Because of the high percent of the variations, hemodynamically significant during unilateral SCP, a suggestion for routine preoperative CT-angio of CoW could be made. Furthermore, an intraoperative follow-up with NIRO, transcranial Doppler, EEG, and so forth could also be recommended.

No abstract

Berlin Heart INCOR system is a left ventricle assist device (LVAD), which generates a laminar blood flow. Its inflow canula is implanted in the heart apex, while its outflow canula-in the ascending aorta. In the present work a new alternative technique for implantation of the device's inflow canula is reported. The suggested technique is quicker and easier than the conventional one. It saves time and gives excellent results. After the implantation no unusual events like thrombosis, anastomosis malfunction, etc., are observed.

63 patients with cardiac tumors underwent operative treatment between January 1970 and December 1988. Three additional patients refused the operation, despite the large left atrial myxomas and obstruction of the mitral valve, recognized by echocardiography. 62 patients had benign tumors: the only malignant neoplasm was a fibrosarcoma, originating from the right ventricle. Myxomas were found in 57 patients: 54 were located in the left and 2 in the right atrium. In one case the myxoma originated from the left ventricle. The hospital mortality of the 22 patients who underwent excision of cardiac myxomas between 1970 and 1984 was 18.18% (4 deaths), and 2.44% (1 death) of 41 patients operated on from 1984 to 1988 for cardiac tumors (35 of them with myxomas). During the follow-up time of 6 to 140 months, recurrence of myxomas occurred in only one patient, 4 years after surgery for multifocal myxoma in the left atrium. Surgical excision of the myxoma is the only acceptable therapy able to cure. Without surgical treatment, the medium and long-term prognosis is fatal. Therefore once the cardiac myxoma is identified by two-dimensional echocardiography, the tumor should be removed even in patients without symptoms. The removal of myxomas doesn't require excision of the full thickness of the interatrial septum or ventricular wall. The risk of postoperative arrhythmias after extensive excision increases. Conduction disturbances may be related to the resection of a large area of the atrial septum or wall. No recurrences have been registered after less radical procedures-- removal with excision only of the underlying endocard.

Although cardiovascular malformations are common in patients with Turner syndrome, dissecting thoracic aortic aneurysm is unusual. Stent-graft repair would appear to be feasible in this situation, but long-term implantation in young patients has not been explored.