We report the eighth case of surgical removal of a papillary endocardial tumor. The surgical approach was aided by intraoperative two-dimensional echocardiography. The tumor was attached to the chorda tendinea of the mitral valve and was successfully removed via a left atrial approach.

Adult↗

PubMedDate not supplied

Vasculo-Behçet's disease: immunological study of the formation of aneurysm.

We report two patients with vasculo-Behçet's disease who had femoral and popliteal aneurysms. The resected aneurysms and occluded distal arteries were studied clinicopathologically. The most interesting features were prominent fibrosis of the adventitia including the surrounding tissue, venous occlusion, perivasculitis and deposits of C3, C4 and immunoglobulins (IgA, IgG and IgM) in the arterial wall and surrounding tissue. These findings indicate that the formation of aneurysm in vasculo-Behçet's disease is caused by destruction of the intimal and outer side of the arterial wall.

Adult↗

PubMedDate not supplied

Late pathological changes of Carpentier-Edwards porcine bioprostheses in the mitral position.

Eighty-nine patients received mitral valve replacement with Carpentier-Edwards porcine bioprostheses between 1975 and 1983. Eighty-three patients (93.3%) were followed up after the operation; early death (within one month of operation) occurred in 6 patients and late death in 2 patients. After the operation, 64 survivors (85.3%), who did not require reoperation, exhibited improved symptoms according to the NYHA functional class. Of the 6 patients (6.7%) who required reoperation, 5 patients underwent reoperation 50 to 85 months after the implantation. Pathologically, all the removed valves showed degeneration of collagen and elastic fibers, no host endothelialization and mild to moderate infiltration of inflammatory cells. Thrombus in the left atrium was detected in one case. Destruction of the cusps was seen in three cases and calcification of the cusps developed in three cases. In general, the Carpentier-Edwards porcine bioprosthesis provided good clinical improvement over the periods studied. However, morphological changes of the bioprosthetic valve, such as destruction collagen and elastic fiber, and inflammatory cell infiltration of the cusps, seems to occur more frequently with the passage of time. We therefore suggest that patients with this prosthesis should be followed carefully, particularly at late intervals after implantation.

Adult↗

PubMedDate not supplied

Questionable role of glucose-insulin in cardioplegic solution.

To evaluate the myocardial protective effect of glucose-insulin (GI) in a cold cardioplegic solution, we compared the effect of a solution not containing GI (solution I) with that of an identical solution containing GI (solution II) under cardiopulmonary bypass in mongrel dogs. After 120 minutes of ischemic arrest, defibrillation was necessary to restore cardiac activity in 12.5% of the solution I group and 42.8% of the solution II group, respectively. No distinct intergroup differences were noted in recovery of left ventricular function, oxygen and lactate extraction of the myocardium during the post-arrest period, the myocardial ultrastructure, and myocardial ATP levels. Although creatine phosphate was less well preserved, glucose-6-phosphate and lactate were more accumulated in the solution II group than in the solution I group. Thus, significant advantages of substrate enhancement by addition of GI to cold cardioplegic solution were not found in spite of multidose cardioplegia and presence of noncoronary collateral blood flow.

Adenosine Triphosphate↗