardiogenic shock due to acute mitral valve rupture. The patient underwent surgical mitral valve replacement, extracorporeal membranous oxygenation (ECMO), and hemodialysis. His course was complicated by an acute lower gastrointestinal bleed that progressed into multiorgan failure and eventually his demise. This case highlights the need to include papillary muscle rupture high on the differential when evaluating a hemodynamically unstable patient in the setting of an acute myocardial infarction (MI). Rapid diagnosis by urgent bedside echocardiogram and surgical intervention is crucial.

Ischemic volvulus of the transverse colon caused by intestinal malrotation: A case report.

Lewis Grizzard and his Bicuspid Aortic Valve

Treatment of infective endocarditis is primarily conservative. Persistent infection, tissue destruction und hemodynamic instabilities argue - in dependence on the microorganisms involved - for an urgent surgical treatment, even when there is still no control of the local and systemic infection. For timing of the surgical intervention, the following suggestions seem to be valid: TIMING OF THE SURGICAL INTERVENTION: Delayed surgical indication is considered a prognostic factor of extraordinary relevance for surgical treatment of infective endocarditis. Presence of intramyocardial, paravalvular and root abscess or development of a septic cardiomyopathy (in addition to the valve-related disturbed pump and muscular function), systemic sepsis and irreversible extracardiac organ destruction (liver, spleen, kidney, brain, lung, bone, etc.) reduce the surgical prognosis even after successful and complete surgical treatment. Extracardiac foci may determine the postoperative course. After cerebral embolization the cardiac operation should be performed as early as possible (within 24-48 h after embolization). Extreme extent of cardiac and extracardiac tissue destruction due to delayed surgical indication can result in a situation, where adequate surgical treatment of the local focus is not likely to be successful anymore and prognosis becomes infaust. In their own patients, the authors observed: NYHA (New York Heart Association) III-IV > 50%; renal failure (dialysis) > 15%, systemic embolization > 30%, cerebral embolization > 8%, cardiogenic shock > 10%. The most important aspect is complete debridement of all infected tissue with a safety margin of about 3 mm. This holds true, even if it results in resection of the entire aortic root, mitral ring, aortic wall, and atrial tissue. There is no contraindication to the implantation of prosthetic materials (valves, bovine pericardium, mitral rings) as long as surgical debridement has been prompt and aggressive. Not the type of prosthesis, but the quality of surgical debridement is of prognostic relevance. Reconstructive techniques are suggested whenever possible and are primarily effective for the treatment of mitral and tricuspid valves. Prompt and aggressive eradication of extracardiac foci is important to the patient's postoperative course. After successful surgical treatment of the intracardiac focus, the postoperative course is mainly determined by extracardiac foci, systemic sepsis, and persistent secondary organ destruction. As the results of conservative treatment of infective endocarditis are still not satisfactory, in some subgroups improved surgical results due to aggressive and radical debridement of infective tissue (with a safety margin of at least 3 mm) will suggest the surgical treatment option even in those patients, that have primarily been considered for conservative treatment.

Late myocardial infarction (MI) is associated with ventricular arrhythmias and sudden cardiac death. The exact mechanistic relationship between abnormal cellular electrophysiology, conduction abnormalities, and arrhythmogenesis associated with late MI is not completely understood. We report a novel, rapid dye superfusion technique to enable whole heart, high-resolution optical mapping of late MI. Optical mapping of action potentials was performed in normal rats and rats with anterior MI 7 days after left anterior descending artery ligation. Hearts from normal rats exhibited normal action potentials and impulse conduction. With the use of programmed stimulation to assess arrhythmia inducibility, 29% of hearts with late MI had inducible sustained ventricular tachycardia, compared with 0% in normal rats. A causal relationship between the site of infarction, abnormal action potential conduction (i.e., block and slow conduction), and arrhythmogenesis was observed. Optical mapping techniques can be used to measure high-resolution action potentials in a whole heart model of late MI. This experimental model reproduces many of the electrophysiological characteristics (i.e., conduction slowing, block, and ventricular tachycardia) associated with MI in patients. Importantly, the results of this study can enhance our ability to understand the interplay between cellular heterogeneity, conduction abnormalities, and arrhythmogenesis associated with MI.

Early Postoperative Perils of Intraventricular Tumors: An Observational Comparative Study.

Can the Hype of “Endoscope” Become a Reality for Colloid Cyst Surgery?