Libman-Sacks endocarditis (LSE), characterized by verrucous vegetations formation, is a typical cardiac manifestation of autoimmune diseases such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). It primarily leads to lesions of cardiac valves and mostly involved valves are mitral and aortic, but isolated tricuspid valve involvement is exceptional. Here we reported a 20-years-old female with past SLE history suffered from acute right heart failure caused by multiple tricuspid vegetations and valve regurgitation. The patient recovered following tricuspid valve replacement with a bioprosthesis. Transesophageal echocardiography(TEE), especially real time 3-dimensional (RT3D) TEE provide a better imaging modality for assessing cardiac valvular involvement of LSE. For patients with active SLE/APS course, uncontrolled systemic inflammation may made it difficult for surgical exposure and suture. The durability of bioprosthesis for this patient and the prosthesis selection for tricuspid LSE both need further follow-up and more clinical investigation.
A novel canine model of acute Stanford type-A aortic dissection has been developed, which showed multiple organ dysfunction that mimicked the clinically relevant features observed in man. This aortic dissection model is unique, and may further improve our understanding of the underlying pathogenesis of aortic dissections.
BackgroundPapillary fibroelastoma (PFE) is a rare primary cardiac neoplasm that is usually discovered incidentally at autopsy or during cardiac surgery. PFE combined with rheumatic heart disease (RHD) is extremely rare, and only a few cases have been reported. Additionally, the growth rate of the tumor is unknown.Case PresentationHere, we present a very rare case of PFE of the aortic valve combined with RHD, which were identified in a female patient who survived for 5 years without surgical intervention, and who subsequently underwent successful surgical treatment.ConclusionsPFEs may be generally slow-growing tumors, however, the better treatment of choice may be surgery because it produces good curative effects with very low risk of complications, while preventing serious disease consequences.
Objective:Type A aortic dissection (AD) and ascending thoracic aortic aneurysm (AA) are thoracic vascular diseases with similar initial pathology but inequable clinical features and outcomes, where local and systemic inflammation play an important part. We aimed to observe and analyze the differences and correlation between inflammation and pathological changes in the aorta and biomechanical strength between AD and AA.Methods:From August 2011 to February 2013, 20 patients with AD (AD group) and 13 patients with AA (AA group) who underwent aorta surgery were included. Serum concentrations of total cholesterol (TC), triglycerides (TG), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were measured just before surgical anesthesia. The longitudinal vessel samples of the affected ascending aorta were harvested during surgery and prepared for subsequent pathological observation and uniaxial tension test to measure the longitudinal tensile strength (TS). Samples were also prepared for further measurement of tissue homogenized TNF-α and IL-6 concentrations.Results:No significant difference was seen between the two groups with respect to baseline data, and the serum concentrations of TC and TG of both the groups were within the normal range (p>0.05). Blood and tissue homogenized levels of IL-6 and TNF-α were significantly higher in the AD group than in the AA group (p<0.001). Pathological observation of the aortic tissue showed more inflammatory cells infiltration and elastic fiber destruction in the AD group than in the AA group, indicating significant aortic medial degeneration. Uniaxial tensile tests showed that the longitudinal TS was significant lower in the AD group than in the AA group (p<0.001). The longitudinal TS showed negative correlations with serum and tissue homogenized concentrations of IL-6 and TNF-α in the AD group (p<0.05), whereas no such significant correlation was seen in the AA group.Conclusion:Patients with AD had acute systemic inflammation, along with acute inflammation and declined biomechanical strength of the affected aorta. The serum and tissue homogenized concentrations of IL-6 and TNF-α showed a significant correlation with the biomechanical strength of affected aorta in AD.
BackgroundPartial anomalous pulmonary venous connection (PAPVC) without an atrial septal defect (ASD) associated with coarctation of the aortic arch is a rare congenital cardiac anomaly. This rare combination is only described in a few studies; none report the correction of these two malformations in a single surgery.Case presentationA 5-year-old girl was admitted to our hospital because the echocardiography revealed coarctation of the aortic arch; this diagnosis was confirmed by computed tomography (CT), which also showed her left superior pulmonary vein draining into the vertical vein without ASD (Fig. 1). She exhibited no special clinical symptoms. Her upper-limb blood pressure was approximately 110/90 mmHg, whereas her lower-limb blood pressure was approximately 75/50 mmHg.ConclusionsWe surgically repaired the case of PAPVC to the vertical vein with aortic coarctation, in which the two cardiovascular malformations were corrected in a single surgery without cardiopulmonary bypass.
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