Pseudoaneurysm Fistulated into the Right Atrium after Double Valve Replacement

We discuss a rare case of an ascending aorta pseudoaneurysm fistulating into the right atrium following prior aortic and mitral valve replacement. Transthoracic echocardiography and computed tomography revealed a pseudoaneurysm of the ascending aorta attached to the right atrium with fistulous communication. The pseudoaneurysm arose from the center of the former aortotomy. Emergency remedian sternotomy was performed without aneurysmal injury and with exposure of the left femoral artery and femoral vein. Aneurysmal resection and ascending aorta repair were performed without complication. Exposing peripheral vessels, and initiating cardiopulmonary bypass only after reentry, might be effective in resternotomy to approach ascending aorta pseudoaneurysms.<br /><br />

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Aneurysm of Right Cervical Aortic Arch with Abnormal Branching Pattern

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600216 ◽

1998 ◽

Vol 6 (2) ◽

pp. 135-137

Author(s):

Sandeep Shrivastava ◽

Shipra Shrivastava ◽

Kurur Sankaran Neelakandhan

Keyword(s):

Cardiopulmonary Bypass ◽

Carotid Artery ◽

Aortic Arch ◽

Rare Case ◽

Circulatory Arrest ◽

Innominate Artery ◽

Ascending Aorta ◽

Branching Pattern ◽

The Right ◽

Total Circulatory Arrest

We report a rare case of congenital saccular aneurysm of the right cervical aortic arch in a 16-year-old girl. There were no branches arising from the aortic arch but 3 branches arose from the ascending aorta: the left innominate artery, the right common carotid artery, and the right subclavian artery. The aneurysm was successfully repaired with a plasma-preclotted woven Dacron interposition graft during profound hypothermic cardiopulmonary bypass without total circulatory arrest.

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Aortic dissection during transoesophageal echocardiography: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa333 ◽

2020 ◽

Author(s):

Rin Hoshina ◽

Hideyuki Kishima ◽

Takanao Mine ◽

Masaharu Ishihara

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Aortic Dissection ◽

Right Coronary Artery ◽

Bypass Graft ◽

Transoesophageal Echocardiography ◽

Ascending Aorta ◽

Maximum Diameter ◽

Abnormal Finding ◽

The Right

Abstract Background Transoesophageal echocardiography (TOE) is a safe and useful tool. In our case, we are presenting a rare case of a patient with aortic dissection during TOE procedure. Case summary A 79-year-old woman was referred to our hospital for recurrent paroxysmal atrial fibrillation (AF) with palpitation. Pre-procedural cardiac computed tomography (CT) showed slight dilated ascending aorta (maximum diameter: 40 mm). We decided to perform catheter ablation (CA) for AF, and recommended TOE before the CA because she had a CHADS2 score of 4. On the day before the CA, TOE was performed. Her physical examinations at the time of TOE procedure were unremarkable. At 3 min after probe insertion, there was no abnormal finding of the ascending aorta. At 5 min after the insertion, TOE showed ascending aortic dissection without pericardial effusion. After waking, she had severe back pain and underwent a contrast-enhanced CT. Computed tomography demonstrated Stanford type A aortic dissection extending from the aortic root to the bifurcation of common iliac arteries, and tight stenosis in the right coronary artery (maximum diameter; 49 mm). The patient underwent a replacement of the ascending aorta, and a coronary artery bypass graft surgery for the right coronary artery. Discussion Transoesophageal echocardiography would have to be performed under sufficient sedation with continuous blood pressure monitoring in patients who have risk factors of aortic dissection. The risk–benefit of TOE must be considered before a decision is made. Depending on the situation, another modality instead of TOE might be required.

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Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

Case Reports in Cardiology ◽

10.1155/2018/6927436 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Christina S. Chen-Milhone ◽

Kalyan Chakravarthy Potu ◽

Sudhir Mungee

Keyword(s):

Tricuspid Valve ◽

Right Atrium ◽

Rare Case ◽

Opportunistic Infections ◽

Immunocompromised Patient ◽

Clinical Suspicion ◽

Ventricular Rate ◽

Immunocompromised Patients ◽

Transthoracic Echocardiogram ◽

The Right

Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

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Unusual abdominal tumors with intracardiac extension. Two cases with successful surgical resection

Revista do Hospital das Clínicas ◽

10.1590/s0041-87811999000500006 ◽

1999 ◽

Vol 54 (5) ◽

pp. 159-164 ◽

Cited By ~ 14

Author(s):

Noedir A. G. Stolf ◽

Gilmar Geraldo dos Santos ◽

Victor L. S. Haddad

Keyword(s):

Cardiopulmonary Bypass ◽

Surgical Resection ◽

Right Atrium ◽

Circulatory Arrest ◽

Vena Cava ◽

Radical Resection ◽

Abdominal Tumors ◽

Cardiac Symptoms ◽

Intracardiac Extension ◽

The Right

Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Although these tumors have different histologic aspects, they may cause similar abdominal and cardiac symptoms and are a serious risk factor for pulmonary embolism and sudden death when they reach the right atrium and tricuspid valve. The best treatment is radical surgical resection of the entire tumor using cardiopulmonary bypass with or without deep hypothermia and total circulatory arrest. We report the cases of two patients, the first with leiomyosarcoma of the inferior vena cava and the other with intravenous leiomyomatosis of the uterus that showed intravascular growth up to right atrium and ventricle, who underwent successful radical resection in a one-stage procedure with the use of cardiopulmonary bypass. We discuss the clinical and histologic aspects and imaging diagnosis and review the literature.

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Aortic Root Enlargement In Case of Double Valve Replacement

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48426 ◽

2020 ◽

Vol 11 (2) ◽

pp. 108-110 ◽

Cited By ~ 1

Author(s):

Mahbub Ahsan ◽

Md Lutfar Rahman ◽

ASM Shariful Islam ◽

Mohammad Arifur Rahman

Keyword(s):

Heart Disease ◽

Cardiopulmonary Bypass ◽

Survival Rate ◽

Valve Replacement ◽

Aortic Root ◽

Double Valve Replacement ◽

Post Operative Period ◽

Patient Prosthesis Mismatch ◽

Small Aortic Root ◽

Aortic Root Enlargement

Rheumatic valvular heart disease is quite common in Bangladesh. It affects most commonly mitral and aortic valve. As a result of annular fibrosis, aortic root become smaller in some patients. So, if smaller prosthesis is implanted, there is gross patient prosthesis mismatch (PPM), poor LV regression, increase overload, and ultimately low survival rate. Its' to report our experience in aortic root enlargement in case of double valve replacement where a patient of severe mitral stenosis and aortic regurgitation with small aortic annulus requiring aortic root enlargement (ARE).Weaning from Cardiopulmonary bypass (CPB) was uneventful, perioperative and post operative period was satisfactory. Post-operative echocardiography revealed normally functioning prosthesis. In case of small aortic root, aortic root enlargement (ARE) can be safely done by double valve replacement to overcome the prosthetic patient mismatch (PPM). KYAMC Journal Vol. 11, No.-2, July 2020, Page 108-110

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Characteristics and long-term outcomes of aortico-left ventricular tunnel

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivaa241 ◽

2020 ◽

Author(s):

Jing Sun ◽

Hongxia Qi ◽

Hongyuan Lin ◽

Wenying Kang ◽

Shoujun Li ◽

...

Keyword(s):

Aortic Valve ◽

Valve Replacement ◽

Surgical Repair ◽

Mechanical Valve ◽

Left Ventricular ◽

Ascending Aorta ◽

Aortic Orifice ◽

The Right

Abstract OBJECTIVES Aortico-left ventricular tunnel (ALVT) is an extremely rare, abnormal paravalvular communication between the aorta and the left ventricle. Few studies have identified the characteristics and long-term prognosis associated with ALVT. METHODS The data of 31 patients with ALVT from July 2002 to December 2019 were reviewed. Echocardiography was performed in all patients during the follow-up period. RESULTS The median age of the patients was 11.5 years. Bicuspid aortic valve and dilatation of the ascending aorta were found in 13 patients, respectively. The aortic orifice in 20 patients showed a close relation to the right sinus and the right–left commissure. Of the 31 patients, 26 were operated on. Mechanical valve replacement was performed in 4 patients and aortic valve repair, in 6 patients. Ascending aortoplasty was performed in 5 patients and aortic replacement was done in 2 patients. One patient died of ventricular fibrillation before the operation. Follow-up of the remaining 30 patients ranged from 1 to 210 months (median 64 months). There were 4 deaths during the follow-up period: 1 had mechanical valve replacement and 3 did not undergo surgical repair. In the 26 patients without aortic valve replacement, 6 had severe regurgitation and 2 had moderate regurgitation. In the 28 patients without replacement of the ascending aorta, 11 had continued dilatation of the ascending aorta, including those who had aortoplasty. CONCLUSIONS The aortic orifice of ALVT showed an association with the right sinus and the right–left commissure. For patients who did not have surgery, the long-term survival rate remained terrible. Surgical closure should be done as soon as possible after ALVT is diagnosed. The main long-term complications after surgical repair included aortic regurgitation and ascending aortic dilatation.

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Nasal Cavity Paraganglioma: Literature Review and Discussion of a Rare Case

Biomedicine Hub ◽

10.1159/000464099 ◽

2017 ◽

Vol 2 (2) ◽

pp. 1-15 ◽

Cited By ~ 2

Author(s):

Juliana Maria de Almeida Vital ◽

Terence Pires de Farias ◽

Fernando Luiz Dias ◽

Juliana Fernandes de Oliveira ◽

José Gabriel Miranda da Paixão ◽

...

Keyword(s):

Computed Tomography ◽

Literature Review ◽

Nasal Cavity ◽

Rare Case ◽

Bleeding Risk ◽

Preoperative Embolization ◽

Long Period ◽

Radiologic Investigation ◽

The Right

Paragangliomas can be found from the skull base to the sacrum. Sinonasal paragangliomas are infrequent. A 16-year-old female reported spontaneous discrete bilateral epistaxis once a month beginning when she was 3 years of age. Computed tomography showed an expansive hypervascular mass occupying the right nasal cavity and nasopharynx. Sinonasal paragangliomas usually occur in middle-aged women. Radiologic investigation is essential for the diagnosis of sinonasal paragangliomas and evaluating extension of the lesion. Endoscopic and conventional approaches are effective, and preoperative embolization is paramount for reducing bleeding risk. Histopathological features cannot differentiate benign from malignant paragangliomas, and since metastasis may eventually occur, follow-up must be carried out for a long period of time.

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Idiopathic Enlargement of the Right Atrium Accompanied by Persistent Superior Vena Cava: A Rare Case

Internal Medicine ◽

10.2169/internalmedicine.48.2718 ◽

2009 ◽

Vol 48 (21) ◽

pp. 1925-1926

Author(s):

Yoshiyuki Kawano ◽

Akira Tamura ◽

Junichi Kadota

Keyword(s):

Superior Vena Cava ◽

Right Atrium ◽

Rare Case ◽

Superior Vena ◽

Vena Cava ◽

The Right ◽

Persistent Superior Vena Cava

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PARATHYROMATOSIS: A RARE CASE OF RECURRENT HYPERPARATHYROIDISM LOCALIZED BY FOUR-DIMENSIONAL COMPUTED TOMOGRAPHY

AACE Clinical Case Reports ◽

10.4158/accr-2019-0225 ◽

2019 ◽

Vol 5 (6) ◽

pp. e384-e387 ◽

Cited By ~ 1

Author(s):

Abraham E. Wei ◽

Matthew R. Garrett ◽

Ankur Gupta

Keyword(s):

Computed Tomography ◽

Rare Case ◽

Clinical Laboratory ◽

Parathyroid Tissue ◽

Severe Hypercalcemia ◽

Positron Emission ◽

Affected Tissue ◽

History Of ◽

The Right ◽

Recurrent Hyperparathyroidism

Objective: To present a rare case of parathyromatosis. Methods: We present the clinical, laboratory, and imaging findings, along with a review of the literature. Results: A 33-year-old man with a history of right upper parathyroid adenoma removal 5 years prior due to hyperparathyroidism was admitted for severe hypercalcemia (15.6 mg/dL; normal, 8.5 to 10.5 mg/dL) with elevated plasma parathyroid hormone (PTH) (882 pg/mL; normal, 15 to 65 pg/mL). Ultrasound, computed tomography (CT), sestamibi, and positron emission tomography scans were unremarkable; however, a four-dimensional CT (4DCT) of the neck showed an area of increased signal enhancement and hypervascularity without discrete nodule in the posterior right thyroid region. The patient underwent parathyroid surgical exploration with right hemithyroidectomy and compartment neck dissection to remove the affected tissue. PTH levels dropped to 208 pg/mL postoperatively; calcium decreased but remained elevated at 12.7 mg/dL. Pathology revealed the presence of several small nodular foci of atypical hyperplastic parathyroid tissue in the right thyroid and soft tissue in the left central neck compartment consistent with parathyromatosis. Conclusion: This case report represents the first-time use of 4DCT to localize parathyromatosis. Parathyromatosis is a rare but problematic cause of recurrent hyperparathyroidism. Ultrasound and 4DCT may represent the best imaging modalities for identification and perioperative management to remove all affected tissue without reseeding.

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