Tehran University Medical Journal

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Background: The usage of pericardium of patient himself, for support of anastomosis lines may carry benefits in patients undergoing aortic valve replacement with pulmonary autograft (Ross). The aim of the present study was to compare the short term results of aortic valve replacement with pulmonary autograft with routine and offered methods.

Methods: In a non-randomized clinical trial, 64 patients who referred to cardiac surgery ward of Imam Khomeini hospital Tehran Iran from December 2002 to December 2006 for aortic valve replacement with pulmonary autograft with two different methods. In the first two years of this study all of the patients were operated with routine procedure (group A, n=28) and during the next two years, all of them were operated with authors' offered method in which the patient`s pericardium was used for support of anastomosis lines (group B, n=36). Some of clinical parameters and outcome were compared between two groups.

Results: There were no significant differences between mean of age, sex, pathology, preoperative and postoperative EF in two groups. In group B, the mean pump time was significantly lower than group A (144.09±26 vs. 179.64±25 min). The mean Cross-clamp time was significantly lower in group B (118.5±22 vs. 136.93±19 min) Need for blood transfusion in ICU was significantly lower in group B (35.71% vs. 68.57%). Mean ICU Stay and Postoperative Hospital Stay were significantly lower in group B (1.3±0.3 vs. 1.9±0.7 and 5.2±0.9 vs. 5.9±1.5 days respectively). Overall mortality was four death (6.25%) which was not significant between two groups.

Conclusions: The usage of patient's pericardium for support of anastomosis lines in patients undergoing aortic root replacement with pulmonary autograft carry advantages to routine procedure and its utilization is advocated in other centers.

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Background: Primary cardiac tumors are rare tumors which should be operated urgently. In this study, cardiac myxoma have been evaluated from diagnosis until dis-charge in a 10 years period and then results including presenting symptoms, approach to the patients were compared with similar study in this center a decade ago. Methods: Patients who underwent operation for myxoma from year 2003 until 2013 in the Shahid Modarres Hospital were included in this study. Results: Eighteen patients included in the study, 11 female and seven male. Patients’ ages were in the range of 13 to 76 years (mean 53 years). Mean time from diagnosis to operation was 5.8 days and mean time from surgery to discharge was 8.6±6.1 days. Most common presenting symptoms were first clinical presentation in four patients. In all patents echocardiography was the main diagnostic modality. In addition to trans thoracic echocardiography (TTE), in five patients TEE was used and in 13 patients coronary angiography was used to rule out concomitant coronary artery disease. 94.4% of all tumors (17 cases) were primary cardiac tumors and only one tumor (5.6%) was recurrent. In 16 patients (88.9%) tumor were found in the Left Atrium (L.A) and in one case, tumor was found in both atria and in another case, tumor was in the ventricle. After tumor excision, atrial septum was repaired primarily in seven cases (38.9%) and with pericardial patch in 9 cases. One patient underwent concomitant coronary artery bypass graft (CABG) and another patient underwent concomitant pulmonary valve repair. 14 patients (77.8%) discharged from hospital without any post operative complication. Heart block occurred in one patient and cerebral emboli with secondary cerebrovascular accident (CVA) developed in two patients. One patient died (5.6%). Conclusion: Comparing results from two similar studies in two consecutive decades revealed that mean time from diagnosis to operation obviously was reduced but ad-vances in diagnostic modalities were unable to change clinical presentation or reduce age of tumor diagnosis or complications or size.