Browsing by Author "Mikić, Aleksandar (57214281171)"

Introduction The implantable device for mechanical support of the left ventricular circulation (LVAD) is widely applied as a therapeutic option for survival and improvement of the quality of life in patients with the end-stage heart failure. The objective of our paper was to present the implantation of the aforementioned device together with the aortic valve replacement in the same procedure. Case outline The patient was admitted to the hospital during his terminal stage of heart failure, with ejection fraction of 18%. The ergospirometry test showed that the maximum VO2 was 10.1 ml/kg/min. Because the medicament therapy hadn’t provided adequate results, the LVAD device was implanted as a bridge until transplantation. Due to severe aortic insufficiency, the aortic valve was concomitantly replaced with bioprosthesis in order to prevent the negative effect of this valvular disease on pump work and clinical outcome. Conclusion This case report confirms that LVAD implantation with the correction of a significant aortic insufficiency is a procedure with satisfactory short-term and long-term results. © 2019, Serbia Medical Society. All rights reserved.

Introduction. Endocarditis is the most common cardiovascular manifestation of brucellosis with high mortality rate. Brucella is less accesable to antibiotic (but not for all) and relapse can occur after a various period of clinical latency. Case report. A 55-year-old farmer was diagnozed with acute systemic Brucella infection in May 2008 and treated with antibiotic therapy in regional hospital for two months and for three months after discharge. He began to feel myalgia, arthralgia, malaise, shortness of breath, abdominal pain, vomiting, diarrhoea and lost weight eight months after initial symptoms occured. Because symptoms progressed he was admitted to our hospital in February 2009. Based on a combination of epidemiological, clinical data (on admission he was catchetic, adynamic, dyspneic, hypotensive 80/50 mmHg, fever up to 39.5°C), positive serological Wright test for brucellosis (1: 5,120), and echocardiographic examination findings, the diagnosis of very severe relapse of brucellosis with mitral valve endocarditis, complicated with perforation of anterior mitral leaflet, severe mitral regurgitation and pulmonary hypertension was established. He was treated with a combined triple antibiotic therapy (vancomycin, ciprofloxacin and gentamicin, and swiched to regimen with doxycycline, gentamicin and imipenem, replacing gentamicin by rifampicin) for 4 weeks and for the next 2 weeks was receiving trimetoprime/sulfamethoxazole and rifampicin. The patients' condition was improved and he was operated. The diagnosis of infective endocarditis was confirmed intraoperatively. Mitral valve replacement was performed, and combined triple antibiotic treatment (amikacin + ciprofloxacin + cefazolin, for 2 weeks and cephazolin + doxycycline + rifampicin, for 2 weeks) was continued, following with two antibiotics (doxycycline + rifampicin) for 5 months. The patient completely recovered without any signs of infection 30 months postoperatively. Conclusion. A combined antibiotic therapy and surgery reduce complications and mortality associated with Brucella endocarditis and improve quality of patients' life.

Introduction. Heart injuries can be classified as penetrating and non-penetrating (blunt). Penetrating wounds are usually caused by stabbing with a piercing object, weapon or projectiles - missiles. The right atrium is damaged in most cases, because of its anatomical position - making the most of the anterior side of the heart. Morbidity caused by stabbing injuries to the heart is 20%-30%, while piercing wounds cause 30%-60% of deaths. Case report. A 28- year-old patient was admitted to our clinic with acute ischemia of the extremities. Angiography revealed a bullet in the right common femoral artery, occluding it. The patient denied having any piercing or shooting wound to his leg, but he said that four years before he had been shot to his chest. Echocardiography revealed an atrial septal defect of secondary type. An event reconstruction revealed that, four years after shooting, the bullet was displaced from the heart to the right common femoral artery. Conclusion. This case report is unique because of the rare type of injury, time that passed from the injury, the way bullet entered the artery (via atrial septal defect) and especially the success of both surgical procedures (embolectomy and repair of atrial septal defect).

Introduction: Cardiac hemangiomas of the right ventricle are very rare and mostly asymptomatic benign tumors. The surgical excision is the first line treatment. Case report: We report a case of 69-year-old woman with an asymptomatic arteriovenous hemangioma of the right ventricle. The complete surgical excision was performed with the use of cardiopulmonary bypass and the patient was discharged on the postoperative day 6 after the uneventral postoperative course. There was no relapse during the six-month follow-up. Literature review revealed totally 35 cases of this tumors including our case Conclusion: Described procedure can be performed safely with the excellent long-term results. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.