Teneurins

A 36-year-old female presented with two episodes of hemoptysis induced by exertion and acute dyspnea. She was diagnosed as a case of hypertrophic obstructive cardiomyopathy (HOCM) with systolic anterior motion (SAM)-induced severe mitral regurgitation (MR). She underwent extended septal myectomy with mitral valve replacement under cardiopulmonary bypass and recovered successfully. This is a unique and rare combination of HOCM with hemoptysis.Cardiac rhabdomyoma is the most common primary heart tumor in childhood. This tumor, which is frequently associated with tuberous sclerosis complex, mostly disappears in childhood with spontaneous regression. Surgical resection is required in case of outflow obstruction and arrhythmia and when protruding to disrupt the filling of the heart cavities. There are very few case series in the literature about rhabdomyoma, whose relationship with other congenital heart defects has not been clearly verified. In this study, we report our approach to the tumor during the corrective surgery of the infant, who was diagnosed with an atrioventricular septal defect and patent ductus arteriosus, and rhabdomyoma accompanying these malformations. We treated this asymptomatic rhabdomyoma with everolimus in line with the current literature, without excision.The modified Nuss procedure using two bars lying parallel or non-intersecting is use to correct pectus excavatum with varying degrees of patient satisfaction. This bar placement has its limitation for certain pectus excavatum morphology where the deformity is deep and focal or located below the subxiphoid. We have altered our bar placement so that bars intersects in an X or cross manner for such pectus morphology. We describe the X or cross bar placement and its specific indications based on morphology in a series of five patients from February 2019 until December 2019 with symmetrical focal deformity along the xiphisternum and asymmetric deformity below the xiphoid. The operating time varied from 90 to 120 min. There was no significant postoperative morbidity. They are on follow-up with period ranging from 4 to 15 months from the day of surgery. Early results show the X or cross bar Nuss procedure can be safely performed to achieve a desired long-term morphological correction of symmetric deep focal xiphisternal defects or asymmetric deformity below the xiphoid.We describe a case of vigorous cough-induced left intercostal artery rupture with partial diaphragmatic tear in a 60-year-old obese male with chronic obstructive pulmonary disease. Nor-NOHA mouse He presented with left hemothorax, a rapidly spreading chest and abdominal wall hematoma, and progression of anemia. Computed tomography (CT) scan revealed a bleeding focus from the left 8th intercostal artery. CT-guided surface marking of the bleeding point was done over the chest wall. The patient underwent open thoracotomy with drainage of clotted hemothorax and ligation of bleeding intercostal artery. Incidentally, a partial diaphragm tear was detected during the surgery which was repaired. The combined presentation of cough-induced intercostal artery rupture with partial diaphragm tear is not reported earlier. Awareness of these co-existing pathologies can facilitate timely diagnosis and appropriate life-saving management.A thrombus straddling the foramen ovale is rare; and optimal management is controversial. Most of the literature on this topic is available only in the form of case reports. Here, we present a case of 30-year-old female with recent history of fibular fracture and thrombus in transit through patent foramen ovale and massive pulmonary embolism who was successfully managed with pulmonary embolectomy, extraction of serpentine thrombus straddling patent foramen ovale, and closure of patent foramen ovale.Mediastinitis is an unusual but potentially life-threatening complication of cardiac surgery. Open drainage is one of the standard therapies, but there could sometimes be potential complications. We had a patient who underwent open drainage surgery for postoperative mediastinitis, and right ventricular rupture occurred subsequently to extubation in an operation room. Retrospectively reviewed, computed tomography showed strong adhesions between the right ventricle and the posterior margin of sternum, pulling his right ventricle to the right side of his sternum. We should have noticed the risk of leaving the sternum open and performed adhesiolysis of the right ventricle and the posterior margin of sternum to prevent the devastating complication. This case illustrates the importance of recognizing the rare computed tomography sign of ventricular pulling-a predictor for right ventricular rupture after open drainage for mediastinitis.Undeterred by all the advancement in the field of cardiac transplantation, heart transplant rejection remained its mammoth quandary. Management of heart transplant recipients has drastically improved with current regimens of immunosuppressive drugs. The adverse effects of calcineurin inhibitors are lacking with the use of belatacept, which is a costimulation inhibitor that interferes with the interaction between CD28 on T cells and the B7 ligands on antigen-presenting cells. It was originally approved for use in renal transplant recipients but it has shown promising results in heart transplant recipients.Chylothorax is the accumulation of chyle in the pleural cavity that typically contains a high concentration of triglycerides. Blunt chest trauma is a rare cause. The aim of this study is to review all of the reported cases of chylothorax caused by blunt chest trauma. Available databases were explored systematically for the condition and the eligible papers were included. The literature search revealed 30 studies with 39 cases, 72.3% of the cases were male, and 21.7% of the patients were female. The age range varied between 4 and 75 years with a mean age of 35.8 years. All of the patients were diagnosed after fluid sampling from the pleural fluid by thoracentesis and/or chest tube insertion. About 71.4% of the patients were treated successfully by conservative management others (28.6%) were managed surgically. Although it is a rare condition, persistent milky drainage after blunt chest trauma should raise the suspicion of chylothorax. Pleural fluid sampling is the cornerstone of the diagnosis. In the majority of the cases, conservative treatment is quite enough.