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Right-sided cardiac echinococcosis shows special clinical and surgical features beyond the rareness of echinococcosis in this position, leading to serious and life-threatening complications. We examined our cardiac hydatid cyst patients, retrospectively, and report our experience of the surgical treatment of right-sided cardiac hydatid cysts. Between 1985 and 2000, seven patients were transferred to our department from the cardiology department with a diagnosis of cystic cardiac masses which were highly suspected of being hydatid cysts. Two were males and 5 were females. In 3 patients the hydatid cyst was located in the right ventricle, and one was in the right atrium. The mean age of the patients was 37 years (ranging from 12 to 60 years). One patient had preoperative pulmonary emboli. In all right-sided cardiac echinococcosis patients, cardiopulmonary bypass was used. All cysts were cleaned after quilting the cystic cavities, and daughter cysts were removed carefully. The cavities were closed with purse-string sutures. Postoperatively, one patient had pulmonary emboli. In all patients, mebendazole was administered postoperatively. When a right-sided cardiac hydatid cyst is diagnosed, early surgical treatment should be performed under open-heart surgery conditions. During the operation, a single cannula in the superior vena cava should be used until fibrillation, and after clamping, the cannula for the pulmonary artery inferior vena cava should be inserted.

SUMMARYThe identification of risk factors for the initiation of left ventricle hypertrophy (LVH), which is an independent risk factor for cardiovascular mortality and morbidity in hypertensive patients, is very important. The objective of the present study was to identify the relationship of aldosterone with LVH and different geometrical patterns of left ventricle that develop in patients with essential hypertension.A total of 83 patients with essential hypertension (44 females, mean age, 51 ± 8 years, 39 males, mean age, 57 ± 10 years) were included in this study. Thirty-two had LVH. When evaluated according to the geometrical patterns of LVH, 18 patients had concentric LVH, 14 had eccentric LVH, and 17 had concentric remodeling. Thirty-four patients had normal left ventricle geometry. Two weeks after the cessation of antihypertensive medications, sodium, potassium, and proteinuria in 24-hour urine samples and plasma aldosterone levels and plasma renin activity were measured. Plasma aldosterone levels of the patients with LVH were found to be significantly higher (9.92 ± 6.34 ng/dL versus 5.83 ± 3.5 ng/dL, P < 0.01). The difference between plasma renin activities was not statistically significant. Linear regression analysis revealed that plasma aldosterone level and age were independent parameters increasing left ventricle mass index. The plasma aldosterone levels of patients with concentric hypertrophy of the left ventricle were significantly higher than those of patients with normal geometry and concentric remodeling. There was no significant difference between plasma renin activities. Twenty-four hour urine protein concentrations of the patients with LVH were found to be significantly higher and sodium to be significantly lower.Plasma aldosterone levels seem to be correlated with LVH especially with concentric hypertrophy of the left ventricle in patients with essential hypertension. (Jpn Heart J 2004; 45: 807-821)

To date, technical experience reported in the literature is very limited on angioplasty in patients with anomalous coronary arteries. Balloon angioplasty may be a more favorable approach for revascularization in these vessels. A major factor is selection of the guiding catheter. The authors report 4 patients with severe atherosclerotic lesions of anomalous coronary arteries who underwent coronary angioplasty of the anomalous vessel. Three patients had an anomalous circumflex artery and 1 had an anomalous right coronary artery. Angiographic and clinical success were achieved in 3 patients.

OBJECTIVES:Acute ST-elevation myocardial infarction is associated with ventricular dysfunction due to ischemia-induced progressive myocardial damage. The decrease in ventricular compliance causes left atrial dilatation and stretching of the atrial myocardium, which are the main stimuli for the secretion of atrial natriuretic peptide. The aim of this study was to evaluate left atrial dimensions and atrial natriuretic peptide levels in patients early after their first acute ST-elevation myocardial infarction and assess the probable interaction between coronary lesions and these measurements.METHODS:A total of 110 patients with acute myocardial infarction and 50 controls were studied. Plasma atrial natriuretic peptide was measured at admission. Left ventricular function, diameter, and volume index were evaluated using transthoracic echocardiography. Gensini and vessel scores of the patients who underwent coronary angiography were calculated.RESULTS:Plasma atrial natriuretic peptide in the patients with myocardial infarction was increased compared with that in controls (3.90±3.75 vs. 1.35±0.72 nmol/L, p<0.001). Although the left atrial diameter was comparable in patients and controls, the left atrial volume index was increased in patients with acute myocardial infarction (26.5±7.1 vs. 21.3±4.9 mL/m2, p<0.01). Multivariate regression analysis showed a strong independent correlation between the left atrial volume index and the plasma atrial natriuretic peptide level (β = 0.23, p = 0.03).CONCLUSIONS:The left atrial volume index and plasma atrial natriuretic peptide level were correlated in patients with acute myocardial infarction.