Gigantic aneurysm of a venous bypass graft causing superior vena cava syndrome.

A case of a 66-year-old patient 13 years after coronary artery bypass grafting (CABG) admitted to hospital with typical ischemic chest pain and symptoms of superior vena cava syndrome (SVCS) is described. Non-invasive diagnostics confirmed acute coronary syndrome: non-ST-elevated myocardial infarction (ACS NSTEMI). Trans-thoracic echocardiography (TTE) revealed a gigantic tumor mass modeling the right atrium, causing chronic cardiac tamponade. Angiography showed that the tumor mass was in fact the aneurysmatically changed venous bypass graft to the right coronary artery (RCA). Computed tomography angiography (CT-angio) confirmed venous aneurysm size (the longest diameters were 10.2 cm × 8.7 cm). We also present treatment planning and the aneurysmal surgical removal procedure of this very rare case.

[Debranching of aortic arch as part of a complex cardiac surgery]. / Debranching luku aorty jako element zlozonego zabiegu kardiochirurgicznego.

We present 54 year-old man diagnosed with an aneurysm of the ascending aorta and arch with aortic regurgitation and coronary artery disease. Surgery consisted of removing an aneurysm of the ascending aorta and arch of subtraction (debranching)cephalic brachiocephalic trunk and the common carotid artery and anastomosis of the descending aorta with vascular prosthesis and coronary artery bypass grafting. Postoperative course was uneventful. In 14 days after surgery the patient was discharged from the unit. Debranching method allowed avoiding hypothermia during surgery and shortening the time of cardio pulmonary bypass.

[Massive infiltration of the right vetricular wall caused by large B-cell lymphoma]. / Masywny naciek wolnej sciany prawej komoryprzez chloniaka z duzych komórek B.

We presented a case of symptomatic secondary cardiac B-cell lymphoma localised in the free wall of the right ventricle (RV). It was detected during transthoracic echocardiography and confirmed by nuclear magnetic resonance imaging. The RV free wall motion abnormalities, decreased dimensions of RV and small pericardial effusion were found. The tumour dimensions declined after the first cycle of chemiotherapy with antracyclins.

[Asymptomatic myxoma of the tricuspid valve septal leaflet]. / Bezobjawowy sluzak platka przegrodowegozastawki trójdzielnej.

We presented a case of asymptomatic myxoma of the tricuspid valve septal leaflet. The tumour was diagnosed accidentally during rutine transthoracic echocardiography and confirmed by transesophageal echocardiography. It was resected and the septal leaflet repaired during surgery.

[A large asymptomatic pericardial cyst in the apical region]. / Duza bezobjawowa torbiel osierdzia w okolicy koniuszka serca.

We presented a case of the large asymptomatic pericardial cyst localised near cardiac apex, filled with fluid of water- -equivalent density. The cyst was detected accidentally during transthoracic echocardiography and confirmed by 64-slice multi-detector computed tomography. Repeated transthoracic echocardiography was recommened.

[Fungal endocarditis of mitral and aortic biological prosthetic valves]. / Grzybicze zapalenie wsierdzia na protezie biologicznej w ujsciu mitralnym i aortalnym.

We present a rare case of fungal (Candida albicans) endocarditis on the two (mitral and aortic) biological prosthetic valves. Vegetations were detected by transthoracic echocardiography and confirmed by transesophageal echocardiography.

[Severe tricuspid regurgitation due to ventricular pacing lead - a case report]. / Ciezka niedomykalnosc zastawki trójdzielnej spowodowana zbyt krótka elektroda komorowa ukladu stymulujacego.

We present a case of severe symptomatic tricuspid valve regurgitation due to shifting of the septal leaflet of the valve toward the interventricular septum by a permanent ventricular pacemaker lead, making coaptation of the tricuspid leflats in systole impossible.

[Quadricuspid aortic valve]. / Czteroplatkowa zastawka aortalna.

We reported a case of a 45 year-old woman who had a quadricuspid aortic valve associated with moderate aortic regurgitation. The valve abnormality was detected by transthoracic echocardiography. Transesophageal echocardiography showed mild thickening of 4 symmetric aortic valve cusps, a small rectangular central regurgitant orifice, and moderate aortic insufficiency. In addition visualised this anomaly in 3D transesophageal echocardiography too.

Mitral valve repair in a patient with previous percutaneous annuloplasty with a CARILLON device.

A 67-year-old female patient was referred to our clinic for coronary artery bypass graft and severe mitral regurgitation (MR) treatment. The patient had a history of coronary disease and MR treated in 2007 with a CARILLON device. Left mammary and saphenous vein were used to graft the diseased coronaries. MR was corrected with a saddle ring; however, we had some difficulties anchoring ring sutures to the mitral annulus caused by the protruding CARILLON. The ring was finally stitched, and the patient was weaned from bypass. A transoesophageal echo showed a competent valve. The patient was transferred to the intensive care unit on moderate catecholamines.

[Mild type of the Ebstein anomaly]. / Lagodna postac anomalii Ebsteina.

Ebstein anomaly is a congenital malformation of the heart that is characterised by apical displacement of the septal and posterior tricuspid valve leaflets, leading to atrialisation of the right ventricle with a variable degree of malformation and displacement of the anterior leaflet. We present a case of a mild type Ebstein anomaly leading to moderate tricuspid valve regurgitation and some degree of right ventricular dysfunction.

[Intraventricular septum rending from inferoposterior left ventricular wall during myocardial infarction]. / Oderwanie przegrody miedzykomorowej od sciany dolno−tylnej lewej komory w przebiegu zawalu serca.

Intraventricular septum (IVS) rending from left ventricular wall after acute myocardial infarction is a rare and dramatic mechanical complication. We describe a patient, who survived after rending of IVS from left ventricular inferoposterior wall after acute myocardial infarction. This complication was diagnosed using transthoracic and transesophageal echocardiography and confirmed by 64 MSCT. The patient underwent successful IVS repair plus three coronary artery bypass grafts and inferoposterior wall aneurysm plasty.

[Circumflex coronary artery fistula during staphylococcal aortic valve endocarditis]. / Przetoka do tetnicy okalajacej w przebiegu gronkowcowego zapalenia wsierdzia zastawki aortalnej.

We presented a very rare case of the fistula to coronary artery during staphylococcal aortic valve endocarditis in a young man. The tranesophageal echocardiography detected vegetation on aortic valve leaflets and large regurgitatin. During transesophageal echocardiography the peri-anular multi-chamber abscess formation and fistulous communication to circumflex coronary artery was detected.

[Massive infective endocarditis treated with triple bioprostheses implantation]. / Masywne infekcyjne zapalenie wsierdzia leczone metoda implantacji trzech biologicznych protez zastawkowych.

A case of a 50-year-old man admitted to the cardiology department due to massive infective endocarditis is presented. Diagnosis was confirmed by further investigations and patient was referred to cardiosurgery department. The surgery revealed destruction of mitral, tricuspid and aortic valve, thus three bioprostheses were implanted. The treatment was successful and six months after surgery patient was in good overall condition.

[Asymptomatic descending aorta dissection after cardiac surgery using extra corporeal circulation- a case report]. / Bezobjawowe odwarstwienie blony wewnetrznej aorty wstepujacej. Powiklanie zabiegu w krazeniu pozaustrojowym - opis przypadku.

Subacute ascending aortic dissection following open heart surgery is a rare but potentially fatal complication. It is associated with dilatation of the aortic root or cystic medial necrosis. We present associated a case of a 65-year old patient with non-fatal ascending aortic dissection after coronary artery bypass grafting using extracorporeal circulation.

[Left ventricular non-compaction with papillary muscle involvement - a case report]. / Kardiomiopatia gabczasta z zajeciem miesnia brodawkowatego - opis przypadku.

Non-compaction myocardium of the left ventricle (LVNC) is a genetically heterogeneous congenital cardiomyopathy characterised by excessive prominent trabeculations and deep intertrabecular recesses which communicate with the left ventricular cavity. Echocardiography plays a pivotal role as a first line diagnostic tool of this rare abnormality. We presented a case of 64-year-old male with LVNC and with papillary muscle involvement.