We report a case of endocarditis months after a Bentall procedure. This was caused by Candida Lusitaniae, in an immunocompetent patient with a recent SARS-CoV-2 infection. The patient underwent a new Bentall procedure. SARS-CoV-2 has been associated with co-infection by Candida species since the beginning of the pandemic, nevertheless, Candida Lusitaniae remains a very uncommon causative agent of prosthetic endocarditis. We suggest a possible role of the SARS-CoV-2, which may have delayed the diagnosis of endocarditis and the appropriate therapy.
Partial anomalous pulmonary venous return into the azygous vein is a rare pathological finding. We describe the case of a 28-year-old girl who had a successful staged approach to treat this rare congenital heart disease. To avoid potential connection of a systemic venous return to the left atrium, the proximal part of the azygous vein was occluded with a percutaneous approach, then the azygous vein flow was redirected into the left atrium with a surgical procedure.
We present a 68 years-old lady with ascending aortic pseudoaneurysm discovered by CT-angio 11 years after CABG in the States. Three out of 4 grafts were patent. Once the aorta was opened we found a localised chronic dissection likely originating from previous aortic cannulation site.
In this video we show chest reopening, aneurysm isolation and cannulation in the arch and right atrium. Aortic clamp was applied high, aneurysm was opened and the dissected aorta resected, keeping 4 top-ends attached to the aortic wall as an island. Cardioplegia was given into aortic root and selectively into venous grafts. An interposition 26 mm vascular conduit was anastomosed to sino-tubular junction and distal ascending aorta. After unclamping, the island containing top-ends was reattached to vascular conduit by 10 mm interposition graft.
We present a case of a 61 years-old man with aortic dissection involving the arch and descending aorta 7 years after a Bentall and CABG procedure reoperated 3 years later for right button pseudoaneurysm.
In this video we show our surgical approach. CPB was established using direct brachiocephalic trunk and right atrial cannulation. A moderate hypotermic circulatory arrest (26°C) was utilized and once the aortic arch was opened, cerebral perfusion was achieved separately for the brachiocephalic trunk and for the left carotid and subclavian arteries.
A FET procedure was carried out using a 26/28 mm Thoraflex prosthesis. Distal reperfusion was resumed through the prosthesis side branch after distal anastomosis was completed. Left subclavian and left carotid arteries were reimplanted during rewarming. Once proximal anastomosis was completed, heart was restarted and brachiocefalic trunk reattached on a beating heart.
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