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Introduction: Bacterial endocarditis is one of the high mortality complications after the valve surgery. Despite the medical advancements, the mortality rate of Bacterial Endocarditis has not been decreased. We designed this study to determine the epidemiology of Bacterial Endocarditis following surgery. Materials and Methods: This is retrospective study from 2012 to 2016 in Mashhad University of Medical Science. Patients with history of Cardiac Surgery with Implantation of Prosthetic valve. The diagnostic method of bacterial endocarditis was based on the Duke's criteria, Transthoracic echocardiography, and culture lab. Results: Among 2802 patients with cardiac valve surgery, 9 patients had developed Bacterial endocarditis. The common infectious valve was mitral (58.4%) and prosthetic valves were mostly used in general (77%). There was no relationship between gender (p=0.47), marital status (p=0.68), and type of surgery (p=0.29) and Bacterial endocarditis. But there was a significant relationship between the type of valve surgery and Bacterial endocarditis (p=0.01). Also, 3 patients with Bacterial endocarditis had a history of smoking and drugs. Three patients also died and were excluded. Conclusion: Bacterial endocarditis differ according to the different studies and our results were compatible with previous studies. Our study confirmed that the utilization rate of the prosthetic valve was higher than the homograft valve. The use of antibiotics should be evaluated prior to performing a culture test which could affect the test results and consequences of the study. [ABSTRACT FROM AUTHOR]

Although classic and standard procedure for patients with ascending Aorta aneurysm with Sever aortic Regurgitation is Bentall surgery but in some selected cases this complex surgery was not performed with different reason like advanced age and coexisting comorbidity involving renal and hepatic and lung Function. In our cases 75 years old man with chronic renal failure (Cr= 3.2) who was known case of sever aortic Regurgitation and Ascending Aortic Aneurysm with 5.5 diameter. Replacement of Aortic Valve with Biologic Prosthesis Aortic Valve and Reduction Aortoplasty with Mesh prosthesis was done successfully with good result with early follow up. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative bleeding in cardiac surgery is not an uncommon complication and can be evaluated with surgical and nonsurgical causes. Although any type of coagulopathy should be treated before, during, and after the surgical procedure, cardiac surgeons should have perfect surgical techniques for step by step hemostasis to minimize blood loss. Materials and Method: This retrospective study was conducted on 85 patients out of 1075 (0.07%) ones required Reexploration of the Mediastinal to control the excessive bleeding after different cardiac procedures in Imam Reza Hospital in Mashhad of Iran from January 2018 to January 2019. Results: Out of 85 patients who required Mediastinal Reexploration, 61 (71%) and 24(29%) patients underwent the off-pump procedure and cardiopulmonary bypass, respectively. The most common sites for surgical bleeding in the order were missed branches of left internal mammary artery / saphenous vein graft (65%), proximal or distal coronary anastomosis (18%), and aortic /atrial suture line (16%). The death in patients under study was 7 (8%), half of which were not related to Mediastinal Reexploration. Conclusion: The possibility of postoperative bleeding can be minimized through correction of clotting factor deficiencies, improvement of surgical techniques in hemostasis. [ABSTRACT FROM AUTHOR]

Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective cardiac protector. This narrative review was conducted via searching in four databases, including PubMed, Scopus, Embase, and ScienceDirect. The studies focused on the efficacy and safety of custodiol cardioplegia reviewed, especially in pediatric cardiac surgeries and relevant procedures. In total, 21 articles were eligible, and the findings highlighted the controversies regarding the use of various cardioplegic solutions and the variability of their application by surgeons. However, data were inadequate regarding the optimal cardioplegic solutions in this regard. Some of the studies performed on adults suggested that custodiol cardioplegia may be equivalent to conventional blood cardioplegia. Most of the reviewed articles showed a consensus on the safety and efficacy of custodiol cardioplegia in adult and pediatric cardiac surgeries. It is believed that custodiol procedures are not only easily delivered, but they are also convenient and less time-consuming and provide long-lasting motion and bloodless fields for the surgeon to perform the operation. Therefore, use of custodiol cardioplegia has been reported to be safe, effective, and cost-efficient compared to conventional cardioplegic solutions. However, different findings have also been denoted in some of the studies in this regard, implying the equal effectiveness of these techniques. [ABSTRACT FROM AUTHOR]

Introduction: The use of anticoagulant and antiplatelet medications, especially warfarin and clopidogrel, is on a growing trend. Warfarin usage is commonly accompanied by hemorrhagic complications resulting in a noticeable mortality rate. Patients anticoagulated with warfarin suffers from intracranial hemorrhage after a head injury. Material and Methods: For the purpose of the study, the relevant articles published from 1966 to January 2017 were searched in several databases, including of Medline, Scopus, Google Scholar, and MEDLINE (through PubMed). The search process was performed using the following medical subject headings: "Warfarin" combined with "Warfarin-associated hemorrhage", "Head injury and warfarin-related intracranial hemorrhage", "Intracerebral hemorrhage", and "Treatment of coagulopathy". Results: The search process resulted in the inclusion of 242 articles. According to the results of the reviewed studies, the best treatments for the reversal of coagulopathy in warfarinised patients in elective or urgent conditions following a head injury are prothrombin complex concentrate (PCC) and fresh frozen plasma, along with vitamin K, based on the discretion of the treating physician. Conclusion: According to the studies, the administration of PCC or any other treatments with a similar or close formulation to PCC is significantly more effective and faster in the reversal of coagulopathy and reduction of international normalized ratio in comparison with the use of fresh frozen plasma or other therapies in warfarinised patients admitted with serious intracranial hemorrhage following a head injury. Delivery of an effective treatment to these patients can be accomplished by planning for medical interventions, decreasing time delays for operations, and selecting a suitable or alternative treatment. [ABSTRACT FROM AUTHOR]

We report the case of a 23-year-old woman who died due to endograft stenosis 20 months after thoracic endovascular aortic repair. The patient presented with the pseudocoarctation syndrome. Although angioplasty of stenosis endograft was successfully performed, severe metabolic complications were lethal. [ABSTRACT FROM AUTHOR]

Coronary aneurysms in adults are rare clinical entities. Herein, we presented a 54-year-old man who was admitted with an acute extensive anterior myocardial infarction. The emergency coronary angiography revealed an isolated large aneurysm at the proximal segment of the left anterior descending coronary artery. The patient was successfully treated with a graft-coated stent. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MS) is considered as an important risk factor for advanced coronary artery disease. This condition can increase the mortality and morbidity in the patients undergoing coronary artery bypass graft (CABG) surgery. The aim of study was compared mortality and morbidity after off Pump - CABG surgery between patients with and without Metabolic syndrome. Materials & Methods: This prospective cross-sectional study was conducted on 120 patients, who underwent off-pump CABG surgery within October 2014-October 2016. The participants were equally divided into two groups including the patients with and without MS (MS and non-MS, respectively). Results: According to the results, 68 (56.6%) patients were male. Furthermore, out of the 60 participants with MS, 36 (60%) cases were male. The mean ages of the MS and non-MS groups were 64.96±9.6 and 65.62±10.6 P=0.6 years, respectively. No statistically significant difference was observed between the two groups in terms of the mortality and morbidity (e.g., surgical wound infection, length of Intensive Care Unit and hospital stay, atrial fibrillation rhythm, and bleeding in the first 24 h). The intubation time in patients with Metabolic Syndrome was significantly higher than patients without Metabolic Syndrome (6.66 ± 1.97 vs 5.83 ± 1.93 respectively; P=0.007) Conclusion: Metabolic syndrome was not associated with higher mortality and morbidity after CABG surgery compare to patients without Metabolic syndrome, although patients with Metabolic syndrome had higher risk for long intubation time. [ABSTRACT FROM AUTHOR]

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Introduction: Patients with primary acute aortic dissection are at higher risk of complications, including increasing aortic aneurysm diameter, aortic rupture, aortic pseudo aneurysm, and recurrent aortic dissection. Case presentation: We presented the case of a recurrent pseudo aneurysm and rupture of the aorta in the distal ascending aorta and proximal arch 3 years after the initial procedure for acute aortic dissection. The patient had bleeding from previous skin incision. In computed tomography angiography, the site of rupture of the aorta and abnormal communication with sternum were confirmed. Conclusion: Recurrent aortic dissection is a catastrophic event and has high mortality; however, it is rare and is treated in a short time by redo surgery. [ABSTRACT FROM AUTHOR]

Introduction: Although coronary endarterectomy is not an ideal procedure, it is the only available option for cardiac surgeons in some patients with diffuse coronary artery disease. Based on the majority of conducted studies, the results of coronary endarterectomy (including survival, graft patency, and recurrence of the symptoms of myocardial ischemia) are less prevalent than standard coronary artery bypass grafting. Generally, the left anterior descending artery (LAD) is the most commonly involved artery in coronary endarterectomy. The aim of this study was evaluate clinical and early results of Endarterectomy of LAD artery. Materials and Methods: In total, 30 cases of coronary endarterectomy of the LAD were studied from January 2015 until January 2016.This is a retrospective study. Endarterectomy procedure was performed in Imamreza hospital of Mashhad university of medical sciences. Results: The mean age of the subjects was 63±4.5 years (range: 45-78 years). As the findings revealed, 18 patients were male (60%), and the mean ejection fraction index was 43±5.1 (range: 15-60). Also, prior history of myocardial infarction was documented in 8 (26%) patients. The mortality rate among patients was estimated at 6.6% (n=2). In total, 12 (40%) and 7 (23%) patients required high-dose inotropic support and intra-aortic balloon pump, respectively. Risk of preoperative myocardial infarction was observed in 5 (16.5%) cases, and 3 (10%) patients required re-exploration due to significant hemorrhage. Conclusion: If coronary endarterectomy of the LAD is performed by experienced cardiac surgeons, favorable outcomes can be obtained. [ABSTRACT FROM AUTHOR]

A 54-year-old female patient was presented with upper extremity ischemia. Further investigation revealed ulcerated atherosclerosis plaque in aorta with intramural hematoma and clot formation. The subject underwent a successful resection of mass with the assistance of cardiopulmonary bypass and total circulatory arrest. [ABSTRACT FROM AUTHOR]

Endocarditis and intracardiac infection have been increased recently especially in dialysis dependent renal failure patients. This is usually intractable infection to broad spectrum Antibiotic therapy and in most cases surgical intervention was necessary. We have presented 45 years old man with intracardiac infection at the tip of dialysis catheter that after catheter removal intracardiac infection was removed. [ABSTRACT FROM AUTHOR]

Cardiac laceration from blunt thoracic trauma is not a common presentation. The rate of mortality due to this injury is very high since it is not diagnosed and treated immediately. In this study, we present the case of a 65-year-old man with blunt cardiac trauma, causing right atrial rupture and pericardial tamponade. Successful management of this patient was firstly done with initial pericardiocentesis. Then, the patient was immediately transferred to the operating room for tamponade relief and cardiac wall repair. We recommend that cardiac surgeon have an important suspicious for cardiac involvement in Blunt chest wall trauma. [ABSTRACT FROM AUTHOR]

Recently, there have been more reports of cardiac valve infections due to the increasing number of intravenous (IV) drug abusers and chronic renal failure patients. Among cardiac valves, tricuspid valve is most commonly affected in the course of endocarditis. Appropriate management of these patients is a challenging and controversial issue in the field of cardiac surgery. Treatment options in such cases include IV antibiotics, surgical excision alone, and surgical excision with the re-implantation of prosthetic valve. In this study, we present a case of tricuspid valve endocarditis (TVE), confirmed by echocardiography, in a young IV drug abuser. Tricuspid valve replacement was performed by using a biological prosthesis with remarkable results in the early and long-term follow-up of the patient. [ABSTRACT FROM AUTHOR]

A retraction of the online version of the article "Long-term assay of off-pump atrial septal defect closure using vena caval inflow occlusion and minimally invasive approaches in 130 cases" " that was published in October 17, 2014 issue is presented.