The Annals of thoracic surgery
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Pentacuspid aortic valve is an extremely rare congenital aortic valve anomaly. In this case, pentacuspid aortic valve with severe aortic regurgitation was detected by transthoracic echocardiography and multiple-detector computed tomography; the patient recovered smoothly after aortic valve replacement.
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We report four cases of ventricular pacing through the coronary sinus in patients with tricuspid biological valves for whom recordings of atrioventricular block indicated required pacemaker implantation. To avoid risk of tricuspid damage, endocardial pacemaker implantation is not recommended for patients with prior tricuspid valve replacement. ⋯ For our cases, satisfactory pacing data was collected for a 6-year follow-up. This technique enables a minimally invasive approach and effective stimulation for patients with a prosthetic tricuspid valve.
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Injury to the circumflex artery after mitral valve (MV) repair or replacement is a recognized complication of this procedure. We designed an echocardiographic method to visualize the course and flow of the circumflex artery, to detect iatrogenic injury to this structure intraoperatively, as well as to predict the coronary dominance pattern in MV surgery patients. ⋯ The early recognition of iatrogenic injury of the circumflex artery is feasible with intraoperative transesophageal echocardiography examination, and may lead to treatment before extensive myocardial infarction occurs. We suggest that visualization of the circumflex artery with our technique should be performed more frequently in patients undergoing MV surgery.
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Clinical Trial
Initial experience with a miniaturized multiplane transesophageal probe in small infants undergoing cardiac operations.
There has been reluctance to use intraoperative transesophageal echocardiography (TEE) in small infants. We assessed the utility and safety of a new miniaturized multiplane micro-TEE probe in small infants undergoing cardiac operations. ⋯ The micro-TEE provides high quality, useful diagnostic images without hemodynamic or ventilation compromise in small infants undergoing cardiac operations. This advance is important with the growing trend towards complete repair of complex structural heart disease in small infants.
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The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF). ⋯ Emergency CPB after prolonged cardiac arrest improves survival and allows systemic hyperkalemia to convert intractable VF, but fails to reduce neurologic damage.