Initial clinical experience indicated that constructing geometrically perfect cusp-like configurations was uncomplicated and implantation of the moulded autologous pericardial cusps restored adequate aortic valve competence. We believe that the simplicity and reproducibility of this approach may assist in the dissemination of aortic cusp reconstruction procedures.

A solitary fibrous tumor of the kidney with thrombus extended into the inferior vena cava and right atrium is very rare. The current surgical approach is to combine intra-abdominal and cardiac surgery with cardiopulmonary bypass. We describe a rare case of renal solitary fibrous tumor extended to the inferior vena cava and right atrium, treated with urgent cardiac surgery using deep hypothermic circulatory arrest one month after an inappropriate right nephrectomy because of the development of cavo-atrial obstruction symptoms.

Objectives Pulmonary dysfunction is a recognized postoperative complication that may be linked to use of cardiopulmonary bypass. The off-pump technique of coronary artery bypass aims to avoid some of the complications that may be related to cardiopulmonary bypass. In this study, we compared the influence of on-pump or off-pump coronary artery bypass on pulmonary gas exchange following routine surgery. Methods Fifty patients (mean age 60.4 ± 8.4 years) with no preexisting lung disease and good left ventricular function undergoing primary coronary artery bypass grafting were prospectively randomized to undergo surgery with or without cardiopulmonary bypass. Alveolar/arterial oxygen pressure gradients were calculated prior to induction of anesthesia while the patients were breathing room air, and repeated postoperatively during mechanical ventilation and after extubation while inspiring 3 specific fractions of oxygen. Results Baseline preoperative arterial blood gases and alveolar/arterial oxygen pressure gradients were similar in both groups. At both postoperative stages, the partial pressure of arterial oxygen and alveolar/arterial oxygen pressure gradients increased with increasing fraction of inspired oxygen, but there were no statistically significant differences between patients who underwent surgery with or without cardiopulmonary bypass, either during ventilation or after extubation. Conclusions Off-pump surgery is not associated with superior pulmonary gas exchange in the early postoperative period following routine coronary artery bypass grafting in patients with good left ventricular function and no preexisting lung disease.

Background A solitary fibrous tumor (SFT) of the kidney with thrombus extended into the inferior vena cava (IVC) and right atrium (RA) is very rare. Methods and conclusion We reported here an extremely case of right renal SFT extended to the IVC and RA, treated late with an urgent RA mass removal and IVC thrombectomy.

Background Surgical pulmonary thromboendarterectomy has been established as the treatment of choice for chronic thromboembolic pulmonary hypertension. We conducted a survey among Asia-Pacific cardiothoracic surgeons to examine their current practice demographics and reflect their views on the future prospects for pulmonary thromboendarterectomy surgery. Methods All cardiothoracic surgeons who were registered on the CTSNet.org website and based in the Asia-Pacific region were invited to participate in an online survey. The electronic questionnaire was completed by 172 (6.3%) surgeons. Responses were recorded anonymously and tabularized as absolute figures and fractions. Results Pulmonary thromboendarterectomy surgery has been performed by few Asia-Pacific surgeons and in small numbers of patients, but survival rates and functional outcomes were satisfactory in most experiences. Failures were thought to have resulted primarily from the difficulty in selecting suitable candidates for surgery. The need for greater clinical experience was clear, yet this might be hampered by the limited recognition of pulmonary thromboendarterectomy surgery as a potential cure for chronic thromboembolic pulmonary hypertension. Most surgeons considered that this procedure should be restricted to designated expert centers, and acknowledged the need to organize dedicated regional meetings where clinical practice guidelines can be established and updated as appropriate for regional healthcare facilities. Conclusions Although much effort is needed before pulmonary thromboendarterectomy surgery becomes widely adopted in the Asia-Pacific region, many surgeons and centers are already seeking its implementation. Designating expert centers, bringing together a regional working group on pulmonary thromboendarterectomy, and establishing clinical practice guidelines as appropriate for regional healthcare facilities were recommended.