Conservative aortic valve surgery and supra-coronary tube: a case report.

Conservative aortic valve surgery is becoming an effective alternative to aortic valve replacement for patients with aortic insufficiency (AI) and ascending aortic aneurysms. It has become a crucial component of the therapeutic arsenal recommended by the learned societies. This paper reports the case of a patient with severe AI following dilatation of the supra-coronary aorta that underwent aortic plasty associated with a supra-coronary tube in the Cardiovascular Surgery Department 'A' of the Ibn Sina Hospital, Rabat, Morocco.

[Self-inflicted cardiac injury : He "nailed" it]. / Plaie cardiaque auto-infligée : il l'a « cloué ¼.

INTRODUCTION: Nail guns are responsible for an estimated 14% of injuries among residential carpenters, intrathoracic injuries are rare but almost always require operative management with a sternotomy or thoracotomy. CASE REPORT: We report the case of a young carpenter who injured himself by accident during work. The nail perforated the right ventricle. He was operated and postoperative course was uneventful. CONCLUSION: This case highlights the importance of urgent and adequate management of these cases and the need to raise awareness about work safety among carpenters.

An unusual cause of multiple embolic strokes: cardiac myxoma, about a case.

Cardiac myxomas are the most common primary intracardiac tumors, accounting for 50% of all cardiac neoplasms, with an estimated frequency of 0.5/million/inhabitants/year. Presenting symptoms are related to cerebral or peripheral embolism, and/or intracardiac obstruction. Thus, urgent management of myxoma is mandatory due to embolism's risk. Herein, we report the case of an 82-year-old woman with a myxoma of the left atrium, revealed by a multiple ischemic strokes, to raise awareness of this entity.

Use of neocords in the treatment of mitral valve prolapse: about 6 cases.

INTRODUCTION AND IMPORTANCE: Mitral insufficiency is a common valve disease with a prevalence of 2% and increases after the age of 65. This is the second valvulopathy operated after aortic stenosis. The surgical management of mitral insufficiency has been completely changed in recent years. The mitral valvular replacement with was the gold standard; is currently preceded by conservative surgery thanks to the emergence of reproducible and durable surgical techniques. The aim of our study is to highlight the place of Neogortex in the treatment of mitral valvular prolapse. METHODS: This is a retrospective study that includes 6 adult patients operated on for mitral insufficiency by prolapse of the large valve between October 2016 and June 2018 in the Cardiovascular Surgery Department A of the Ibn Sina Hospital in Rabat, Morocco. RESULTS: We collected 6 patients. The average age is 56 years. The clinical presentation was made of dyspnea in the 6 patients. On the echocardiographic level, all patients had mitral insufficiency due to prolapse of the large mitral valve in 2 patients and a restriction of the play of the valve by shortening of the ropes in 2 patients. The 6 patients were operated. The technique was the installation of a prosthetic ring with neogortex fixation between the free edge and the abutment and a tricuspid plasty type Devega. The operative sequences were simple. CONCLUSION: Mitral valve repair gives satisfactory results in terms of survival and symptomatic improvement with a low operative risk.

Surgicel mimicking early onset prosthetic valve endocarditis: case report.

BACKGROUND: Surgicel is one of the commercial forms of oxidized regenerated cellulose used as a bioabsorbable topical haemostatic agent during surgical procedures. However, its presence can mimic an abscess, tumour, lymph node or retained foreign body on imaging studies. The challenge in cardiac surgery is to differentiate the haemostatic material from an abscess that might be mistaken for an early onset prosthetic valve endocarditis. CASE SUMMARY: A 56-year-old woman was admitted to our department for a suspicion of early onset prosthetic valve endocarditis after an aortic valve replacement. An early clinical and biological improvement, features on a chest computed tomography scan, as well as a surgical correlation were able to rectify the diagnosis. The acute fever was linked to urinary tract infection, whereas the periaortic echogenic mass shown at the transoesophageal echocardiography corresponded to Surgicel. DISCUSSION: Oxidized regenerated cellulose can mimic an abscess on cardiac imaging, especially when used in excess during cardiac surgery. Fortunately, some radiographic features can help differentiate the haemostatic material from an abscess. Hence, sharing the use and location of Surgicel between the surgeon, radiologist, and cardiologist is very important and necessary to make the correct diagnosis.

Traumatic tricuspid insufficiency with a ventricular septal defect in a child: a case report.

Traumatic tricuspid insufficiency is very rare. In this report we describe an interesting case of a 13-year-old boy who suffered chest trauma from a horse kick. Echocardiography demonstrated a remarkable tricuspid regurgitation with ventricular septal defect. Once assessing the diagnosis, an emergency open heart surgery was necessary to repair the injuries with good results.

Double-orifice mitral valve associated with atrioventricular canal defects.

A 4 year-old male presented with effort dyspnea, and was diagnosed as atrioventricular canal defects. This finding was confirmed by open heart surgery, and a congenital double orifice mitral valve was discovered. The septal defect was closed but the double orifice mitral valve was respected because of the absence of hemodynamic disturbance. We report this case with review of literature.

Transmitral exclusion of a giant congenital left ventricular aneurysm associated with mitral insufficiency in adult.

Congenital left ventricular aneurysm is rare, poorly understood and potentially lethal. It usually occurs in isolation. Its combination with mitral insufficiency is an uncommon entity. Because the literature on this kind of aneurysms consists of case reports and small series described especially in children, we report here an interesting and unique case of an adult aged 35 years bearing simultaneously a congenital left ventricular aneurysm and mitral insufficiency. Without medical past history, he consults for palpitations and dyspnoea. Once diagnosis was made by chest X-ray, echocardiography and computed tomography, an open heart surgery was necessary to prevent complications. Through a transmitral approach, aneurysmal exclusion was performed by closing the aneurysmal collar with a Dacron patch and mitral replacement was accomplished. At 12 months, follow-up was favourable without residual communication between aneurysm and ventricle or paraprosthetic leak.

Intracavitary hydatid cyst of the left ventricle in child: an emergency surgery case report.

Hydatid cysts of the heart are very rare in child. In this report we describe an interesting and unique case of an 8-year-old boy with a large cardiac intracavitary hydatid cyst filling the left ventricle. Echocardiography, computerized tomography, magnetic resonance imaging and serologic test were necessary for the diagnosis. Once assessing the diagnosis, an emergency open heart surgery was necessary to prevent the complications. Surgery associated to medical treatment provides good results as demonstrated in this case report.