Stentless bioprosthetic aortic valve replacement after a homograft root replacement: Toronto SPV implantation after a homograft root

Stentless bioprosthetic valves for the aortic position offer excellent hemodynamic characteristics, making them an attractive choice ahead of other valve prostheses. We present a unique case in which a patient underwent aortic valve replacement with a stentless porcine valve and mitral valve repair for severe aortic and mitral regurgitation 1 year after a homograft root replacement for acute aortic endocarditis. The rationale for our approach is outlined in the context of current surgical trends.     

Pulmonary homograft endocarditis after Ross procedure

We report the case of a 36-year-old patient who experienced an isolated acute pulmonary homograft endocarditis two years after a Ross procedure for aortic valve infective endocarditis.     

Gallbladder volvulus: two cases report

The authors report two cases of gallbladder volvulus. The diagnosis of this rare pathology is mainly identified preoperatively. Ultrasonographic findings include a "floating gallbladder" with thickened hypoechoic walls. The treatment is emergency cholecystectomy.     

Vesical endometriosis: report of two cases

Endometriosis affecting the urinary tract is very rare and the most common site of involvement is urinary bladder. The clinical features are urgency and frequency, hipogastric pain and hematuria. Cistoscopic examination is the most valuable diagnostic test but definitive diagnosis requires histologic confirmation. We report 2 cases of endometriosis in 2 young women, one with previously cesarean section, in which surgical treatment was effective. After 1 and 3 years of follow-up respectively the patients remain assymptomatic.     

Epignathus: a report of two cases

Two cases of epignathus are presented. The classification and clinical and radiological diagnoses are reviewed. Epignathi are rare embryological tumors, but with better preoperative assessment and awareness, safe surgical excision can be carried out. A careful long-term follow-up with regular examinations is essential to detect any residual lesions or extensions of the original embryological malformation.     

Perineal testis: report of two cases

Perineal testis is a very rare congenital anomaly. Since the first case of the disease reported by John Hunter in 1786, more than 113 cases have been reported in the English literature, and 13 cases have been reported in the Japanese literature. The 14th and 15th cases are presented herein. Case 1 was a 38-year-old man who came to our clinic with the chief complaint of discomfort of the perineum. Physical examination revealed emptiness of the left scrotal contents and there was a small hen's-egg growth mass corresponding to the normal testis at the left side of the perineum. Excretory urogram showed no abnormality. Orchiopexy to the left scrotum was performed. On surgical exploration the gubernaculum testis was found obviously fixed to the perineum. Histologic examination of the biopsied ectopic testis revealed mild hypospermatogenesis. Case 2 was a 2-year-old boy who was referred to our clinic with the chief complaint of emptiness of the right scrotal contents. Physical examination revealed a bean-sized mass corresponding to the normal testis at the right side of the perineum. Orchiopexy to the right scrotum was performed. On surgical exploration the gubernaculum testis was found to be fixed to the perineum.     

Spontaneous pneumomediastinum: report of two cases

Spontaneous pneumomediastinum (SPM) is an uncommon, benign, self-limited disorder that usually occurs in young adult males without any apparent precipitating factor or disease. SPM responds extremely well to conservative treatment, without recurrence in the great majority of cases. In this report, two patients who were admitted for SPM are discussed together with the associated literature.     

Waugh's syndrome: report of two cases

The association of intussusception and intestinal malrotation has been reported rarely in the literature. This association is called Waugh’s syndrome. The authors report 2 cases of Waugh’s syndrome and discuss diagnostic features and treatment methods.