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Background: Currently, non-valved conduits are preferred for extracardiac total cavo-pulmonary connection (TCPC). However, previous work has failed to provide objective data comparing the postoperative outcome between non-valved TCPCs and bovine jugular vein valved xenograft (BJV) TCPCs. Hence, the objective of this study is to compare the postoperative outcomes in extracardiac TCPC patients who received BJV vs synthetic non-valved conduits and evaluate the effect of BJV on liver fibrosis.Methods: Of 206 patients who had extracardiac TCPC from 2002 to 2017 were divided into three groups. Group A (n = 66) received BJV, group B (n = 37) received PET conduits and group C (n = 103) received polytetrafluoroethylene (PTFE) tube. Study endpoints were hospital outcomes, conduits thrombosis, reinterventions, and survival. Liver stiffness and fibrosis were assessed in eight patients with BJV.Results: Preoperative parameters were comparable among groups. Thrombosis was significantly lower in group C (P < .0003) but no difference between groups A and B (P = .951). Reinterventions did not differ significantly among groups (Log-rank P = .598). Hospital deaths occurred in seven patients (3.4%). There was no difference in survival between groups (Log-rank P = .221). The median liver stiffness score was 18.65 kPa and the eight patients had advanced liver fibrosis (grade F3-4) in group A.Conclusion: PTFE is the recommended conduit for TCPC with a lower risk of thrombosis compared to BJV and PET. BJV conduits in TCPC circuits may not protect against liver fibrosis. BJV should not be considered as an option for TCPC. [ABSTRACT FROM AUTHOR]

Background: Electric shock-induced cardiac injuries, such as myocardial infarction, thrombosis, and dissection, are rare. Few cases have been previously reported. The right coronary artery is most often affected because of its proximity to the chest wall.Aims: To study the extend of electrical injuries on cardiac tissues and its surgical management.Materials and Methods: We conducted a retrospective study on our patients in the last five years, looking for cardiac electrical injuries treated surgically in our department, we identified three cases.Result: Our three-case series, reported herein, showed that multiple cardiac tissues are susceptible to electrical injuries, specifically the left coronary artery, inferior vena cava, and right ventricular free wall. In our series, the first patient was a 32-year-old man with triple vessel thrombosis and dissection who survived the electric shock. The second patient was a 23-year-old man who had an inferior vena cava burn and bruising; his heart was used for transplantation. After the transplant, the recipient had a left coronary artery dissection and underwent coronary artery bypass grafting. The third patient was a 30-year-old man (potential heart donor) who had a hematoma of the right ventricular free wall, possible coronary artery dissection, inferior vena cava bruising, and tissue damage. His heart was not used for transplant because of quality concerns.Conclusion: We recommend that any person who sustains high voltage (500 V or more) electric shock should be evaluated carefully in the emergency department, including with echocardiography and cardiac catheterization, if indicated, to determine the extent of the injury and the viability of the heart, for patients who do not survive as a donor organ. [ABSTRACT FROM AUTHOR]

Background: Renal cell carcinoma (RCC) with tumor thrombus extending into the inferior vena cava (IVC) occurs in 4%-10% of cases. Within this subset, pulmonary tumor embolism (PTE) appears in approximately 0.9%-2.4% of cases. We wanted to review our experience in managing patients with RCC with IVC involvement and a preoperative diagnosis of PTE.Methods: A total of seven patients presented at our center between January, 2005 and January, 2015 with RCC, IVC involvement, and PTE (diagnosed either by chest computerized tomography angiography or preoperative transesophageal echocardiogram). Each patient underwent a radical nephrectomy and tumor thrombectomy using an organ transplant-based approach.Results: Surgical removal of the PTE was performed in three patients (tumor embolectomy in two cases, right lower lobe resection in one case); the PTEs in four patients were considered to be too small to undergo surgical resection. PTE pathology found neoplastic cells in each patient that had surgical removal. No postoperative complications were observed in any of the seven patients. All four patients who were metastasis-free preoperatively (with 2/4 having tumor embolectomy performed) developed distant metastasis; median time-to-developing metastatic disease was 6.5 months. With a median follow-up of 19 months, three deaths because the disease have occurred.Conclusion: Although RCC with IVC tumor thrombus complicated by PTE may not be catastrophic in most cases, it appears to be associated with an increased risk of developing metastatic disease. In addition, as the PTEs appear to contain neoplastic cells, pulmonary artery embolectomy at the time of nephrectomy should be performed whenever possible. [ABSTRACT FROM AUTHOR]

Intravascular tumor extension in the inferior vena cava (IVC) is known to occur with abdominal tumors, such as renal cell, hepatocellular, adrenal cell carcinoma, and Wilm's tumor. We encountered a 53-year-old male patient presenting with pulmonary embolism and a right atrial mass with imaging evidence of an adrenal tumor extending into the IVC, up to the right atrium. The patient underwent surgery for the resection of the tumor using cardiopulmonary bypass by a team of cardiothoracic surgeons and urologists. Histology identified the tumor as hepatocellular carcinoma, which developed as ectopic hepatic tissue in the right adrenal gland. [ABSTRACT FROM AUTHOR]

Primary cardiac neoplasms are rare, cardiac hemangiomas are even rarer, and a mixed thrombus followed by a primary cardiac hemangioma is exceptionally rare epidemiology. Here, we report the case of a man with a right atrium mixed-thrombus surgical history who went on to develop a cardiac hemangioma. [ABSTRACT FROM AUTHOR]

Left ventriculotomy for thrombus removal is usually associated with a high incidence of cardiac arrhythmias and decreased ejection fraction. A 51-year-old male patient was admitted to the emergency department with loss of consciousness. Transthoracic echocardiography revealed a 20 × 24-mm left ventricular apical nonpedunculated thrombus with normal ejection fraction. A persistent thrombus was shown on magnetic resonance imaging despite anticoagulation therapy. Robotic surgery was planned to avoid possible ventriculotomy-related complications, considering the preoperative neurological condition of the patient. The thrombus was completely removed surgically through left atriotomy using the DaVinci robotic system. In conclusion, robotic surgery can be used in the surgical treatment of left ventriculotomy thrombus in selected patients. [ABSTRACT FROM AUTHOR]

We describe the resection for lipomatous hypertrophy of the interatrial septum which necessitated complete reconstruction of the right atrium with Dacron grafts connecting the superior and inferior vena cava with the tricuspid orifice, and connection of the pulmonary veins to the mitral orifice with xenopericardium. [ABSTRACT FROM AUTHOR]

Keywords: adrenal tumor; ectopic hepatocellular carcinoma EN adrenal tumor ectopic hepatocellular carcinoma 1405 1406 2 07/14/20 20200701 NES 200701 Filippos-Paschalis R et al1 described a very interesting and unique case of ectopic hepatocellular carcinoma (HCC) in the adrenal gland with inferior vena cava (IVC) thrombosis and right atrial extension. The adrenal gland, the right atrium tumor, and IVC tumor thrombus were removed successfully. There are select cases of RCC and adrenal HCC with tumor thrombus extension which can be removed safely from the right atrium and IVC without the use of CPB.2,7,8 It is important to remember that these tumors do not cause thrombosis of the IVC, as the tumor thrombus (different from thrombosis) extends into the IVC. [Extracted from the article]

Therefore, a median sternotomy was performed and the VA-ECMO cannulas in his right common femoral artery and inferior vena cava (IVC) via the right common femoral vein were connected to a cardiopulmonary bypass (CPB) circuit and CPB was initiated. After snaring his IVC, a right atriotomy was performed, and a 29 cm long thrombus (Figure 2) was removed from his right atrium that likely formed as a result of chronic IVC partial interruption with a 30-year-old Adams-DeWeese clip that was noted on his computed tomography scan (Figure 3). [Extracted from the article]

Embolizing aortic thrombus can be associated with severe complications. Here, we present images showing a rare presentation of an ascending aorta thrombus. [ABSTRACT FROM AUTHOR]

Background: A 73-year-old female presented with leg claudication and chest pain. A mobile mass in the ascending aorta was found.Results: The mass was removed through a transverse aortotomy on circulatory arrest via sternotomy.Conclusion: Free-floating ascending aortic thrombus is a rare source of peripheral embolization. We advocate for emergent surgical resection to prevent further embolization and stroke. [ABSTRACT FROM AUTHOR]

We introduce our surgical experience in treating recurrent aortic coarctation or coarctation associated with intracardiac abnormalities, which is difficult to manage. Four patients underwent the operation with hypothermic cardiopulmonary bypass. During the surgery, the posterior pericardium was opened and the thoracic aorta was dissected and sidebiting clamped, and an end-to-side anastomosis of the artificial graft to the descending aorta was performed. The graft was passed in between the inferior vena cava and the inferior right pulmonary vein and posterior to the pericardium. After that, the aorta was clamped and intracardiac repair was finished. Then the proximal artificial graft was anastomosed to the right side of the ascending aorta with heart beating. All patients recovered smoothly. There was no early or late death, without bleeding or other complications after operation. Conclusion: “Complex coarctation” can be treated with ascending-to-descending aortic bypass via posterior pericardium and satisfied result can be achieved. [ABSTRACT FROM AUTHOR]

Several photographs are presented which shows the lobulated mass of right hepatic lobe, inferior vena cava and right atrium of a 69-year old male with dyspnea captured using a cardiac magnetic resonance imaging.