[Minimally Invasive Cardiac Surgery for a Left Atrial Myxoma with Atrial Septal Defect:Report of a Case].

A 48-year-old woman presented with abnormal electrocardiogram was diagnosed as having a left atrial tumor by echocardiography. She was asymptomatic and had no history of cardiac abnormality. Transthoracic echocardiography revealed a relatively hyperechoic and heterogenous tumor with the diameter of 5~6 cm originated from the left atrial septum but could not detect atrial septal defect. Transesophageal echocardiography showed atrial septal defect of fossa ovalis but failed to uncover shunt flow behind the tumor. We diagnosed as left atrial myxoma complicated with atrial septal defect, and an operation was performed through small right intercostal thoracotomy. The tumor was excised and the atrial septal defect was completely repaired after pulmonary vein isolation. The post-operative course was uneventful. Cardiac myxoma coexisting atrial septal defect is rare, and preoperative transesophageal echocardiography is considered essential for the diagnosis of coexistent lesions especially in the patients minimally invasive cardiac surgery is planned.was uneventful. Cardiac myxoma coexisting atrial septal defect is rare, and preoperative transesophageal echocardiography is considered essential for the diagnosis of coexistent lesions especially in the patients minimally invasive cardiac surgery is planned.

Endovascular Aortic Repair of an Infective Native Aortic Aneurysm.

An infective native aortic aneurysm (INAA) is a rare, life-threatening, and complex disease. Therefore, the diagnosis and treatment of INAA remain uncertain. We describe the case of a 64-year-old man who had abdominal pain and a fever for more than one week. We diagnosed him with INAA on the basis of the clinical presentation, laboratory findings, and computed tomography (CT) images. After administering preoperative antibiotic therapy for four weeks, we performed endovascular aortic repair (EVAR). He then received antibiotic treatment for 12 months postoperatively. After successful treatment of an INAA with endovascular aortic repair, the patient had no recurrence for more than six years after the end of antibiotic therapy.

A Rare Case of Partial Anomalous Pulmonary Venous Connection.

Partial anomalous pulmonary venous connection (PAPVC), in which the right and left lower pulmonary veins drain into the coronary sinus (CS), is very rare, and only one case has been reported previously. The diagnosis of PAPVC is difficult, as the symptoms may be not specific. Multidetector computed tomography (MDCT) angiography and MRI help in the diagnosis of congenital cardiac anomalies. Our case, who underwent closure of atrial septal defect (ASD) 31 years prior, presented with chest tightness and palpitation. MDCT angiography revealed PAPVC with both lower pulmonary veins draining into the CS. We performed surgical repair of PAPVC by the cut-back method. The postoperative course was uneventful.

Mini open stent grafting with half sternotomy for aortic arch aneurysm.

BACKGROUND: Open stent grafting is an alternative of graft replacement and thoracic endovascular aortic repair for aortic arch aneurysm. We have performed open stent grafting with half sternotomy (mini-OSG) to reduce in-hospital stay and recovery time of patients and herein report seven cases of mini-OSG for aortic aneurysm and dissection. CASE PRESENTATION: The patients' mean age was 66 years. Cardiopulmonary bypass was performed conventionally, and an open stent graft was inserted via an aortotomy on the aortic arch during circulatory arrest. No mortality occurred. The mean operation time was 387 min, and the mean blood loss was 587 ml. The patients were weaned from the ventilator 7.1 h postoperatively. No pseudoaneurysm or endoleakage was observed during the 2- to 20-month follow-up. CONCLUSIONS: Mini-OSG might be less invasive, although further studies and intensive follow-up are needed.