MULTIPLE CALCIFIED RIGHT ATRIAL MYXOMAS ASSOCIATED WITH TRICUSPID INSUFFICIENCY IN A CHILD

Multiple calcified myxomas of the right atrium were discovered in a 12-year-old girl and were associated with a dysplastic tricuspid valve that was grossly insufficient. Surgical resection of three pedunculated masses was performed, and the tricuspid valve was replaced with a biologic prosthesis.     

SURGICAL CORRECTION OF COMBINED DOUBLE-OUTLET RIGHT VENTRICLE AND TAUSSIG-BING SYNDROME

Total surgical correction of a Taussig-Bing type double outlet right ventricle (DORV) was successfully performed in a severely cyanotic 3-year-old girl. The malformation was associated with bilateral conus, d-transposition of the great arteries, d-loop, and a subpulmonary ventricular septal defect (VSD) without significant pulmonary stenosis in situs solitus. It was impossible to create a tunnel repair by resecting the markedly hypertrophied muscular conus that separated the aortic valve from the subpulmonary ventricular septal defect. Therefore, the VSD was repaired with a Dacron patch, transforming the double outlet right ventricle into a transposition, after which total correction was achieved by means of a Mustard procedure.     

FALSE ANEURYSM OF THE LEFT VENTRICLE: CASE REPORT WITH PRE- AND POSTOPERATIVE EVALUATION

A 66-year-old woman developed chronic congestive heart failure after myocardial infarction of the anterior wall of the left ventricle. Angiographic studies revealed total proximal occlusion of the left anterior descending coronary artery and a large saccular aneurysm located on the anteroapical aspect of the left ventricle. Resection of a false aneurysm at operation resulted in improved cardiac function, and the patient made an uneventful recovery. Repeat evaluation six months later confirmed normal cardiac hemodynamics and left ventricular angiographic characteristics. To our knowledge, this is the first documented case of normalized heart function resulting from resection of a false aneurysm of the left ventricle. Functional classification according to the New York Heart Association improved dramatically, rising from Class IV preoperatively to Class I after operation.     

USE OF AN EXTRACARDIAC CONDUIT IN THE REPAIR OF l-TRANSPOSITION WITH l-LOOPING ASSOCIATED WITH SEVERE SUBVALVULAR PULMONIC STENOSIS AND A VENTRICULAR SEPTAL DEFECT

Total correction was performed in a child with l-transposition of the great arteries, severe subpulmonic stenosis, and a ventricular septal defect. The subpulmonic obstruction was bypassed with an extra-cardiac valved conduit. This alternate method of relieving ventricular outflow obstruction should be considered when conventional techniques cannot be employed because of complex intracardiac anatomy. Proper placement of the pulmonary ventriculotomy is important in order to avoid injury to coronary arteries on the upper and lower ventricular wall and to papillary muscles in the mid-portion of the ventricle.     

SURGICAL MANAGEMENT OF A NEONATE WITH INTERRUPTED AORTIC ARCH, TRANSPOSITION OF THE GREAT ARTERIES, AND TRICUSPID ATRESIA

A critically ill infant presented to our Center with congestive heart failure due to Type A interrupted aortic arch, D-transposition of the great arteries, tricuspid atresia, a large ventricular septal defect, and a closing ductus arteriosus. Partially corrective surgery including aortic arch reconstruction, ductal division, and pulmonary artery banding was successful. Future total correction is planned.     

COMBINED CORRECTION OF TETRALOGY OF FALLOT AND CORONARY ARTERY OCCLUSIVE DISEASE: CASE REPORT

A 49-year-old patient with known tetralogy of Fallot for which an aortopulmonary anastomosis (Pott's shunt) had been performed 23 years previously, underwent simultaneous myocardial revascularization for severe coronary occlusive disease and total correction of his congenital anomaly. The operation and postoperative course were uneventful, and he made a full recovery.