Angiolymphoid hyperplasia with eosinophilia (ALHE) is an unusual vascular tumor most frequently located in the superficial head and neck. Noncutaneous localization of this pathology in large arteries presenting as a pulsatile mass is extremely rare. We describe an adult male with a giant left axillary artery tumor secondary to ALHE. ALHE should be considered in the differential diagnosis of localized peripheral arterial masses, especially in young patients.

Stent infection following percutaneous transluminal coronary angioplasty is rare. We present such a case involving a drug-eluting stent placed in the left anterior descending coronary artery that was managed surgically with removal of the stent with concomitant coronary artery bypass grafting. Early surgical intervention directed at removal of the infected stent, debridement and distal vessel revascularisation is recommended to deal with the infection and prevent myocardial compromise.

Familial homozygous hypercholesterolemia is a potentially dangerous risk factor that can result in premature coronary arterial disease in children and young adults. This can result in severe morbidity and premature death in young individuals. We also emphasise the need to screen first-degree relatives and extended family members, this playing an important role in early detection and treatment. Despite recent advances in treatment using lipid lowering agents, the disease remains a significant challenge.

Cases of aorto-ventricular tunnel involving the right ventricle and more commonly, the left ventricle have been described. The site of origin is located above the right coronary cusp and occasionally, the left. We describe an aorto-left ventricular tunnel in a 16-year-old girl, with aneurysmal expansion into the right ventricular outflow tract. Its aortic origin was above the commissure of the right and noncoronary cusps of the aortic valve.

Objective To analyze the echocardiographic and operative findings with respect to mitral valve anatomy in individuals undergoing emergency surgery for acute severe mitral regurgitation (MR) following balloon mitral valvotomy (BMV). In addition, the clinical profile and outcomes are highlighted. Background Acute severe MR is a major complication of BMV. There are only a few reports which have studied the echocardiographic and operative findings in this setting. In addition, optimal timing of surgery is uncertain. Methods Prospective study of 50 consecutive patients undergoing emergency mitral valve replacement (MVR) for acute severe MR following BMV. Results In 3855 patients who underwent BMV, acute severe MR developed in 50 cases (1.3%) and was referred for emergency MVR. Hypotension (72%), hypoxia (64%), orthopnea (14%), and pulmonary edema (12%) were the clinical manifestations. Severe MR was secondary to anterior mitral leaflet tear in 36 cases (72%), paracommisural tear with annular involvement in seven cases (14%), posterior mitral leaflet tear in five cases (10%) and chordal tear in two cases (4%). The correlation between two‐dimensional transthoracic echocardiography (2D‐TTE) and operative finding for mitral valve calcification was found to be strong (r = 0.862), in contrast to submitral fusion, where it was found to be moderate (r = 0.536). In‐hospital mortality was 12%. Mortality was higher in patients whose time to surgery was ≥24 hr when compared to those who underwent MVR within 24 hr (P < 0.001). Conclusions Hypotension and hypoxia are the predominant manifestations of acute severe MR following BMV. Anterior mitral leaflet tear is the most common etiology for severe MR. 2D‐TTE underestimated the severity of submitral disease. Early MVR (<24 hr) is recommended for optimal outcome. © 2012 Wiley Periodicals, Inc.

Primary cardiac tumors are very rare, and tumors arising from cardiac valves are extremely rare. We present a case of lipomatous hamartoma of the mitral valve in a young female. This is the 6th case of lipomatous hamartoma of the mitral valve to be reported. We discuss the operative and histopathological findings.

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:  Pulmonary artery (PA) stenosis due to Takayasu Arteritis (TA) is usually managed by angioplasty techniques. We present a patient with isolated PA stenosis with TA with in‐stent stenosis. The surgical management and pathophysiology of this disease are reviewed. (J Card Surg 2012;27:365‐367)