Third-time aortic valve replacement in a patient with a totally calcified (Porcelain) aortic homograft [Meeting Abstract]
Objective: Homograft aortic root replacement provides an excellent hemodynamic restoration of valve function for prosthetic aortic valve endocarditis, but is susceptible to degeneration and calcification. The optimal surgical intervention for valvular disease after homograft root replacement is controversial due to the high risk of morbidity and mortality with reintervention.
Method(s): This video demonstrates a case of redo sternotomy with mechanical aortic valve replacement (AVR) in a patient post 2 previous AVRs and a porcelain homograft. A 38-year-old female presented in heart failure from prosthetic valve endocarditis, with a history of systemic lupus erythematosus, complicated by end-stage renal failure requiring dialysis and lupus anticoagulant.
Result(s): The patient had severe prosthetic aortic insufficiency, severe mitral regurgitation, and severe tricuspid regurgitation. A third-time redo sternotomy was performed. A mechanical sized #17 valve was placed in the aortic position and a #23 sized mechanical valve was placed in the mitral position. A bovine patch aortoplasty of the aorta was required after the calcified wall shattered into fragments upon transection with a patch of bovine pericardium. Postoperative echo revealed preserved left ventricular and right ventricular function with good function of the mechanical aortic and mitral valves.
Conclusion(s): Mechanical AVR, without replacement of the aortic root, is a feasible and potentially effective method of reestablishing a functional aortic valve in a patient with a severely calcified aortic homograft
Constrictive Pericarditis Caused by IgG4-Related Disease Requiring Pericardiectomy After Partial Response to Corticosteroids [Case Report]
Immunoglobulin G4-related disease is a systemic fibroinflammatory disease; pericardial involvement has occasionally been reported in publications. A 79-year-old man with biopsy-proven immunoglobulin G4-related disease with pleural involvement was admitted in acute heart failure, with imaging and hemodynamic studies consistent with constrictive pericarditis. He was treated with corticosteroids for 2Â months with partial response manifest by decreases in pericardial thickening and immunoglobulin G4 levels. However, persistent constriction required pericardiectomy, leading to significant symptomatic improvement. (Level of Difficulty: Intermediate.).
A case of nonvalvular endocarditis with biventricular apical infected thrombi [Case Report]
We report what appears to be the first case of biopsy-proven nonvalvular endocarditis with biventricular apical infected thrombi. A 47-year-old man presented with hypoxic respiratory failure from a multilobar pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). Transthoracic echocardiography and cardiac magnetic resonance imaging revealed biventricular apical masses suggestive of nonvalvular endocarditis with infected thrombi. Given concern for ongoing septic embolization to the lungs and brain despite appropriate antimicrobial therapy, the masses were surgically resected. Culture and histopathology confirmed MRSA-positive infected thrombi. In this case report, we highlight the differential diagnosis of apical masses and the role of multimodality imaging.
Mediastinal cystic teratoma masquerading as a hydatid cyst
A case is presented in which a preoperatively diagnosed hydatid cyst was found to be a mature cystic teratoma on pathological examination. Diagnostic dilemmas surrounding each disease are discussed.
Intrathoracic Myxoid Spindle Cell Lipoma, A Rare Presentation of a Myxoid Neoplasm
Here we present a case of a 38 year old male with an incidentally found right upper lobe lung mass. The patient underwent thoracoscopic resection of the mass which revealed a myxoid spindle cell lipoma. This is an exceedingly rare location for this tumor biology and here we discuss its pathological features and treatment options.
Pneumonectomy in a Patient with Synchronous Primary Lung Tumors and Endobronchial Metastasis [Meeting Abstract]
Pulmonary Mucoepidermoid Carcinoma, with Persistent Dyspnea in a 25 Year Old [Meeting Abstract]
A Rare Case of a Chest Wall Atypical Epithelioid Schwannoma [Meeting Abstract]
Selective use of the intra-aortic filter in high-risk cardiac surgical patients leads to better postoperative outcomes
Incidental Thyroid Cancer Found Post Pneumonectomy For Lung Adenocarcinoma: A Case Report [Meeting Abstract]