1,721,008 research outputs found
Cardiogenic shock due to metastatic cardiac lymphoma: still a diagnostic and therapeutic challenge
No full textMyocardial involvement by metastatic lymphoma progressively leads to severe contractile impairment and fatal outcome. Correct diagnosis is often late due to misleading presentation signs. We report on a case of extensive cardiac involvement of a T-cell thymic lymphoma in a young woman, necessitating emergent extracorporeal membrane oxygenation (ECMO) circulatory support, with satisfactory hemodynamic recovery and subsequent ECMO weaning. Unfortunately, the following clinical course was rapidly fatal. This case seems to confirm that early aggressive instrumental diagnosis is crucial before severe myocardial impairment can prevent any therapeutic option. Extensive use of transesophageal echocardiographic examination and early endomyocardial biopsy are highly recommended
Life-threatening anaphylactic shock caused by porcine heparin intravenous during mitral valve repair
No full textTransapical off-pump Neochord implantation on bileaflet prolapse to treat severe mitral regurgitation
No full textBeating heart mitral valve repair with neochordae implantation: real-time monitoring of haemodynamic recovery
No full textTransapical off-pump Neochord implantation on bileaflet prolapse to treat severe mitral regurgitation
Full text linkA 74-year old lady was admitted for the presence of a symptomatic severe mitral regurgitation (MR) due to bileaflet prolapse. The patient refused any surgical conventional procedure because of severe arthrosis and osteoporosis documented by previous fractures requiring knee and hip replacements, and was sent directly to us for transapical off-pump mitral valve repair with Neochord implantation (TOP-MINI procedure). The TOP-MINI procedure was performed under general anaesthesia and transoesophageal echocardiographic guidance. Four Neochordae were implanted on the posterior leaflet and two on the anterior leaflet in order to correct a residual anterior prolapse that was not seen at preoperative screening. After 11 months of follow-up, the patient presented with recurrence of symptomatic moder-ate MR due to rupture of one of two neochordae implanted on the anterior leaflet and new onset of atrial fibrillation. The patient under-went uneventful mitral valve replacement. Keywords:Mitral regurgitation • Transapical mitral valve repair Transapical off-pump mitral valve (MV) intervention Neochord implantation (TOP-MINI, Neochord Procedure) is a MV repair technique that has been proved to have a safety and efficacy profile in patients with degenerative mitral regurgitation (MR) due to a flail leaflet or prolapse of one leaflet (anterior or poster
Double Transapical Access During Neochord Implantation
No full textMitral valve repair using trans-apical off-pump beating-heart neochordae implantation is a relatively new procedure with promising early and mid-term results in selected patients. However early failures few days after the procedure, requiring surgical reintervention, have been described. We describe a case of intraoperative acute procedural failure treated with a second procedure through a different trans-apical access adjacent to the first one. The final result was excellent with trivial residual regurgitation and the subsequent hospitalization was uneventful. This case demonstrates that a second trans-apical mitral neochordae implantation is feasible and should be considered in case of intraoperative acute procedural failure
Awake video-assisted surgical lung biopsy for the diagnosis of interstitial lung disease
No full textIn patients with suspected interstitial lung disease, diagnostic confirmation can be achieved through an awake video-assisted surgical lung biopsy. This procedure enables the collection of a substantial amount of parenchymal tissue for diagnostic purposes while minimizing perioperative complications associated with mechanical ventilation with the patient under general anaesthesia, given the impaired lung function due to the underlying condition
Transapical off-pump mitral valve repair with Neochord Implantation (TOP-MINI): step-by-step guide
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