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Primary cardiac angiosarcomas are frequently found at a large size with infiltration into the adjacent heart structure owing to their asymptomatic characteristics until an advanced stage. Therefore, extensive resection is often required to achieve a good prognosis. We herein report a case of entire circumferential resection of the right atrium surrounded by angiosarcoma and excellent three-dimensional reconstruction of the right atrium.

Purpose Automated donor to recipient anastomosis has the potential to reduce procedural & ischemic times . A major impediment to automated anastomosis is creating the hemostatic end to end anastomosis without luminal compromise. We present our design of a conformational felt sandwich anastomotic device. Methods An adjustable anastomotic platform with a calibrated railing system (diameter: 10-100mm) was designed and tested in-vitro with a biomimetic heart phantom. Felt-incorporated two circular platforms, anvil and staple cartridge respectively, can be circumferentially tightened and released. Staples are deployed in an interlocking triangular pattern for hemostasis . Results A one cm cuff is created for both donor and recipient heart structure to be anastomosed. A modular anvil with incorporated conformational felt was then clasped around the structure to be anastomosed and the wall was everted on to the anvil and engaged in the spikes (Figure). The positional pins were then engaged, with a clockwise movement accurate apposition was achieved. The handle was depressed to discharge a specially arranged staple to achieve a hemostatic seal. The automated anastomosis obtains a hemostatic seal with a conformational felt on the outside of the vessel wall (Figure). The system also works well with bovine pericardium . Conclusion An automated donor to recipient anastomosis can improve the operational ease and reduce procedural/ischemic times while obtaining reproducible results.

The concept of food has expanded beyond its traditional role of survival and hunger satisfaction, to include a role in the prevention and treatment of disease. Polyphenols are classes of compounds that are synthesized by plants to serve a wide variety of functions including growth pollination and defense. These compounds have recently received increased attention in medical research. In this group, one of the most studied has been resveratrol (3,5,4,-trihydroxystilbene), a polyphenol, which is found predominantly in grapes and berries. Over the past two decades, researchers have studied the ability of resveratrol to prevent or reverse the development of abnormalities in heart structure and function in animal models of heart disease and heart failure. The results from animal studies have been promising, and very recently, this knowledge has been translated into examining the efficacy of resveratrol in humans with heart disease/failure. In this review we will discuss the current status of resveratrol research on cardioprotection.

Cardiac looping is a key morphogenetic event in vertebrate heart development. In a complex progression, the linear heart tube adopts a sweeping rightward curvature, establishing an architecture for the multichambered organ it soon becomes. Looping is an asymmetric event, its rightward direction being determined by an embryonic left-right axial pathway. The dextral loop has been a vehicle for development of heart complexity during evolution, to the extent that in higher vertebrates and humans, heart structure and function is extremely susceptible to perturbations of laterality, which may be common. The first clues to genetic control of laterality and looping are now emerging. Key issues to resolve include the origin of laterality information in the embryo, the exact nature of the effector molecules that link laterality to looping and the intrinsic mechanisms that drive the looping process itself.

by initial treatment strategy (MED, PCI, CABG) using SF-36 physical function, health utility and Seattle angina questionnaire. Linear modeling to predict 1 year physical function (SF-36 PF) included pt characteristics and treatment strategy. Results: PCI was the initial treatment strategy in 41%, CABG 22% and MED 37% I” elderly CAD pts. Survival at 1 yr was highest among pts undergolng CABG (60% CABG, 72% PCI, 50% MED). Pts undergoing CABG also had less angina, higher health utility rating, and better physical functioning at 1 yr than those treated with either PCI or MED (Table). CABG remained a significant predlctor (p=O.OOl) of higher 1 yr physical function (PF) even after adjusting for baseline PF. age, gender, education, prior MI, DM, PVD, EF, CAD severity and other predictors. In contrast, pts undergoing PCI had a non-significant trend toward better physical functioning at 1 year. Conclusions: After adjusting for potential confounders, CABG still affords elderly pts significantly better angma relief and funchonal outcomes at 1 year than either MED or IO:45 a.m.