Combined resection of the superior vena cava (SVC) is sometimes challenging during radical surgery for malignant mediastinal tumors. We report a case of a 21-year-old man with a malignant mediastinal germ cell tumor who underwent surgical resection with SVC reconstruction involving an extra-thoracic temporary bypass from the right brachiocephalic vein to the right atrium using venous return cannula because of left brachiocephalic vein occlusion. This is a convenient and safe optional technique providing an excellent intra-thoracic surgical view for temporary SVC bypass in patients with invasive malignant mediastinal tumor associated with venous return via the hemi-lateral brachiocephalic vein.
  The study aims to compare the clinical outcomes of patients with juvenile myasthenia gravis (JMG) who underwent robotic thymectomy with that of those who only received medication therapy.
 
  We retrospectively reviewed patients who visited our institution for the diagnosis or treatment of MG with an age at onset younger than 18 years. Patients who underwent thymectomy comprised the surgical group and those who received only medication therapy comprised the nonsurgical group. The clinical outcomes were assessed according to the Myasthenia Gravis Foundation of America Post Intervention Status.
 
  Forty-seven patients (35 female 12 male) were included as the surgical group and 20 patients (15 female 5 male) comprised the nonsurgical group. Significant differences were observed between the surgical and nonsurgical groups in antibody against acetylcholinesterase receptor (91.5% versus 65%, p=0.012), disease duration (16 [7-25] months versus 96 [42-480] months, p<0.001) and corticosteroids requirement (53.2% versus 15%, p=0.004) at baseline. Kaplan-Meier analysis showed a higher cumulative probability of complete stable remission (CSR) in the surgical group (p=0.002), compared with that in the nonsurgical group. Moreover, thymectomy (HR 3.842, 95%CI 1.116-13.230, p=0.033) and age at onset (HR 0.89, 95%CI 0.80-0.99, p=0.037) were still associated with the achievement of CSR in the multivariable analysis. Furthermore, a significant steroid-sparing effect was only observed in the surgical group, but not in the nonsurgical group.
 
  Robotic thymectomy seems to be more effective than medication therapy on JMG in terms of inducing remission and reducing the use of corticosteroids.
 Robotic thymectomy seems to be more effective than medication therapy on JMG in terms of inducing remission and reducing the use of corticosteroids.Mechanical support of patients with superior cavopulmonary connection (SCPC) is challenging; multiple factors contribute to SCPC failure elevated pulmonary vascular resistance, aorto-pulmonary collateral flow, veno-venous collaterals, ventricular dysfunction, and atrioventricular valve regurgitation. We report 2 cases of conversion from a single ventricle circulation to biventricular mechanical support by re-establishing caval continuity. Both patients have demonstrated recovery of end-organ function and participation in rehabilitation. This method of support results in improved systemic venous pressures and pulmonary blood flow compared with systemic mechanical circulatory support with a cavopulmonary connection and transfers some of the complexity of the transplant to the ventricular assist device implant.Optimal timing of surgical repair for patients diagnosed with a post-myocardial infarction ventricular septal rupture (post-MI VSR) is controversial. Urgent surgical intervention to prevent hemodynamic decompensation must be balanced against delayed repair to allow for tissue stabilization and increased likelihood of a successful outcome. We report the use of an axillary Impella 5.5 temporary left ventricular assist device to aid in hemodynamic stabilization, shunt fraction reduction, and tissue maturation with eventual definitive surgical repair in a patient that presented with a post-MI VSR and cardiogenic shock.The Annals of Thoracic Surgery published a seminal article by the late Dr Amram ("Ami") Cohen and his associates entitled "Save a Child's Heart We Can and We Should" in 2001. It stressed the moral imperative and challenge of pediatric heart care in the developing world. The current article presents an update of the past 25 years of the history, experience, and international ramifications of 1 institution and 1 UN-recognized Israeli organization.Transcatheter aortic valve replacement is a well-established therapy for severe aortic stenosis (AS) in patients with high surgical risk. Transcatheter mitral valve replacement just recently emerged as a novel modality to treat severe mitral regurgitation (MR). We present the first case of a transcatheter, transapical native double valve replacement for severe AS and MR. Our case shows that it is a safe and effective method, not requiring cardiopulmonary bypass and drastically reducing the procedural time. Therefore, patients with significant comorbidities that portend a high surgical risk with poor long-term outcome may stand to benefit from this minimally invasive procedure.We present an exceedingly rare case of right ventricular outflow tract (RVOT) obstructing mass in an adult patient, who presented with dyspnea and dizziness and trans thoracic echocardiography and CT angiogram of the chest showed a big mass in the right ventricle obstructing the outflow tract. Dual right ventriculotomy and right atriotomy surgical approach to completely resect the mass from the inter ventricular septum (IVS) and subsequently confirmed histopathologically as mature cystic teratoma.Trifecta valve has been reported to have valve dysfunction months to years after operation, However, there was no reports of intraoperative valve dysfunction.  https://www.selleckchem.com/products/shield-1.html  A 73-year-old man with aortic stenosis underwent aortic valve replacement using a 21-mm Trifecta valve GT. Hemodynamics was collapsed after aortic declamp because of severe regurgitation. We forced to replace another biological valve. We noticed that the removed valve's mount post was open outward more than usual. Despite the progress of the biological valve, dysfunction like this case can occur during operation and it should re-operate immediately even if there is no obvious tear or deformity.