J Heart Valve Dis
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Review Case Reports
Mitral valve myxoma: a case report and brief review of the literature.
A case of cardiac myxoma arising from the mitral valve is reported. A 50-year-old woman presented with history of shortness of breath and angina. ⋯ At surgery, the tumor was found to be arising from the anterior leaflet of the mitral valve. The tumor was excised and a defect in the anterior leaflet of the mitral valve was repaired by direct suture.
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Although the results of intracardiac repair for pulmonary stenosis or atresia are generally good, some patients develop symptoms due to to pulmonary regurgitation and right ventricular dilatation. Implantation of a pulmonary homograft may have a beneficial effect on these symptoms. Twenty-seven patients with symptoms due to pulmonary regurgitation and right ventricular dilatation were reoperated. ⋯ We conclude that pulmonary regurgitation after transannular patching can be treated with implantation of a cryopreserved pulmonary homograft with acceptable mortality and low morbidity. Clinical improvement results from reduction of the right ventricular volume overload rather than from decline in right ventricular dilatation. Arrhythmia as the only indication for operation is controversial.
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Previous work in our laboratory has demonstrated a simple, dynamic in vitro calcification method for studying bovine pericardial heart valves. The calcification produced closely resembled that found in clinical explant valves. The current study extends this technique to the porcine aortic bioprosthesis. ⋯ These had all previously inhibited calcification of bovine pericardium in a rat subdermal implant model but had failed to reduce calcification in whole pericardial valves calcified in vitro under dynamic conditions. The modified porcine valves produced similar results: no modification achieved reduction of calcification on exposure to the functional valve calcification model. The dynamic in vitro calcification test has been shown to be useful for the study of both main types of bioprostheses, bovine pericardial and porcine aortic valves, and for the assessment of alterations to these biomaterials.
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Case Reports
Fatal cerebral air embolism during open heart surgery caused by lung parenchyma to left atrial communication.
We present an unusual sequence of events leading to massive cerebral air embolism and death in a patient who underwent mitral valve re-replacement for failure of the previously inserted bioprosthetic valve. An iatrogenic communication was created inadvertently between the adherent lung parenchyma and the left atrium. It caused a massive influx of air from the lung into the left atrium and systemic circulation causing fatal cerebral embolization. Retroperfusion was not effective.