Surgical treatment of annulo-aortic ectasia

Replacement of the aortic valve and the entire ascending aorta (modified Bentall's technique) was performed in 11 patients with annulo-aortic ectasia. Nine patients are alive and well postoperatively. In comparison with our previous surgical technique, by which the aortic root was left remaining without removal, the new technique required less bypass time, including less coronary perfusion time and less amount of intraoperative bleeding than the cases handled by the previous technique, whereas amount of postoperative bleeding in both groups was not significantly different. Details of the new technique were described and the advantages of this technique are security of intraoperative hemostasis as well as shortened operation time. The Björk-Shiley tilting disc prosthesis was really convenient for this surgical technique because of its low profil architecture, and also this prosthesis gives excellent postoperative results in combination with the new surgical technique.

Electrocardiogram of secumdum type atrial septal defect simulating endocardial cushion defect

Three groups of patients are identified in the series of secumdum atrial septal defect with left axis deviation in an analysis of 910 patients of secundum atrial septal defect with or without other accompanying anomalies: 1) 12 patients with isolated ostium secumdum defect; 2) 5 patients with associated prolapse of posterior leaflet of the mitral valve; 3) 4 patients with associated hypertrophic cardiomyopathy and/or single (left) coronary artery. The findings of these 21 patients with proved secumdum atrial septal defect are analysed. The combination of such anomalies should be considered in the differential diagnosis of primum endocardial cushion defect from the electrocardiographic viewpoints.