Notes

Successive versus seo'ed lung problematic vein solitude pertaining to paroxysmal atrial fibrillation: an airplane pilot examine.
Cardiac myxomas are common and account for 50% of primary intracardiac tumors. Atypical locations of cardiac myxoma increase the risk of intraoperative iatrogenic injuries. Herein, we report a case of using three-dimensional printing (3D) to facilitate the removal of an atypical cardiac myxoma in a 63-year-old woman.

Mass in the high posterior atrial septum was confirmed through imaging. Due to the potential involvement of the mass to surrounding vital structures, 3D printing of the cardiac mass was performed. CYT387 ic50 The tumor was completely resected via median sternotomy and the resulting defect was repaired with the bovine pericardium. The patient had an uncomplicated postoperative course except for the development of sick sinus syndrome. One-year follow-up showed no tumor recurrent.

3D printing technology in patients with atypical cardiac tumors enhances our understanding of the extent of the tumor invasion and facilitates planning the operation to avoid intraoperative complications.
3D printing technology in patients with atypical cardiac tumors enhances our understanding of the extent of the tumor invasion and facilitates planning the operation to avoid intraoperative complications.
Postoperative thoracic aortic graft infection (TAGI) is a serious and potentially fatal complication. The classical approach is to replace the infected graft. However, this approach has a high mortality rate. Alternatively, treatment of TAGI without graft replacement can be performed METHOD Herein, we present a 72-year-old case with mediastinitis and graft infection after type A aortic dissection operation and successful treatment using omental flap coverage following vacuum-assisted wound closure therapy without graft replacement.

The patient had an uneventful postoperative course and remains infection-free to date.
The patient had an uneventful postoperative course and remains infection-free to date.
To describe an expedited strategy of simultaneous high-output pacing during radiofrequency ablation to achieve scar homogenization and electrical inexcitability as an approach for substrate ablation for scar-related ventricular tachycardia (VT).

Scar homogenization with additional testing for electrical inexcitability is known endpoints for catheter ablation, but achieving both can be time consuming. We describe a strategy of simultaneous pacing during radiofrequency ablation to expedite this approach.

Ten patients (age 74 ± 6 years; all men, (LV) ejection fraction of 33% ± 8%, ischemic cardiomyopathy, 9; VT storm, 7) underwent scar homogenization with electrical inexcitability to pacing (10mA, 9ms pulse width), as well as noninducibility of any VT as an acute procedural endpoint. Thirty-four VTs were inducible in 10 patients with a total of 1127 ablation lesions applied. Median ablation lesions per patient were 97 (interquartile range [IQR]
71-151), and the total ablation time was 49 minutes (IQR
45-56 minutes) with average duration per lesion of 32.2 seconds (IQR
25.8-37.8 seconds). Average power was 33 W (IQR
32-38 W), average contact force was 13g (IQR
11.9-14.6g) with a median impedance drop of 9.6 Ω/lesion (IQR
8.1-10.0 Ω). There were no ventricular fibrillation episodes using this strategy. The median procedure time was 246 minutes (IQR
214-293 minutes). Acute procedural success was seen in nine patients with 97% of VTs noninducible.

Simultaneous ablation with high output pacing to achieve scar inexcitability, when combined with scar homogenization and noninducibility of any VT may be an expeditious, safe, and effective technique for catheter ablation.
Simultaneous ablation with high output pacing to achieve scar inexcitability, when combined with scar homogenization and noninducibility of any VT may be an expeditious, safe, and effective technique for catheter ablation.
Displacement of Impella 5.0 secondary to patient movement or transportation is a well-known complication. Typically, repositioning of an Impella across the aortic valve is attempted over a guidewire. We present the first case, to our knowledge, of repositioning a dislodged Impella 5.0 without a guidewire under transesophageal echocardiography (TEE) guidance, by inducing rapid ventricular pacing to cross the aortic valve.

A 70-year-old man with low left ventricular ejection fraction underwent off-pump coronary artery bypass grafting. On 2nd postoperative day a low cardiac output state developed with increasing lactate levels and consequently the patient was taken to the cardiac catheterization laboratory for insertion of an Impella 5.0. Suddenly the Impella system failed with a rapid hemodynamic deterioration and it was successfully bedside repositioned inducing rapid ventricular pacing.

In case of accidental Impella dislodgement and fast deterioration of the patient's hemodynamic status, rapid pacing may be an option to "open" the aortic valve thus aiding quick replacement of Impella 5.0 through the aortic valve into the left ventricle under TEE guidance.
In case of accidental Impella dislodgement and fast deterioration of the patient's hemodynamic status, rapid pacing may be an option to "open" the aortic valve thus aiding quick replacement of Impella 5.0 through the aortic valve into the left ventricle under TEE guidance.Because primary skin cancers in organ transplant recipients are rare, little is known about the characteristics and risk factors for skin cancers in organ transplant recipients. We searched the Asan Medical Center database of 13 469 organ transplant recipients for cases of all skin cancers from January 1990 to December 2018. Characteristics of and risk factors for skin cancers were analyzed and compared according to the period of transplantation. Of the identified 113 patients with skin cancers, squamous cell carcinoma was the most common cancer followed by basal cell carcinoma and Kaposi sarcoma. The cumulative incidence of skin cancers at 28 years was 5.3%. Over the 10-year period from January 2009 to December 2018, the standardized incidence ratio for premalignant in situ skin lesions increased, whereas the standardized incidence ratio for skin cancers decreased. Age at transplantation and treatment with more than two immunosuppressive agents were risk factors for the development of new skin cancers in organ transplant recipients.
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