Since its introduction in Japan in 1980, the extracorporeal left ventricular assist device has been used as a bridge to the recovery of cardiac function or to heart transplantation by many institutions. In this case report, we describe a 23-year-old female with peripartum cardiomyopathy. She had a persistently low cardiac index despite intensive care with intravenous inotropes, intra-aortic balloon pumping and extracorporeal membrane oxygenation; thus, we implanted an extracorporeal left ventricular assist device. Thereafter, her cardiac function gradually improved; the device was removed 2 months after the implantation. She currently has good heart function.
We report a case of surgical treatment for neonatal Ebstein's anomaly with circular shunting. A prenatal diagnosis of Ebstein's anomaly was made at 30 weeks of gestation. In addition to severe tricuspid regurgitation, severe pulmonary regurgitation was also noted, resulting in a 'circular shunt'. At 38 weeks and 2 days of gestation, the baby was delivered by Caesarean section. A two-stage palliative operation was planned. As the first palliation, the pulmonary artery was ligated 1 h after birth to eliminate the circular shunt. Lipo-prostaglandin E 1 was administrated continuously to keep the ductus arteriosus patent. Four days after first operation, modified Starnes operation was performed as the second-stage palliation. The tricuspid valve was closed by an ePTFE patch with 3-mm fenestration. Pulmonary blood flow was supplied by a right modified Blalock-Taussig shunt with a 3.5-mm diameter ePTFE graft. The infant's postoperative haemodynamic status was stable. The patient is being followed up carefully and is scheduled to have a univentricular repair in the future.
An emergency thoracic endovascular aortic repair (TEVAR) with zone 2 landing
without revascularization of the left subclavian artery was performed due to the
impending rupture of a distal arch aneurysm in an old patient presenting
hemoptysis. Two months later, the patient had recurrent massive hemoptyses and
continued after additional zone 0 TEVAR. The lung parenchyma was considered to
be the bleeding source and transcatheter pulmonary artery embolization was
performed, and the episodes of massive hemoptysis appeared to have ceased.
However, the patient died of sudden recurrent massive hemoptysis 40 days later.
Inflammation and/or infection of the lung parenchyma adjunct to the aortic
aneurysm could be cause of fatal hemoptysis, and aggressive therapy such as lung
resection should be considered in such patients.
Introduction: Idiopathic mitral valve chordal rupture is rare among infants. Once it has occurred, acute heart failure progresses, and emergency surgical repair is necessary in most cases. Our surgical experience with idiopathic mitral valve chordal rupture is reported.
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