Use of an intra-aortic balloon pump (IABP) is helpful for maintaining hemodynamic stability in patients with low cardiac output and compromised left ventricular function undergoing coronary artery bypass grafting. Although the incidence of complications has decreased significantly as experience with the device has increased, IABP use still carries a risk of complications. The most common complication is limb ischemia, mainly as a result of IABP entrapment and thromboembolism. Here we report a case of IABP entrapment in a nonatherosclerotic common iliac artery where forced removal caused fracture of the catheter.
Hydatid cyst (HC) is an endemic infestation in the cattle-breading countries such as in Iran. The involvement of heart by HC is rare; however, nesting of larva in the left ventricular apex with subsequent rupture to the systemic circulation and thrombus formation in the remaining cyst cavity is an exceedingly rare phenomenon. A 45-year-old man referred to our emergency cardiac room with chest pain and a transthoracic echocardiography (TTE) that showed a cardiac apex cystic lesion. The differential diagnosis of a cystic tumor, a HC, or aneurysm in the apex of the left ventricular walls was considered and evaluated by TTE and magnetic resonance imaging. However, the thrombotic HC was confirmed at the surgery. The cyst with its thrombotic component was excised surgically by on-pump cardiac surgery. The postoperative period was uneventful and the patient was discharged to home and treated with a full course of Albendazole therapy for 4 weeks. Six-month follow-up with TTE revealed complete healing of the apex defect without recurrence of the cyst.
The reported annals incidence of pericardial cysts (PC) in medical literature varies from 1/100000 to 1/120000. They are usually incidentally found during a thoracic or cardiac surgery or by an imaging modality by chance or remain clinically asymptomatic until the 3rd or 4th decades of life. However, in rare cases, compression or rupture of cysts into the surrounding structures, lead to the appearance of symptoms that may further be diagnosed by imaging modalities. We report the case of a 35-year-old man, with presentation of palpitation and chest pain and dyspnea. A transthoracic echocardiography (TTE) and computed tomography (CT scan) confirmed the presence of a cystic lesion the in right lower cardiac border. With the impression of a hydatid cyst, he has undergone open cardiac surgery and during mediastinal exploration a well-defined cyst filled with pasty and thrombotic materials was found intrapericardialy that was attached to the right atrial wall. The cyst with the inflammatory thick wall was enblockly resected. In the histological examination, diagnosis of pericardial cyst was confirmed. The postoperative phase was uneventful and during 6 months of follow-up he was good with no pericardial effusion on TEE.
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