scholarly journals Asymptomatic fatal post-lobectomy hemopericardium

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
C. Kotoulas ◽  
S. Meraj ◽  
N.J. Odom
Keyword(s):  
Epicardial Fat ◽  
Circumflex Artery ◽  
Post Surgery ◽  
Pathologic Findings ◽  
Significant Injury

We report a case of an asymptomatic post-lobectomy hemopericardium in a female who died suddenly at day two post surgery. Autopsy revealed no pathologic findings, but 250 ml of blood and clots in the pericardium and a non-significant injury to the epicardial fat overlying the circumflex artery territory.

Abstract 16801: Papillary Muscle Tip Approximation in Repair of Ischemic Mitral Regurgitation in a Chronic Swine Model

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kanika Kalra ◽  
Samantha Zhan Moodie ◽  
Dongyang Xu ◽  
Muralidhar Padala
Keyword(s):  
Mitral Regurgitation ◽  
Papillary Muscle ◽  
Left Ventricular ◽  
Ischemic Mitral Regurgitation ◽  
Diastolic Filling ◽  
Swine Model ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Post Surgery ◽  
Better Than

Introduction: Mitral valve (MV) repair with undersized annuloplasty (UMA) for ischemic mitral regurgitation (IMR) is being abandoned in favor of valve replacement (MVR) following CTSN trial results. However, in patients with durable repair, survival and left ventricular function (LVF) were significantly better than MVR. Achieving a durable repair with UMA is challenging as it draws leaflets away from papillary muscle (PM) insertions, causing unphysiological tethering and unicuspid configuration that fails (FigA-B). Hypothesis: Drawing PM tips together with an approximating stitch (PMT-A) can relieve leaflet tethering and enable better repair (FigC). A chronic swine model of IMR was used to compare effects of isolated PMT-A, UMA and PMT-A+UMA on MV and LV at 3 months post surgery. Methods: Twenty-five farm swine underwent catheterization and occlusion of left circumflex artery, resulting in postero-lateral myocardial infarction (MI). Two months after MI, IMR severity of >2+ was confirmed on echo, and animals underwent one of the 3 repairs: PMT-A (n=6), UMA (n=8), PMT-A+UMA (n=11). Echo was performed postoperatively and repeated with MRI at 3 months (FigD). MV kinematics, coaptation geometry, and LVF were assessed. Results: IMR was eliminated after all repairs and did not recur through the study. Annulus continued to grow after PMT-A, but not in UMA or PMT-A+UMA group (FigE1) without increasing severity of IMR. Compared to prerepair, tenting depth was significantly reduced only in PMT-A and PMT-A+UMA groups (FigE2). Both leaflet excursion angles (diastolic minus systolic angles) increased after PMT-A, but not in other groups (FigE3-4). LV size and LVF was similar between groups, confirming that PMT-A did not perturb diastolic filling. Conclusions: In this model of IMR, PMT-A improved leaflet mobility, compared to isolated UMA or PMT-A+UMA. PMT-A is a simple technique that can potentially improve durability of MV repair by restoring valvular kinematics.

scholarly journals A case report of unusual clinical features of a spontaneous coronary artery rupture: pathologic findings in the rupture site

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Daichi Fujimoto ◽  
Mitsuru Takami ◽  
Amane Kozuki ◽  
Junya Shite
Keyword(s):  
Coronary Artery ◽  
Troponin I ◽  
Cardiopulmonary Arrest ◽  
Vital Signs ◽  
Stable Condition ◽  
Pericardial Fluid ◽  
Circumflex Artery ◽  
Pathologic Findings ◽  
Atherosclerotic Changes ◽  
Coronary Artery Rupture

Abstract Background Spontaneous coronary artery rupture (SCAR) is an extremely rare but life-threatening state. The aetiology and the pathologic findings remain to be fully elucidated. Case summary A 62-year-old woman, who had been on haemodialysis for 27 years, presented with chest discomfort worsening on deep inspiration that had been ongoing for the past 2 weeks. An echocardiogram and computed tomography showed diffuse pericardial fluid. ST elevation in the broad leads, especially in leads I, II, and aVF, and increased C-reactive peptide and Troponin I levels suggested pericarditis. The patient initially had a stable course with no medications. The chest symptoms disappeared and her vital signs were stable. On Day 13 after admission, however, she had a sudden cardiopulmonary arrest due to a cardiac tamponade. An emergency coronary angiography showed extravasation of the contrast into the epicardium from the branch of the circumflex artery. She was diagnosed with SCAR and underwent a successful coil embolization. However, she went into an irreversible coma due to the cerebral hypoxia. On Day 33, she died of pneumonia. An autopsy showed a rupture of the internal elastic layer of the coronary artery. However, no specific findings, such as aneurysm and dissection, were evident. The common atherosclerotic changes were observed. Discussion The stable condition lasting for over 2 weeks was a rare clinical course for SCAR. Long-term hypertension and dialysis would have caused the rupture of the coronary artery with common atherosclerotic changes. We should consider SCAR as one of the differential diagnoses when we observe pericardial fluid.

Effects of Hypophysectomy on the Occurrence and Calcifiability of Matrix Vesicles in the Epiphyseal Growth Plate of Immature Rats

1980 ◽  
Vol 38 ◽  
pp. 578-579
Author(s):  
S. I. Coleman ◽  
W. J. Dougherty
Keyword(s):  
Growth Plate ◽  
Matrix Vesicles ◽  
Epiphyseal Growth Plate ◽  
Hard Tissue ◽  
Hormonal Factors ◽  
Post Surgery ◽  
Mineral Deposition ◽  
Thin Sectioning ◽  
Integral Role ◽  
Cellular Secretion

In the cellular secretion theory of mineral deposition, extracellular matrix vesicles are believed to play an integral role in hard tissue mineralization (1). Membrane limited matrix vesicles arise from the plasma membrane of epiphyseal chondrocytes and tooth odontoblasts by a budding process (2, 3). Nutritional and hormonal factors have been postulated to play essential roles in mineral deposition and apparently have a direct effect on matrix vesicles of calcifying cartilage as concluded by Anderson and Sajdera (4). Immature (75-85 gm) Long-Evans hooded rats were hypophysectomized by the parapharyngeal approach and maintained fourteen (14) days post-surgery. At this time, the animals were anesthetized and perfusion fixed in cacodylate buffered 2.5% glutaraldehyde. The proximal tibias were quickly dissected out and split sagittally. One half was used for light microscopy (LM) and the other for electron microscopy (EM). The halves used for EM were cut into blocks approximately 1×3 mm. The tissue blocks were prepared for ultra-thin sectioning and transmission EM. The tissue was oriented so as to section through the epiphyseal growth plate from the zone of proliferating cartilage on down through the hypertrophic zone and into the initial trabecular bone. Sections were studied stained (double heavy metal) and unstained.

Psychophysiological correlates of pre- and post-surgery stress in cardiosurgical patients

2008 ◽  
Author(s):  
E. A. Levin ◽  
A. N. Savostyanov ◽  
V. G. Postnov ◽  
M. Kh. Kadochnikova ◽  
O. V . Zhukova
Keyword(s):  
Post Surgery ◽  
Psychophysiological Correlates

Beurteilung der Adriamycin-Kardiotoxizität mittels der Äquilibrium-Radionuklid-Ventrikulographie

1987 ◽  
Vol 26 (05) ◽  
pp. 206-211 ◽  
Author(s):  
P. Knesewitsch ◽  
N. H. Göldel ◽  
S. Fritsch ◽  
E. Moser
Keyword(s):  
Left Ventricular ◽  
Peak Filling Rate ◽  
Base System ◽  
Filling Rate ◽  
Time To Peak ◽  
Ejection Rate ◽  
Follow Up Studies ◽  
Pathologic Findings ◽  
Peak Ejection Rate

Results of 606 equilibrium radionuclide ventriculographies (ERNV) performed in 348 non-selected patients receiving Adriamycin (ADM) therapy were stored in a data base system. The aim of the study was to assess the influence of a potential cardiotoxic therapy on left ventricular pump function. Increasing ADM doses yielded a significant (p <0.05) decrease of the resting ejection fraction (R-gEF), the peak ejection rate and the peak filling rate. Enddiastolic and endsystolic volumes increased significantly. Stroke volume, heart rate and time to peak filling rate did not change significantly. 368 follow-up studies were performed in 128 patients: 65/128 patients presented a decrease of R-gEF, but only in 45 of these patients R-gEF values fell into the pathologic range. In 44 of these follow-ups, R-gEF remained unchanged. In 19 patients, a R-gEF increase was observed. At the beginning of ADM therapy 14% of the patients had subnormal R-gEF values. With increasing ADM doses pathologic findings increased to 86% in patients with ADM doses higher than 500 mg/m2.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

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