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Combined atrial septal defect and pulmonic or aortic stenosis are relatively uncommon conditions in adult patients, with few reported cases of percutaneous treatment. We present two patients with secundum type atrial septal defect and concomitant pulmonic or aortic stenosis and their treatment by transcatheter techniques.

ObjectivesTo determine the long-term and transplantation-free survival of all patients after atrial correction of transposition of the great arteries (TGA) in the Czech and Slovak republics, including its preoperative and perioperative determinants.MethodsRetrospective analysis of all 454 consecutive patients after atrial correction of TGA was performed. Of these, 126 (27.8%) were female, median age at operation was 7.4 months (Q1 5.3; Q3 13.3) and 164 (36.1%) underwent the Mustard procedure. The relationships between age, weight, the complexity of TGA, operative technique, additional surgical procedures, immediate postoperative presence of tricuspid regurgitation and revision procedures during follow-up to major composite outcome, as such defined as long-term and transplantation-free survival, were tested.ResultsEarly 30-day mortality did not differ between the Mustard (9.76%) and Senning (8.97%) cohorts (p=0.866). The long-term and transplantation-free survival, which differed between the Mustard and Senning cohorts in favour of the Senning procedure (HR 0.43; 95% CI 0.21 to 0.87), was shorter in complex TGA (HR 2.4; 95% CI 1.59 to 3.78) and in complex surgical interventions (HR 3.51; 95% CI 2.31 to 5.56). The immediate presence of at least moderate tricuspid regurgitation after correction was associated with a shorter long-term and transplantation-free survival in the univariate but not in the multivariable model.ConclusionsThe lower long-term survival of patients after an atrial switch operation of TGA in the Czech and Slovak republics is associated with greater complexity of TGA, complex surgical interventions and application of the the Mustard operative procedure.

OBJECTIVES The prevalence of infectious endocarditis (IE) in intravenous drug users (IDUs) is increasing, and the number of patients who need surgery is also rising. Relatively little is known about the short-term and long-term outcomes of these operations. METHODS This study is a retrospective analysis of our institutional results, focussing on risk factors for perioperative death, major adverse events and long-term survival. A total of 50 of the 66 (75.75%) patients had postoperative follow-up, and the mean follow-up time was 53.9 ± 9.66 months. Patients were divided into 2 groups depending on whether they were having their first operation or were being reoperated for recurrent IE. RESULTS From March 2006 to December 2015, a total of 158 patients underwent surgery for IE; 72 (45.6%) of them were identified as active IDUs. The operative mortality in IDUs was 8.33% (6 patients), with no significant difference between the 2 groups (P = 0.6569). Survival rates at 1 year, at 3 years and at the end of follow-up were 92%, 72% and 64%, respectively. There was significantly worse survival of patients with recurrent IE (log-rank test, P = 0.03). CONCLUSIONS Although the short-term results of operation for IE in IDUs are good, long-term outcomes are not satisfactory. The survival of patients with recurrence of IE caused by return to intravenous drug use is significantly worse.