Successful Surgical Treatment of Coronary Aneurysm, Ascending Aortic Aneurysm, and Bicuspid Aorta for a Kawasaki Disease Patient

Abstract Kawasaki disease was first reported in 1967, and it was classified as an autoimmune vasculitis of the small and medium arteries. It is a self-limiting condition that occurs mostly in childhood, but it may involve complications — such as coronary artery aneurysms, myocardial ischemia, and arrhythmias — with significant morbidity and mortality that occur later in life. In this article, we present the association of an ascending aortic aneurysm with bicuspid aortic disease in addition to coronary aneurysm in a 55-year-old patient diagnosed with Kawasaki disease.

A rare simultaneous occurrence: Mitral valve endocarditis complicated by iliac saddle and cerebral embolisms / Un incidente simultáneo inusual: endocarditis de la válvula mitral complicada por embolia ilíaca en silla de montar y embolia cerebral

Abstract Infective endocarditis is a severe disease with a high mortality and morbidity, and its clinical heterogeneity is a challenging barrier to rapid diagnosis and treatment. Diagnosis of infective endocarditis is based on clinical, microbiological, and echocardiographic findings; however, a high index of suspicion is mandatory because this disease may present either as an acute, rapidly progressive infection or as a chronic disease. Approximately 20-50% of cases show multiple embolic events as the first presentation of infective endocarditis. We report a patient with a rare case of infective endocarditis complicated with iliac saddle and cerebral embolisms who underwent simultaneous operations for mitral valve endocarditis and iliac embolism.

Resumen La endocarditis infecciosa es una enfermedad grave, que conlleva alta morbimortalidad; su heterogeneidad clínica constituye una barrera desafiante para un rápido diagnóstico y tratamiento. El diagnóstico se basa en hallazgos clínicos, microbiológicos y ecocardiográficos; sin embargo, se requiere un alto índice de sospecha ya que esta enfermedad puede debutar ya sea como una infección aguda de rápida evolución o como una enfermedad crónica. Aproximadamente, 20 a 50% de los casos presentan múltiples eventos embólicos como primera manifestación de la endocarditis infecciosa. Se informa de un paciente con un caso inusual de endocarditis infecciosa complicada por embolia ilíaca en silla de montar y embolia cerebral, quien fue sometido a cirugías simultáneas por endocarditis de la válvula mitral y embolia ilíaca.

Predictive value of mean platelet volume in saphenous vein graft disease

Abstract Objective: To determine whether mean platelet volume (MPV), platelet distribution width (PDW), and platelet count could be used as determinants of mortality following coronary artery bypass graft (CABG) surgery and patency of saphenous vein grafts (SVG). Methods: The records of 128 patients who underwent emergency or elective coronary angiography after CABG surgery, and who died at an early stage were retrospectively reviewed. Patients were divided into three groups as early death, no SVG disease (SVGD), and SVGD group. MPV, PDW, and platelet count were evaluated at different times. Results: MPV was significantly higher in the stenotic group than in the nonstenotic group (9.7±1.8 fl and 8.2±0.9 fl, P<0.05). The postoperative MPV ratio was found to be higher in the stenotic group when compared to the preoperative period (9.6±1.8 fl and 7.8±0.9 fl, P<0.05). MPV values were also found to be higher in patients who died during the early stage than in surviving patients (9.4±1.9 fl and 8.0±1.0 fl, P<0.05). There was no statistically significant difference regarding platelet count and PDW ratios between the early deaths group and surviving patients. An MPV value higher than 10.6 predicted SVGD with 85% sensitivity and 45% specificity; and an MPV higher than 7.9 predicted early death with 80% sensitivity and 68% specificity were observed. Conclusion: MPV may be a useful indicator for the prediction of SVGD and mortality following CABG surgery.