Echocardiographic detection of left atrium and left ventricle tumoral invasion via the left upper pulmonary vein, leading to the diagnosis of lung cancer.

Left atrial (LA) invasion by lung cancer via hematogenous pathways is relatively uncommon. Herein we report the case of a 68-year-old male without any medical history, in whom lung cancer was diagnosed by transesophageal echocardiographic detection of the LA and left ventricle tumoral invasion via the left upper pulmonary vein. The primary source of tumor was found out by computed tomography.

Transcatheter closure vs totally endoscopic robotic surgery for atrial septal defect closure: A single-center experience.

BACKGROUND: Transcatheter closure is the preferred method for atrial septal defect (ASD) closure. Robotic surgery has become the least invasive technique for ASD closure. Therefore, we sought to evaluate the outcomes in patients who underwent ASD closure with transcatheter or robotic surgery techniques. METHODS: A total of 462 patients underwent totally endoscopic robotic (n = 217) or transcatheter ASD closure (n = 245). Demographic data, perioperative data, and outcomes were compared. RESULTS: The mean age was lower in the robotic surgery group than the transcatheter group (31.4 ± 11.8 vs 39.4 ± 13.2 years; P = .001). Ventilation time, intensive care unit (ICU) stay, and hospital stay was significantly lower in the transcatheter group. The postoperative new-onset neurological event was seen in one (0.5%) patient in robotic surgery, and four (1.6%) patients in the transcatheter closure group. New-onset atrial fibrillation was found to be higher in transcatheter closure (two vs seven patients; P = .133) group. Surgical conversion to a larger incision occurred in two patients (1%) in robotic surgery, while two patients (0.5%) underwent emergency median sternotomy due to device embolization to the main pulmonary artery. There was no mortality in both groups. During follow-up, one patient (0.5%) who underwent robotic surgery was reoperated, and two patients (0.8%) who underwent transcatheter procedure required surgical intervention due to device migration and severe residual shunting (P = .635). CONCLUSION: Both transcatheter and robotic surgery approaches had excellent outcomes but transcatheter closure had shorter hospital and ICU stays. Robotic surgery provides a similar complication risk that can be comparable to the transcatheter approach as well as patient comfort and cosmetic advantage over the other surgical techniques.

The Preventive Effects of Posterior Pericardiotomy with Intrapericardial Tube on the Development of Pericardial Effusion, Atrial Fibrillation, and Acute Kidney Injury after Coronary Artery Surgery: A Prospective, Randomized, Controlled Trial.

BACKGROUND: Pericardial effusion (PE), atrial fibrillation (AF), and acute kidney injury (AKI) are commonly found after coronary artery surgery. These adverse events may also be interwoven in the postoperative period. In this prospective study, we investigated whether posterior pericardiotomy (PP) with intrapericardial tube positioned along the right atrium (pericardial space intervention) is effective in the prevention of these adverse events. METHODS: The patients were randomly distributed to the study and control groups. The study group consisted of patients with pericardial space intervention, whereas the control group consisted of patients without pericardial space interventions. In all patients, a straight tube was placed in the anterior mediastinum and an angled tube was placed into the left hemithorax. RESULTS: A total of 210 patients were studied: 107 in the control group and 103 in the study group. Statistically significant results were obtained in the amount of PE, cardiac tamponade, AF (p = 0.019), and AKI during the postoperative period, in favor of the study group. Length of hospital stay was significantly shorter in the study group (6.11 ± 2.31, p = 0.009). CONCLUSION: The PP with intrapericardial tube approach is safe, easy, and effective in the prevention of PE, cardiac tamponade, and AF. The use of this approach may reduce the risk of developing AKI during the postoperative period. Besides, this technique also reduces the length of hospital stay.

Life Saver: Aortic Wrapping.

Reoperative aortic root reconstruction remains a formidable surgical challenge. Thereof, the wrapping of Dacron graft using remnants of native aorta may be reasonable to avoid complications such as bleeding and infection. Our case that had a modified Bentall procedure at our institute was reoperated because of discontinuity between left ventricular outflow and valved aortic conduit. During reoperation, proximal portion of the valved conduit was partially separated from its attachment in the left ventricular outflow tract. The residual native aorta that was wrapped around the Dacron graft was like in a shape of sac. This technique may play a major role in preventing rupture of the ascending aorta in case of separation of valved conduit from left ventricular outflow.