Coronary steal from an anomalous circumflex artery diagnosed 25 years after ventricular septal defect closure: a case report.

Background: Association of anomalous origin of a coronary artery arising from pulmonary artery (PA) with other congenital heart defects, such as ventricular septal defects (VSDs), is uncommon. In such cases, coronary anomalies may be overlooked and underdiagnosed.

Case Summary: We report a case of late diagnosis of a circumflex coronary artery arising from the right PA, 25 years after VSD-closure during infancy with a complicated post-operative course with severe left ventricular dysfunction.

Surgical Ventricular Septal Defect Repair.

Ventricular septal defects (VSDs), the most common of congenital heart defects, vary widely in anatomy and size. Surgical treatment of very large VSDs can be challenging because no clear recommendations exist about which defects can undergo biventricular repair with septation and which should instead be palliated. Although Fontan circulation is known to be associated with long-term morbidity, information is limited about how ventricular septation of large VSDs affects cardiac function.

Persistent fifth aortic arch in a neonate with interrupted aortic arch: an unexpected intraoperative finding.

Persistent fifth aortic arch (PFAA) is a rare variant of the aortic arch that may be associated with coarctation or interrupted aortic arch. We report the case of a neonate initially referred for coarctation repair. After a left thoracotomy was performed, a rare diagnosis of PFAA associated with interrupted aortic arch was made.

Risk stratification in Eisenmenger syndrome.

Pulmonary arterial hypertension complicating congenital heart disease can progress to the life-threatening irreversible form known as Eisenmenger syndrome. When conservative treatments are inadequate, the risk of death as a result of the disease must be weighed against the risk associated with transplantation. Risk stratification has become a fundamental tool for the prediction of outcomes and the guidance of treatment in pulmonary arterial hypertension.

Cardiac tomography-echocardiography imaging fusion: a new approach to congenital heart disease.

Introduction And Objectives: Diagnosis, management, and surgical decision-making in children and adults with congenital heart disease are largely based on echocardiography findings. A recent development in cardiac imaging is fusion of different imaging modalities. Our objective was to evaluate the feasibility of computed tomography (CT) and 3-dimensional (3D) transthoracic echocardiography (TTE) fusion in children and adults with congenital heart disease.

Pulsatile pulmonary artery pressure in a large animal model of chronic thromboembolic pulmonary hypertension: Similarities and differences with human data.

A striking feature of the human pulmonary circulation is that mean (mPAP) and systolic (sPAP) pulmonary artery pressures (PAPs) are strongly related and, thus, are essentially redundant. According to the empirical formula documented under normotensive and hypertensive conditions (mPAP = 0.61 sPAP + 2 mmHg), sPAP matches ~160%mPAP on average.

Altered expression of fragile X mental retardation-1 (FMR1) in the thymus in autoimmune myasthenia gravis.

Predisposition to autoimmunity and inflammatory disorders is observed in patients with fragile X-associated syndromes. These patients have increased numbers of CGG triplets in the 5' UTR region of FMR1 (Fragile X Mental Retardation 1) gene, that affects its expression. FMR1 is decreased in the thymus of myasthenia gravis (MG) patients, a prototypical autoimmune disease.

Three-dimensional printing for surgical planning of a double aortic arch case.

Background And Aim: Over the past years, three-dimensional (3D) models of patient-specific anatomical conditions are being used to improve the comprehension and surgical management of a variety of diseases. It is an additional diagnostic tool that aids clinical decision-making. Furthermore, this technology is still not routinely used in the medical field since its availability is limited by cost and complex process.

Autologous endothelial progenitor cell therapy improves right ventricular function in a model of chronic thromboembolic pulmonary hypertension.

Background: Right ventricular (RV) failure is the main prognostic factor in pulmonary hypertension, and ventricular capillary density (CD) has been reported to be a marker of RV maladaptive remodeling and failure. Our aim was to determine whether right intracoronary endothelial progenitor cell (EPC) infusion can improve RV function and CD in a piglet model of chronic thromboembolic pulmonary hypertension (CTEPH).

Methods: We compared 3 groups: sham (n = 5), CTEPH (n = 6), and CTEPH with EPC infusion (CTEPH+EPC; n = 5).

Should surgery be part of the multimodality treatment for stage IIIB non-small cell lung cancer?

Background: Traditionally, treatment for stage IIIB (T4N2M0 and T1-4N3M0) NSCLC consists in definitive chemoradiation. Surgery is used only anecdotally. Here, we studied outcome for patients treated with multimodality including surgery.

Ewing Sarcoma of the Chest Wall: Prognostic Factors of Multimodal Therapy Including En Bloc Resection.

Background: Radiotherapy has long been the treatment of choice for local control of Ewing sarcoma of the chest wall (ESCW). However, there is debate regarding the use of surgery versus radiotherapy. The objective of this study was to identify risk factors that may affect long-term outcomes of nonmetastatic ESCW treated with preoperative chemotherapy (CT) followed by en bloc resection and adjuvant CT or chemoradiation.

Stem cell therapy targeting the right ventricle in pulmonary arterial hypertension: is it a potential avenue of therapy?

Pulmonary arterial hypertension (PAH) is an incurable disease characterized by an increase in pulmonary arterial pressure due to pathological changes to the pulmonary vascular bed. As a result, the right ventricle (RV) is subject to an increased afterload and undergoes multiple changes, including a decrease in capillary density. All of these dysfunctions lead to RV failure.

Finegoldia magna, not a well-known infectious agent of bacteriemic post-sternotomy mediastinitis.

Post-sternotomy mediastinitis, a nosocomial infection mostly caused by staphylococci, can be life-threatening. A case of mediastinitis due to Finegoldia magna after a coronary artery bypass graft surgery was reviewed. Although this bacterium is difficult to be isolated from routine blood cultures, a F.