scholarly journals Ventricular tachycardia: beginning and ending fate of a benign invasive cardiac lipoma

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Olga Vriz ◽  
Mawada M. Ahmed ◽  
Suleiman Kharabsheha ◽  
Mohammed Aladmawi ◽  
Bandar Alamro ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Distal Segment ◽  
Electrical Storm ◽  
Appropriate Shocks ◽  
Anatomical Relationship ◽  
Cardiac Lipoma ◽  
Heart Tumors

Cardiac lipomas are rare benign heart tumors. Their clinical manifestations primarily depend on their dimension and location. We describe a case of a 14-year-old boy complaining of palpitations. ECG showed non-sustained ventricular tachycardia (NSVT). Echocardiography and cardiac MRI showed a large apical mass suggestive of a cardiac lipoma. The patient underwent open-heart surgery which detected a pericardial mass, partially attached to the myocardium, and crossed by the distal segment of LAD. This critical anatomical relationship prevents its complete resection. The biopsy confirmed mature fat tissue. Postoperatively, Propranolol was started for NSVT episodes. After 8 months, he presented with VT recurrence. A subcutaneous ICD (S-ICD) was implanted. Two months later, he was admitted for an electrical storm with six appropriate shocks. Since then, amiodarone was added. Lipomas are not always benign and their surgery might be very difficult and unhelpful. A multidisciplinary team is crucial for their diagnosis and management.

scholarly journals Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Mohanty ◽  
C Trivedi ◽  
D G Della Rocca ◽  
C Gianni ◽  
B MacDonald ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ischemic Cardiomyopathy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Long Term Outcome ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Abstract Introduction We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. Method Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar <0.5 mV. Non-inducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up twice a year for 5 years with implantable device interrogations. Results A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%). At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p<0.001). After adjusting for age, gender, hypertension, diabetes, and obstructive sleep apnea, scar homogenization using endo-epicardial approach was associated with 51% less recurrence compared to the endocardial ablation strategy (Hazard Ratio: 0.49, 95% CI: 0.27–0.89, p: 0.02). Conclusion In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Surgical Treatment of Heart Mixomas: the Analysis of 10 Years’ Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 385-392
Author(s):  
V. V. Vladimirov ◽  
A. I. Kovalev ◽  
A. V. Redkoborody ◽  
V. V. Sokolov ◽  
N. M. Bikbova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Well Being ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Heart Neoplasms ◽  
Results Of Treatment ◽  
Heart Tumors

Introduction. Primary cardiac tumors are rare, and the autopsy detection rate does not exceed 0.003%. Approximately 80% of primary heart tumors are benign, 50% of them are myxomas. Diagnosis of cardiac tumors at present in the presence of transesophageal echocardiography is not difficult in most cases. Surgical treatment of mixomas became possible after the introduction of open-heart surgery under cardiopulmonary bypass into clinical practice. After verification of the tumor, its surgical removal is indicated. In the practice of large cardiac surgery clinics, the experience of radical treatment of heart neoplasms is relatively small; therefore, the analysis of tactical approaches and results of operations in this pathology is of absolute interest.Aim of study. To present an analysis of 10 years’ experience in surgical treatment of cardiac mixomas. Material and methods The results of treatment of 58 patients with myxomas who underwent surgical removal of the neoplasm of the heart are presented.Results. Hospital mortality after surgical removal of myxoma was 1.7%, 1 patient died. All patients, we have the long-term period data about, noted a significant improvement in well-being, a decrease or disappearance of dyspnea at rest and/or during exertion, and no recurrence of myxoma was noted. Conclusion. The data obtained indicate, on the whole, good immediate results and high quality of life of patients in the long-term period operated on for heart mixomas. 

scholarly journals Clinical Manifestations in Atrial Myxoma

2004 ◽  
Vol 43 (152) ◽  
pp. 88-90
Author(s):  
U K Shrestha ◽  
B Koirala ◽  
BMS Shrestha ◽  
R Shrestha ◽  
P R Joshi ◽  
...  
Keyword(s):  
Left Atrial ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Venous Hypertension ◽  
Atrial Myxoma ◽  
Open Heart ◽  
Primary Tumors ◽  
Successful Removal ◽  
Regular Open

In Nepal, we started regular open-heart surgery since February 1997. Primary tumors of the heart are rareand the commonest is myxoma. Left atrium is the commonest site of occurrence. There is diagnostic difficultyin this most frequent benign tumor of the heart.We present 5 cases of left atrial myxomas who presented with different clinical features. Among them 4cases were diagnosed preoperatively by transthoracic echocardiography.The youngest was 32 years whereas the oldest was 58 years (mean 49.8 years) and 4 of them were female.Among them, one presented with right unilobar pulmonary venous hypertension; another mimicking mitralstenosis with large left atrial clot; with embolization to brain with motor the third aphasia and the remainingtwo had only constitutional symptoms. All of them were discharged with successful removal of tumor andare surviving at present with no features of recurrence.There are no pathognomic features of atrial myxoma. All suspected cases must be subjected forechocardiography. With the advent of open-heart surgery, extirpation of tumors with good outcome hasbeen a regular service in our hospital.Key Words: Atrial myxoma, Transthoracic Echocardiography, Embolization, Recurrence.

scholarly journals COVID-19 in Neonates, A Case Series Study From Tertiary Neonatal Centers in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sedigheh Rafiei Tabatabaei ◽  
Minoo Fallahi ◽  
Abbas Boskabadi ◽  
Naeeme Taslimi Taleghani ◽  
Fatemeh Pajouhandeh ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Neonatal Intensive Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Case Series ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
Case Series Study ◽  
Novel Coronavirus

Introduction: The Novel coronavirus, sars-cov-2, is responsible for the recent pandemic. Although it mostly affects adults, children of all ages, including neonates, can become ill with Covid-19, as well. The real prevalence rate of coronavirus disease 2019 (COVID-19) in children is unknown. However, the severity of symptoms in children and neonates is less than in adults. Regarding the new presentation of this disease, the current study has reported a case series of COVID-19 in neonates. Case Presentation: In this article, 10 neonates with COVID- 19 admitted to our neonatal intensive care units are reported. All reported neonates had general suspicious symptoms of COVID- 19 with positive results for SARS-CoV-2 assessed by polymerase chain reaction (PCR) from the nasopharynx area or nose of the patients. All neonates, except for two of them, were term neonates. One case had open-heart surgery for congenital heart disease (transposition of the great arteries (TGA)). The patients aged 22 days on admission. The most frequent symptom was fever. Severe respiratory symptoms were reported in two cases. Also, abnormal radiologic findings in the chest x-ray were detected in two cases. Regarding the lack of significant respiratory symptoms in most of the patients, the lung computed tomography (CT) scan was taken just from one neonate. Leukopenia (WBC < 5000/mm3) was detected in one case, with no lymphopenia in all neonates. The positive C-reactive protein test was not found in all cases. No patient was treated by special anti-viral agents for COVID-19, and usual antibiotic treatment for neonatal sepsis was administered for all cases. All patients, except for one, survived with no significant sequela of the disease. Conclusions: This study demonstrated that clinical manifestations, as well as laboratory and radiologic findings of COVID-19, are milder in neonates than in the older ages. Hence, it can be argued that the prognosis of COVID-19 in the neonatal period is generally good.

Investigation of anxiety, depression and perceived caregiving burden in parents of pediatric patients undergoing open heart surgery and being followed up in intensive care

2021 ◽  
Author(s):  
Abdullah Arif Yılmaz ◽  
Mehmet Fatih Üstündağ ◽  
Yasemin Yavuz ◽  
Fatma Ukil Işıldak ◽  
Ömer Faruk Şavluk ◽  
...  
Keyword(s):  
Intensive Care ◽  
Trait Anxiety ◽  
Congenital Heart ◽  
Maternal Education ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Pediatric Cardiovascular Surgery ◽  
The Mean

Objectives: This study aims to investigate the relationship between anxiety levels and perceived caregiver burden in mothers of children who had undergone Congenital Heart Disease Surgery (CHDS) and who were followed up in the intensive care unit with the surgical type and clinical variables applied. Patients and Methods: The study was conducted with the mothers of both patient groups who underwent Palliative Surgery (PS) (n:32) or Corrective (Biventricular) Repair (CR) (n:35) in the Pediatric Cardiovascular Surgery clinic of Istanbul Koşuyolu High Specialty Educational and Research Hospital. Sociodemographic-Clinical Data Form, Beck Depression Inventory (BDI), Standardized Mini-Mental Test, State-Trait Anxiety Inventory (STAI TX I-II), and Zarit Burden Interview (ZBI) were applied to the parents. Results: The rate of interventional birth was higher in the PS group whereas there was no difference between the PS and CR groups in terms of age, gender, birth weights, and presence of additional diseases (p: 0.001). There was no difference between maternal education levels and pregnancy duration. This difference was not significant even though the mean age of the mothers in the CR group was higher compared to the PS group. The mean STAI-S scores of the PS group (State Anxiety) were lower than the CR group, and the STAI-T scores of the PS group (Trait Anxiety) were higher. The ZBI scores were significantly higher in the PS group (p: 0.03) Conclusion: Congenital heart diseases and surgical interventions, as a result, are a major source of distress for affected families. Mothers are mainly affected by this situation. Changes in the mental status of the caregiver may have serious adverse effects on the operated child at every stage of the disease. Caregiving in parents is perceived as a burden and increased anxiety leads to different psychiatric clinical manifestations. Therefore, it is recommended that parents of children who have undergone congenital cardiac surgery receive routine psychiatric support from the early stages of the disease.

scholarly journals Successful treatment of infective endocarditis caused by Listeria monocytogenes in a patient after previous open-heart surgery (clinical case)

2019 ◽  
Vol 21 (4) ◽  
pp. 366-368
Author(s):  
Gufron A. Shamsiev ◽  
F.A. Khammud ◽  
F.I. Zakirov ◽  
Dmitriy A. Popov ◽  
R.A. Lazarev ◽  
...  
Keyword(s):  
Heart Disease ◽  
Listeria Monocytogenes ◽  
Infective Endocarditis ◽  
Successful Treatment ◽  
Rare Case ◽  
Clinical Case ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Open Heart

Listeriosis has a variety of clinical manifestations from febrile gastroenteritis to bacteremia, sepsis, meningoencephalitis and infective endocarditis with valvular heart disease. In this report, we present a rare case of successful treatment of infective endocarditis of the mitral valve due to Listeria monocytogenes after previous open-heart surgery.

Nanomedicine in diagnostics and therapy of cardiovascular diseases: beyond atherosclerotic plaque imaging

2013 ◽  
Vol 2 (4) ◽  
pp. 449-472 ◽  
Author(s):  
Iwona Cicha ◽  
Stefan Lyer ◽  
Christoph Alexiou ◽  
Christoph D. Garlichs
Keyword(s):  
Cardiovascular Diseases ◽  
Heart Surgery ◽  
Vascular Tissue ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Current Therapy ◽  
Systemic Delivery ◽  
Stent Restenosis ◽  
Modified Lipoproteins ◽  
Inflammatory Processes

AbstractAtherosclerosis results from the accumulation of the modified lipoproteins within the artery walls, which triggers complex vascular inflammatory processes. Although the pharmacologic agents for the treatment of clinical manifestations of atherosclerosis are available, their systemic delivery has serious disadvantages, such as considerable side effects or low efficacy at tolerated doses. Moreover, the treatment of atherosclerosis using the interventional techniques bears further shortcomings: the implanted stents require a lengthy antiplatelet therapy and carry the risk of in-stent restenosis. In the surgical approach to atherosclerosis, apart from the overall risk of open heart surgery, the lack of adequate venous material for bypasses constitutes a common problem. The nanotechnology has the potential to overcome the disadvantages of the current therapy of atherosclerosis, e.g., by the formation of nanosized assemblies for the earlier detection of atherosclerotic lesions and for cell-specific delivery of therapeutics. Replacing the current systemic pharmacological approach by a locally targeted treatment of plaques can substantially minimize the adverse effects, by lowering the drug cytotoxicity and reducing the required dosage. Moreover, a new generation of nanotechnological approaches to the revascularization procedures is now emerging, e.g., vascular tissue engineering utilizing the magnetic nanoparticles or the design of stents with the reduced risk of thrombosis and restenosis. This review discusses the possible applications of the nanomedical approaches in the treatment of cardiovascular diseases.

Enhanced Effective Fibrinolysis following the Neutralization of Heparin in Open Heart Surgery Increases the Risk of Post-Surgical Bleeding

1990 ◽  
Vol 63 (02) ◽  
pp. 241-245 ◽  
Author(s):  
Jørgen Gram ◽  
Thomas Janetzko ◽  
Jørgen Jespersen ◽  
Hans Dietrich Bruhn
Keyword(s):  
Blood Loss ◽  
Plasminogen Activator ◽  
Heart Surgery ◽  
Degradation Products ◽  
Open Heart Surgery ◽  
Tissue Type ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator ◽  
Chest Tube Drain ◽  
Median Blood Loss

SummaryThe tissue-type plasminogen activator related fibrinolytic system was studied in 24 patients undergoing cardiopulmonary bypass surgery. The degradation of fibrinogen and fibrin was followed during and after surgery by means of new sensitive and specific assays and the changes were related to the blood loss measured in the chest tube drain during the first 24 postoperative hours. Although tissue-type plasminogen activator was significantly released into the circulation during the period of extracor-poreal circulation (p <0.01), constantly low levels of fibrinogen degradation products indicated that a systemic generation of plasmin could be controlled by the naturally occurring inhibitors. Following extracorporeal circulation heparin was neutralized by protamine chloride, and in relation to the subsequent generation of fibrin, there was a short period with increased concentrations of fibrinogen degradation products (p <0.01) and a prolonged period of degradation of cross-linked fibrin, as detected by increased concentrations of D-Dimer until 24 h after surgery (p <0.01). Patients with a higher than the median blood loss (520 ml) in the chest tube drain had a significantly higher increase of D-Dimer than patients with a lower than the median blood loss (p <0.05).We conclude that the incorporation of tissue-type plasminogen activator into fibrin and the in situ activation of plasminogen enhance local fibrinolysis, thereby increasing the risk of bleeding in patients undergoing open heart surgery

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

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