Familial myxomas in four siblings

Familial myxomas of the heart are very rare, with only two previous reports noted in the literature. This report documents four siblings with myxomas, and three of these patients had two or more myxomas. One sibling had four myxomas excised. The clinical findings, history, examination, and surgical treatment are described.

Carotid sinus syndrome: new surgical considerations

1. Direct surgical denervation of the carotid sinus would appear to offer the best long-term results for carotid sinus syncope. 2. Carotid sinus denervation should be done under temporary cardiac pacing for safety and for completeness of denervation. 3. Arteriography is indicated to eliminate those cases of cerebral vascular insufficiency that might mimic carotid sinus syndrome. Credit must be given to Dr. R. Hughes, Clearfield, Pa., who recognized this diagnosis and referred the patient for therapy.

Congenital heart disease in adults: surgical management

Fifty patients between 17 and 62 years of age who had been operated on in the past five years were reviewed. Of 24 patients with atrial septal defects, pulmonary hypertension and dysarrhythmia, which occurred more frequently in the older patients, contributed to marked disability in 54 percent and congestive heart failure in 25 percent. Correction carried minimal risk. All seven patients with coarctation of the aorta were previously hypertensive, and two remain moderately hypertensive after repair. Three patients with Ebstein anomaly were severely disabled but have improved after plastic repairs, although mild tricuspid insufficiency persists. The eight patients with ventricular septal defect were asymptomatic, but the rest, treated for tetralogy, pulmonic stenosis, patent ductus arteriosus, and coronary artery fistula, were moderately symptomatic. Clinical improvement has been achieved and sustained in all patients following repair. The results confirm that congenital heart malformations can be corrected with a good outcome in adults.

Direct selective myocardial revascularization by internal mammary artery-coronary vein anastomosis

In this report, we shall describe our work with retrograde coronary perfusion, first in mongrel dogs and then in 6 patients. The left internal mammary artery (LIMA) is anastomosed to the left anterior descending coronary vein (LADV) to provide myocardial perfusion. This procedure may be of great value in the treatment of patients who are not suitable candidates for direct coronary bypass grafting, i.e., those who have diffuse atherosclerosis, with poor or no runoff of the left anterior descending coronary artery (LADA),but who have satisfactory left ventricular contraction.