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PP-417 CARDIAC INVOLVEMENT OF MULTIVISSERAL HYDATIDOSIS IN A CHILD
S224
Posters / International Journal of Cardiology 155S1 (2012) S129–S227
condition at that time. The patient was advised for surgery, but she didn’t accept. Conclusions: Penetrating cardiac injuries by gun bullets may cause severe cardiovascular damage. Valle analyzed 2,811 patients with penetrating chest trauma sustained in the Korean War between. He described a group of 42 patients with metallic foreign bodies within the pericardium who developed severe precordial pain, fever, tachycardia, and shortness of breath. These symptoms developed during a time period ranging from shortly after injury to 6 weeks after injury. Our case is one of the rare examples of cardiac bullet who stay asymptomatic for years.
patient recovered without complications and was discharged with albendazole prophylaxis. Results: Cardiac hydatid cyst should be kept in mind in cerebral hydatidosis. Echocardiography is gold standard for investigation of cardiac involvement of the hydatidosis. Conclusions: Despite successful results with medical treatment with benzimidazole derivatives, early surgical removal of whole germinative membrane is essential for the curative treatment.
Contemporary Solutions for Diseases of the Aorta PP-425 SURGICAL TREATMENT OF ANEURYSM OR DILATATION AT THE ASCENDING AORTA: RESULTS IN 65 PATIENTS 1 1 ¨ u¨ 1 , A. Colak M. Ceviz1 , N. Becit1 , Y. Unl ¸ , E. Godekmerdan ¨ , 2 2 M. Acıkel ¸ , H. Senocak ¸ , H. Kocak ¸ 1 . 1 Department of Cardiovascular Surgery, Atat¨ urk University, Erzurum, Turkey; 2 Department of Cardiology, Atat¨ urk University, Erzurum, Turkey
Figure: Left coronary angiography showing a bullet image.
PP-417 CARDIAC INVOLVEMENT OF MULTIVISSERAL HYDATIDOSIS IN A CHILD D. Bozdo˘gan1 , Z. Eyileten1 , A. Aliyev1 , F. Demir2 , E. Tutar2 , S. Atalay2 , A. Uysalel1 . 1 Ankara University School of Medicine, Cardiovascular Surgery Department, Ankara, Turkey; 2 Ankara University School of Medicine, Pediatric Cardiology Department, Ankara, Turkey Objective: Echinococcus is endemic in some parts of the world but cardiac involvement is rare. It has potentially fatal complications like valvular dysfunction, free wall rupture, embolism, anaphylactic reactions, conduction disturbances or congestive heart disease. The most frequent localization of the hydatid cyst in the heart is the wall of left ventricle. Methods: We report a six year old boy who had history of surgical removal of cerebral hydatid cyst. Following surgery, he had been on antihelmintic treatment with albendazole for one year until Computerized Tomographic (CT) scan of thorax and abdomen revealed well defined cystic lesions in lung and liver. Surgery was planned. During rutin preoperative investigation, echocardiography showed 20 x 15 mm cystic lesion in the posterior wall of the left ventricle nearby the anterolateral papillary muscle of mitral valve. Further evaluation with Cardiac Magnetic Resonance Imaging (CMRI) showed the protrusion of the mass into the left ventricular cavity. The patient underwent cardiac surgery to excise the mass which later on identified as a hydatid cyst on histopathologic examination. Left atriotomy – posterior to the interatrial groove was performed under cardiopulmonary bypass. The cyst was not visualized through mitral valve at first, external and internal palpation of left ventricle wall was helpful. It was found attaching to the anterior papillary muscle, with protrusion into the left ventricular cavity. Following the puncture-aspiration of cyst contents, hypertonic saline was instilled into the cavity. The germinative membrane was removed along with the excision of cyst wall. The pouche 11x5 mm in size, was closed with capitonnage. Whole pericardial cavity was irrigated with hypertonic saline. The
Objective: This is a retrospective study of early and long-term results of surgery for ascending aortic aneurysm and dilatation. Methods: Between January 2006 and November 2011, 65 patients underwent ascending aortic replacement or wrapping for aneurysm and dilatation. There were 53 males (82%) and 12 females (18%) patients and were between 19 and 77 ages, mean age was 53.43 years. Forty-two patients (65%) were treated for ascending aortic aneurysm, and twenty-three (35%) for ascending aortic dilalation. One patient had a rupture of the ascending aortic aneurysm. The Bentall procedure was performed in 30 patients (47%), separate ascending aortic replacement and aortic valve replacement or repair was carried out in 13 (20%) patients, ascending aortic wrapping was performed in 21 (32%) patients those underwent CABG or AVR and ascending aortic replacement was performed only in one patient. Results: Prolonged hospital stay were seen in 4 patients for systemic infection and in 2 patients for wound infection. Permanent pacemaker was required in only one patient for complete heart block. Hospital mortality was 4.61% (3 deaths). Conclusions: Ascending aortic replacement and wrapping are lifesaving and can be performed with low hospital mortality and morbidity. PP-426 AN UNUSUAL CONGENITAL ANOMALY OF THE AORTIC ARCH IN A NEWBORN ¨ un ¨ ur ¨ Ceylan1 , V. Do˘gan1 , U.A. Or ¨ 1 , S. Ozg ¨ 1 , M. Keskin1 , O. 1 2 1 S. Karademir , N.H. Aydın . Dr. Sami Ulus Child Health and Diseases Research and Training Hospital, Department of Pediatric Cardiology, Ankara, Turkey; 2 Dr. Sami Ulus Child Health and Diseases Research and Training Hospital, Department of Cardiovascular surgery, Ankara, Turkey Objective: A 18 day old male newborn is referred to our hospital for surgery, with the diagnosis of ventricular septal defect (VSD) patent ductus arteriosus (PDA), coarctation of aorta (CoA), isthmus hypoplasia and ineffective baloon coarctation angioplasty. In addition to these lesions arch aortogram and echocardiography showed a membrane like structure located just distal to the origin of left carotid artery, producing a pressure gradient of 20 mmHg with Doppler echocardiography. We considered that surgical correction should involve excision of the web, but clinical state of the patient was not favorable for cardiopulmonary by-pass, therefore resection with end-to-end anastomosis and pulmoner banding was carried out. In this article we present an unusual congenital anomaly of the aortic arch with echocardiography and angiograpy images.
Posters / International Journal of Cardiology 155S1 (2012) S129–S227
condition at that time. The patient was advised for surgery, but she didn’t accept. Conclusions: Penetrating cardiac injuries by gun bullets may cause severe cardiovascular damage. Valle analyzed 2,811 patients with penetrating chest trauma sustained in the Korean War between. He described a group of 42 patients with metallic foreign bodies within the pericardium who developed severe precordial pain, fever, tachycardia, and shortness of breath. These symptoms developed during a time period ranging from shortly after injury to 6 weeks after injury. Our case is one of the rare examples of cardiac bullet who stay asymptomatic for years.
patient recovered without complications and was discharged with albendazole prophylaxis. Results: Cardiac hydatid cyst should be kept in mind in cerebral hydatidosis. Echocardiography is gold standard for investigation of cardiac involvement of the hydatidosis. Conclusions: Despite successful results with medical treatment with benzimidazole derivatives, early surgical removal of whole germinative membrane is essential for the curative treatment.
Contemporary Solutions for Diseases of the Aorta PP-425 SURGICAL TREATMENT OF ANEURYSM OR DILATATION AT THE ASCENDING AORTA: RESULTS IN 65 PATIENTS 1 1 ¨ u¨ 1 , A. Colak M. Ceviz1 , N. Becit1 , Y. Unl ¸ , E. Godekmerdan ¨ , 2 2 M. Acıkel ¸ , H. Senocak ¸ , H. Kocak ¸ 1 . 1 Department of Cardiovascular Surgery, Atat¨ urk University, Erzurum, Turkey; 2 Department of Cardiology, Atat¨ urk University, Erzurum, Turkey
Figure: Left coronary angiography showing a bullet image.
PP-417 CARDIAC INVOLVEMENT OF MULTIVISSERAL HYDATIDOSIS IN A CHILD D. Bozdo˘gan1 , Z. Eyileten1 , A. Aliyev1 , F. Demir2 , E. Tutar2 , S. Atalay2 , A. Uysalel1 . 1 Ankara University School of Medicine, Cardiovascular Surgery Department, Ankara, Turkey; 2 Ankara University School of Medicine, Pediatric Cardiology Department, Ankara, Turkey Objective: Echinococcus is endemic in some parts of the world but cardiac involvement is rare. It has potentially fatal complications like valvular dysfunction, free wall rupture, embolism, anaphylactic reactions, conduction disturbances or congestive heart disease. The most frequent localization of the hydatid cyst in the heart is the wall of left ventricle. Methods: We report a six year old boy who had history of surgical removal of cerebral hydatid cyst. Following surgery, he had been on antihelmintic treatment with albendazole for one year until Computerized Tomographic (CT) scan of thorax and abdomen revealed well defined cystic lesions in lung and liver. Surgery was planned. During rutin preoperative investigation, echocardiography showed 20 x 15 mm cystic lesion in the posterior wall of the left ventricle nearby the anterolateral papillary muscle of mitral valve. Further evaluation with Cardiac Magnetic Resonance Imaging (CMRI) showed the protrusion of the mass into the left ventricular cavity. The patient underwent cardiac surgery to excise the mass which later on identified as a hydatid cyst on histopathologic examination. Left atriotomy – posterior to the interatrial groove was performed under cardiopulmonary bypass. The cyst was not visualized through mitral valve at first, external and internal palpation of left ventricle wall was helpful. It was found attaching to the anterior papillary muscle, with protrusion into the left ventricular cavity. Following the puncture-aspiration of cyst contents, hypertonic saline was instilled into the cavity. The germinative membrane was removed along with the excision of cyst wall. The pouche 11x5 mm in size, was closed with capitonnage. Whole pericardial cavity was irrigated with hypertonic saline. The
Objective: This is a retrospective study of early and long-term results of surgery for ascending aortic aneurysm and dilatation. Methods: Between January 2006 and November 2011, 65 patients underwent ascending aortic replacement or wrapping for aneurysm and dilatation. There were 53 males (82%) and 12 females (18%) patients and were between 19 and 77 ages, mean age was 53.43 years. Forty-two patients (65%) were treated for ascending aortic aneurysm, and twenty-three (35%) for ascending aortic dilalation. One patient had a rupture of the ascending aortic aneurysm. The Bentall procedure was performed in 30 patients (47%), separate ascending aortic replacement and aortic valve replacement or repair was carried out in 13 (20%) patients, ascending aortic wrapping was performed in 21 (32%) patients those underwent CABG or AVR and ascending aortic replacement was performed only in one patient. Results: Prolonged hospital stay were seen in 4 patients for systemic infection and in 2 patients for wound infection. Permanent pacemaker was required in only one patient for complete heart block. Hospital mortality was 4.61% (3 deaths). Conclusions: Ascending aortic replacement and wrapping are lifesaving and can be performed with low hospital mortality and morbidity. PP-426 AN UNUSUAL CONGENITAL ANOMALY OF THE AORTIC ARCH IN A NEWBORN ¨ un ¨ ur ¨ Ceylan1 , V. Do˘gan1 , U.A. Or ¨ 1 , S. Ozg ¨ 1 , M. Keskin1 , O. 1 2 1 S. Karademir , N.H. Aydın . Dr. Sami Ulus Child Health and Diseases Research and Training Hospital, Department of Pediatric Cardiology, Ankara, Turkey; 2 Dr. Sami Ulus Child Health and Diseases Research and Training Hospital, Department of Cardiovascular surgery, Ankara, Turkey Objective: A 18 day old male newborn is referred to our hospital for surgery, with the diagnosis of ventricular septal defect (VSD) patent ductus arteriosus (PDA), coarctation of aorta (CoA), isthmus hypoplasia and ineffective baloon coarctation angioplasty. In addition to these lesions arch aortogram and echocardiography showed a membrane like structure located just distal to the origin of left carotid artery, producing a pressure gradient of 20 mmHg with Doppler echocardiography. We considered that surgical correction should involve excision of the web, but clinical state of the patient was not favorable for cardiopulmonary by-pass, therefore resection with end-to-end anastomosis and pulmoner banding was carried out. In this article we present an unusual congenital anomaly of the aortic arch with echocardiography and angiograpy images.