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Background: Heart transplantation is no longer considered an experimental operation, but rather a standard treatment; nevertheless the context has changed substantially in recent years owing to donor shortage. The aim [...]

Abstract: We would like to report a rare case of post-stenotic aneurysm of the pulmonary trunk and its left branch in a 51-year-old man. His cardiac disease, which was first diagnosed at the age of 4, was left untreated because of absence of symptoms and normal physical development. A CT scan, recently performed because of decrease in exercise tolerance and worsening dyspnea, showed a pulmonary artery aneurysm (52mm×79mm). The echocardiography revealed a severe pulmonary commissural stenosis. Through a surgical approach the pulmonary trunk and its left branch were excised and reconstructed using a 30mm Dacron graft; the right pulmonary branch was then reimplanted on the right side of the tube. The patient''s postoperative course was uneventful. He was discharged on the seventh postoperative day and there were no adverse events or complications at 1- and 3-month follow-up. [Copyright &y& Elsevier]

Purpose of review: Chronic thromboembolic pulmonary hypertension (CTEPH) is a major cause of precapillary pulmonary hypertension leading to right heart failure and death if left untreated. In addition to pulmonary endarterectomy, which is considered the standard of care, and specific drug therapy that is not however expected to offer relief from the mechanical component of the disease, the therapeutic options for CTEPH have expanded with the development of balloon pulmonary angioplasty (BPA). The purpose of this review is a better understanding and evaluation of BPA as a treatment option in CTEPH patients. Recent findings: With the evolution of BPA almost all over the world, more centers outside Japan, which remains the leader for the technique, presented their results confirming the efficacy, safety, and feasibility of this procedure as a complementary strategy in the treatment algorithm of CTEPH. Summary: Summarizing, more data from all over the world confirm that BPA is a challenging but potentially effective intervention for the treatment of inoperable CTEPH patients. However, there is a need for standardization of the technique, and furthermore, large, international, multicenter randomized controlled trials comparing BPA with the other treatment modalities of CTEPH are imperative. [ABSTRACT FROM AUTHOR]

Objective: This paper intends to report our experiences by using an operation of off-pump occlusion of transthoracic minimal invasive surgery (OPOTTMIS) on the treatment of consecutive 210 patients with simple congenital heart diseases (CHD) including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA). Methods: The retrospective clinical data of OPOTTMIS in our institute were collected and compared to other therapeutic measures adopted in the relevant literatures. After operation, all the patients received electrocardiography (ECG) and echocardiography (echo) once a month within the initial 3 months, and no less than once every 3 ∼ 6 months later. Results: The successful rate of the performed OPOTTMIS operation was 99.5%, the mortality and complication incidence within 72 hours were 0.5% and 4.8%, respectively. There were no major complications during perioperation such as cardiac rupture, infective endocarditis, strokes, haemolysis and thrombosis. The post-operation follow-up outcomes by ECG and echo checks of 3 months to 5 years showed that there were no III° AVB, no obvious Occluder migration and device broken and no moderate cardiac valve regurgitation, except 1 VSD and 1 PDA with mild residual shunts, and 2 PDA with heart expansion after operation. However, all the patients' heart functions were in class I∼II according to NYH standard. Conclusion: The OPOTTMIS is a safe, less complex, feasible and effective choice to selected simple CHD patients with some good advantages and favorable short term efficacies. [ABSTRACT FROM AUTHOR]

An author index for the November 2008 issue of "Journal of Cardiac Surgery" is presented.