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Autologous vascular arterial or venous graft are not available in 10-40% of patients, due to vascular pathologies, and the utility of decellularized biological scaffolds would be a solution for those cases. The purpose of this research was to obtain a functional acellular xenograft, prior to in-vivo testing as a vascular graft in an experimental animal.

Background: Aortic stenosis is the valvulopathy with the highest incidence, having congenital (frequently bicuspid valve) or degenerative etiology. Objective: The purpose of this paper is to present a case of severe cardiac dysfunction due to the aortic stenosis, in which the surgical benefit is impressive, even if the optimal moment has been exceeded. Material and methods: We present a case of a 39 years old male, with bicuspid aortic valve and moderate aortic stenosis, periodically investigated by cardiologists, without indication of surgery at that time who had a sudden decompensation of the clinical status. He had severe fatigue, dyspnea and a thrombophlebitic episode in the lower left limb. The patient was hospitalized in the Cardiovascular Surgery Clinic of the Institute, where we highlighted severe aortic stenosis, severe tricuspid insufficiency, a tumor in the left atrium and severe dysfunction of the left ventricle (EF 30%). Chest CT scan revealed multiple peripheral pulmonary infarctions, probably in the context of the thrombophlebitis. Blood tests revealed liver dysfunction due to the severe tricuspid insufficiency and also the presence of hepatic B virus, undiscovered until then. We practiced aortic valve replacement, tricuspid annuloplasty and myxoma excision from the left atrium. Results: Postoperative, the evolution was favorable, with increasing in the performance of the heart contractility (up to NYHA I, EF 45%), the decrease of the hepatic dysfunction, the improvement of the clinical status and the quality of the patient's life. Conclusions: The replacement of the aortic valve should be performed before the onset of cardiac dysfunction. It may also be beneficial in selected cases, for patients with decompensated stages of the disease, but with good myocardial function in the first decades of life. [ABSTRACT FROM AUTHOR]

Background: Transposition of great arteries is a rare and very serious congenital heart defect. The discordant ventricular-arterial arrangement results in parallel circulation, depleting the body of oxygen rich blood. Objective: We report and comment on the imaging in the case of a baby boy with Ross IV heart failure due to transposition of great arteries, atrial and ventricular septal defect, aortic arch hypoplasia and aortic coarctation. Material and methods: A three months old baby was transferred to our hospital, previously being diagnosed with ventricular septal defect and complaining of functional respiratory syndrome, failure to thrive and low tolerance towards feeding. Upon admission the patient was cyanotic, with SaO2 of 60-65% under oxygen therapy. The imaging assessment (ultrasound and CT examination) diagnosed a right ventricle with double output, d-TGA without pulmonary protection, VSD wide outlet, bidirectional shunt, wide aortic coarctation, aortic arch hypoplasia, persistent arterial canal with bidirectional shunt and pulmonary hypertension. Results: Arterial switch surgery was performed at the same time with closing of the atrial and ventricular septal defect and the ligation of arterial canal. Three days later, surgical correction of aortic coarctation was performed. After proper treatment the patient's evolution was favorable. He was discharged with better respiratory function (SaO2 95%) and weight gain. Conclusion: The imaging assessment can reveal the spatial relationship between great arteries and diagnose all associated malformations for patients with d-TGA. Thus, knowing the congenital anatomy and developing an imaging focus for each patient, before surgical intervention, plays a crucial role. [ABSTRACT FROM AUTHOR]