Journal of cardiac surgery
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We report a 62-year-old female who required surgery for severe mitral regurgitation. Under robotic assistance, the valve was repaired by transection of the fibrous bridge, implantation of four neo-chordaes to the anterior leaflet, commissuroplasty of the posterolateral commissure, and annuloplasty.
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Mitral valve operations are increasingly performed through minimally invasive approaches such as the right anterior minithoracotomy. To facilitate exposure with this technique, a diaphragmatic suture may be implemented. We describe a liver laceration caused by the diaphragmatic suture in minithoracotomy mitral repair and its successful nonoperative management with arterial embolization.
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The immediate postischemic period is marked by elevated intracellular calcium levels, which can lead to irreversible myocyte injury. Del Nido cardioplegia was developed for use in the pediatric population to address the inability of immature myocardium to tolerate high levels of intracellular calcium following cardiac surgery. Our aim in this study is to determine if this solution can be used safely and effectively in an adult, reoperative population. ⋯ Del Nido cardioplegia use in an adult, reoperative aortic valve population offers equivalent postoperative outcomes when compared with whole blood cardioplegia. In addition, use of del Nido solution requires lower total and retrograde cardioplegia volumes in order to achieve adequate myocardial protection.
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Case Reports
Interventricular septal rupture after transcatheter aortic valve implantation: surgical and perioperative management.
Transcatheter aortic valve implantation (TAVI) is associated with various complications, usually related to valve positioning or prosthesis delivery. We report the rare complication of an iatrogenic ventricular septal defect, secondary to aortic annulus disruption after TAVI-transfemoral procedure, generating a significant left-to-right shunt and cardiac failure. Open surgical procedures under cardiopulmonary bypass remain the best option for this lethal complication.