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Methods In emergency situation, preoperative patient work-up for cardio-vascular surgery is quite different from the elective setting. Since 03/2000 till 01/2012 we have analyzed a consecutive series of 12 172 cases out of which 2214 underwent emergency procedures (18.19%). The most frequent problems requiring urgent intervention were thoracic aortic aneurysms (448 cases; 20.24%); coronary artery disease (1006 cases; 45.47%) abdominal aortic aneurysms (125 cases 66 with rupture; 2.96%), peripheral vascular (364 cases; 16.46%), and others (329 cases: 14.87%).

Background The native aortic valve can be explained with rules of the equal side triangle, and as a part of the aortic root it is wedged between the heart and the ascending aorta. Beside different types of aortic valve replacements, reconstructive techniques are increasingly performed to restore normal aortic valve function. Reconstructive techniques themselves can be divided into isolated reconstruction of aortic valve/root structures and the isolated replacement of one or more structures. With this study we evaluated clinical results of reconstructive surgery of the aortic root with 3 leaflets pericardial patch. Methods We created this reconstructive technique using bovine/ equine pericardium, replacing valve cusps on aortic fibrous ring of patient. The leaflets are made from same pericardium from which other biologic valve prosthesis are done. The ring of patient’s aorta was used as guide for sizing this valve. Leaflets are implanted separately; using continuous sutures with 2 supported stitches at newly created commissure, without a stent or sowing ring. Main including criteria was stenosis of the aortic valve and patients with aortic annuli ring dilatation had been excluded. Intraoperative and postoperative TEE was performed for every created valve. Results

An increasing number of patients with peripheral and carotidal vascular disease are undergoing coronary artery bypass grafting. Such patients have an increased risk of adverse outcomes. Our aim was to quantify the effect of on time cardiopulmonary bypass in this group of patients.

Material and methods From January 2008 till May 2013, 16 patients age 55 ± 7 years, had been treated. They were symptomatic, with mean aneurysm dimension of 10 ± 2 centimeters. One patient had Crawford type IV TAAA that was unrecognized, mistaken for tumor and biopsied following explorative laparotomy for acute abdominal pain in another hospital. Surgery was performed through thoracophrenolaparotomy, with construction of composite end to end prosthesis between tubular and bifurcated graft and proximal end to side prosthesis implantation on thoracic aorta. End to end anastomosis with both iliac arteries was performed, followed by implantation of the celiac trunk, superior mesenteric and renal arteries over short 10 mm vascular grafts on the prosthesis.

Methods 450 consecutive patients undergoing valvular were studied prospectively. Intraoperative 2D and 3D transesophageal echocardiographic (TEE) examinations were performed using a recently introduced TEE probe that provides realtime 3D imaging. Expert echocardiographers blinded to 2D TEE findings assessed the etiology of MR on 3D transesophageal echocardiography. Similarly, experts blinded to 3D TEE findings assessed 2D TEE findings. Both were compared with the anatomic findings reported by the surgeon.

Result In a first step patient got primary stenting with an immediate relief of the gradient. All antihypertensive medications were discontinued immediately. After 5 months patient got a surgery in a second step, preserving a nature aortic leaflets into the Dacron graft and with reimplantation of the both coronary arteries. Control transoesophageal echocardiography and CT scan showed normal morphology of the ascending aorta, no regurgitant jet trough the aortic valvula, no pressure gradient on the descending aorta.

Backgound Infected aneurysm (or mycotic aneurysm) is defined as an infectious disease of the wall of an artery with formation of a blind, saccular out-pouching that is contiguous with the arterial lumen. Symptoms are frequently absent or non-specific during the early stages. Once clinically presented, infected aneurysms are often at an advanced stage of development and associated with complications such as rupture. Nontreatment or delayed treatment of infected aneurysms has a poor outcome, with high morbidity and mortality rate of fulminant sepsis or hemorrhage. In clinically suspected cases, computed tomography is state –ofthe-art technique used for diagnosis. Imaging features of infected aneurysms include a lobulated vascular mass, an indistinct irregular arterial wall, perianeurysmal edema, and a perianeurysmal soft-tissue mass. Urgent surgery performed for solving aortic rupture, carries high morbidity and mortality rates.