Anterior meningocele misdiagnosed as an ovarian cyst.

OBJECTIVE: An undiagnosed anterior meningocele may mimic an ovarian cyst. Careful evaluation and consultation must be the mainstay of surgery for adnexal masses. RESULTS: A patient initially diagnosed as having an adnexal mass was discovered to have an anterior meningocele at surgery. In vitro fertilization plans were delayed to prevent complications during procedures.

The role of pulmonary artery anatomy in repair of tetralogy of Fallot.

Pulmonary artery anatomy is the key factor that determines the type of surgical treatment required in tetralogy of Fallot. Despite the fact that routine primary repair is now done on infants, inadequate pulmonary artery size can dictate the need for staged surgical repair in even the oldest age groups. From October 1986 to October 1998, 361 patients at our clinic underwent surgery to correct tetralogy of Fallot. A total of 292 cases were treated with primary repair, 69 surgeries were palliative, and 30 of these 69 underwent corrective surgery. The Nakata index was used as a pulmonary artery index (PAI), and PAI< 200 was the criterion for requirement of two-stage repair. Of the 30 patients that underwent staged repair, the Blalock-Taussig shunt (BTS) procedure was used in 24; the remaining six patients had right ventricular outflow tract reconstruction (RVOTR). The mean age of all the palliative surgery patients was 3.4 years (range 6 months to 11 years), and of those who received corrective surgery was 5.5 years (range 2-12 years). These patients' PAI values were 181 +/- 37.5 mm2/m2 and 359 +/- 130.7 mm2/m2, respectively. The period between the two operations ranged from two months to four years. Mortality rates were 2.8 percent for palliative surgery as a whole, 4.1 percent for primary repair, and 16.6 percent for staged repair. Our policy with regard to corrective surgery for tetralogy of Fallot is to do primary repair regardless of a patient's age and weight, except in cases where the pulmonary artery anatomy is appropriate for the patient's body size.

Two discrete masses of leiomyomatosis in a patient, one extending to the right atrium.

Leiomyomatosis extending to the right side of the heart through the inferior vena cava (IVC) is an extremely rare neoplasm. Although it is pathologically classified as a benign neoplastic formation, its growth and recurrence rate makes its extirpation mandatory. In this case report, we describe a 57-year-old woman who presented with leiomyotosis extending from the IVC to the right atrium (RA). This patient had presented with uterine leiomyoma three years previously. The patient died in the operating theatre from hemostatic problems after surgical complications arising from the unexpected presence of a second tumor.

Anatomic correction in transposition of the great arteries with unusual coronary pattern and side-by-side location.

Switch operation is the treatment of choice in infants with transposition of the great arteries. The anatomic correction restores the left ventricle to its normal systemic function. In complete transposition, however, the diverse spectrum of coronary pattern influences the surgical outcome. We describe a successful arterial switch operation without LeCompte manoeuvre in a neonate with unusual coronary artery anatomy and side-by-side great arteries.