Lipomatous Hypertrophy of the Interatrial Septum: A Rare Cause of Right Ventricular Impairment

Abstract We report a case of a 70‐year‐old woman admitted with symptoms of decompensated heart failure. Magnetic resonance imaging revealed lipomatous hypertrophy of the interatrial septum with partial upper right atrial inflow obstruction, partial obstruction of the right ventricular outflow tract, and excessive accumulation of adipose tissue in the pericardial space. The patient underwent excision of the septal lipomatous mass, which relieved the right ventricular outflow obstruction. (J Card Surg 2010;25:171‐174)     

Femoral neck fracture following intramedullary nailing with misplacement of an end cup: report of two cases

Femoral neck fracture is an unusual complication of intramedullary fixation of a broken femur. We report on two cases of femoral neck fractures attributed to misplacement of an end cup and subsequent invasive maneuvers in an effort to remove it. Iatrogenic fractures of the femoral neck during or after intramedullary nailing are reported in the medical literature. Authors associate it with many possible technical mistakes performed during the procedure, yet no complications after missed end cup placement were noted. We suggest that the fractures described below were a consequence of injury to the vascular supply and bone stock of the initially intact femoral neck.     

The effectiveness of deep brain stimulation with intraoperative spatial mapping of subthalamic nucleus using intraoperative microrecording. Report of two cases

The aims of the study were to present the surgical technique of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) and to analyze our experience with the MedtronicStealthStation Treon neuronavigation system and Framelink 4.1 software in targeting STN using single-unit extracellular action potentials (microrecording). The prospective study included 2 patients with bilateral STN DBS. The STN boundaries were mapped using microrecording, without microstimulation and recording of kinesthetic cells. For macrostimulation the longest trajectory with neuronal activity characteristic of STN was chosen. The patients were assessed using Unified Parkinson's Disease Rating Scale UPDRS version 3 and Schwab and England Scale. Postoperatively we did not notice intracerebral haemorrhage. Also there were no transient or permanent side effects. The mean number of microelectrode tracts was 4 per STN. Framelink 4.1 software is reliable to plan individual microelectrode trajectories and help avoid the intraparenchymal vessels.     

Congestive heart failure and continuous murmur in patient after lumbar disc surgery--a case report

We present a case of a 61-year-old female who was admitted to the hospital with symptoms of congestive heart failure. Diagnosis of arteriovenous fistula was suggested by the echocardiographic signs of high-output state and a continuous murmur heard especially close to the surgical scar from an intervention on the L4-L5 disc that the patient had undergone eight months before. Aortography confirmed arteriovenous fistula between the right common iliac artery and inferior vena cava. After surgical closure of the fistula, normal cardiac function was restored.     

Different reactivity of the proximal and distal segments of the radial artery to vasoconstrictors in patients undergoing coronary artery bypass grafting

BACKGROUND: Complete arterial revascularisation using the radial artery (RA) is an attractive alternative to venous graft implantation for the coronary artery bypass grafting (CABG). In spite of the favourable long-term results of this approach, the sensitivity of RA to vasoconstriction and spasm is still limiting its use. It has been suggested that vasospastic properties of the artery may differ depending on the location (proximal or distal). AIM: To compare the vasoreactive properties of proximal and distal sections of RA grafts. METHODS: Proximal and distal segments of RA were obtained from 27 patients undergoing CABG and isometric recordings of changes in smooth muscle force were performed mounted in the organ bath. Responses to cumulatively increasing concentrations of phenylephrine (PE), angiotensin II (AT-II), prostaglandin F2 (PGF2) and endothelin-3 (ET-3) were evaluated. RESULTS: Both proximal and distal segments of RA constricted in response to KCl, PE, AT-II, PGF2 and ET-3. Proximal segments demonstrate significantly greater spastic response to KCl, as well as to receptor-mediated agonists PE and more importantly vasoactive peptide AT-II. These differences remained statistically significant after correcting for vessel size and weight. In contrast, reactivity of both segments of RA to increasing cumulative doses of PGF2 and ET-3 was similar. CONCLUSION: Proximal segments of the radial artery are more susceptible to vasoconstriction induced by PE and AT-II, which should be taken into consideration in the clinical setting of CABG surgery. Increased muscle content in this segment does not fully explain this difference, which may result from varying receptor density and properties.     

Light-controlled self-assembly of reversible and irreversible nanoparticle suprastructures

Nanoparticles (NPs) decorated with ligands combining photoswitchable dipoles and covalent cross-linkers can be assembled by light into organized, three-dimensional suprastructures of various types and sizes. NPs covered with only few photoactive ligands form metastable crystals that can be assembled and disassembled "on demand" by using light of different wavelengths. For higher surface concentrations, self-assembly is irreversible, and the NPs organize into permanently cross-linked structures including robust supracrystals and plastic spherical aggregates.