Argentine Journal of Cardiovascular Surgery

Left gonadal vein transposition in the nutcracker syndrome

Leonela S. Aloy — 2025-08-15

The cause of pelvic congestion symptoms is usually nutcracker syndrome. We present
the clinical case of a 58-year-old female patient who consulted for lumbar and left flank
pain, microhematuria, and dyspareunia of 10 years of evolution. Angiotomography
showed compression of the left renal vein at the level of the aortomesenteric
compass, associated with pelvic varices. It was resolved with surgical treatment by
transposition of the left gonadal vein to the inferior vena cava and embolization of
the distal bed with coils and foam. The patient had an uncomplicated postoperative
period with complete resolution of symptoms.

Surgical resolution of mechanical prosthetic dysfunction in a patient with a porcelain aorta

Rutilio Daniel Jiménez Espinosa — 2025-08-15

We present a clinical case with a satisfactory surgical outcome of a patient in the seventh decade of life with a diagnosis of dysfunction of a mechanical valve prosthesis in the aortic position and with a calcified aorta (porcelain aorta) from the root to the bifurcation of the iliac arteries. The decision for surgical replacement of the aortic valve was based on the presence of thrombosis and pannus, which, in addition, were the cause of severe aortic stenosis and secondary mitral insufficiency, also severe.
This scenario is not accounted for in cardiovascular surgical risk scales, such as the EuroSCORE, the Society of Thoracic Surgeons (STS) risk scale, or the Parsonnet scale, among others. This adds a further risk for this procedure, as this fully calcified aortic morphology increases the predisposition for aortic dissection or rupture. For this reason, the repair is difficult because there is no adequate plane for the coaptation of the surgical suture. In this patient, age, the presence of comorbidities such as chronic renal failure, severe pulmonary hypertension, the need for reoperation, and tissues in poor condition are added as risk factors, despite which the postoperative result was satisfactory.

Ventricular myxoma

José Miguel Quintero — 2025-08-15

Myxomas are benign cardiac tumors predominantly located in the left atrium and are more common in women aged 30 to 60 years. This article presents the case of a 36-year-old woman with a complex medical history who was diagnosed with an incidental finding of an intraventricular myxoma. Imaging studies, including echocardiogram and MRI, revealed cardiac masses. During surgery, lesions were found in the right atrium and a mass in the left ventricle. Pathology confirmed the diagnosis of cardiac myxoma, suggesting a possible association with Carney syndrome due to the patient's history. This case highlights the rarity and complexity of myxomas, underscoring their significance in clinical practice and the necessity for a multidisciplinary approach to facilitate early diagnosis and treatment.

Resolution of annular mitral disjunction through minimally invasive surgery

Ludmila Rachinsky — 2025-08-15

We present the case of a 60-year-old patient with a history of hypertension, diagnosed with mitral insufficiency in the context of functional class 3 dyspnea.
Mitral annular disjunction is a structural anomaly characterized by the separation of the myocardium of the left ventricle and the mitral annulus that supports the posterior leaflet during systole. A strong link between mitral annulus disjunction and arrhythmogenic valve prolapse is recognized in this entity.

First case of branched thoracic endograft to the subclavian artery in Colombia

Julio César Daza — 2025-08-15

This case report describes an 83-year-old female patient with a history of recovered heart failure and multiple comorbidities, presenting a high risk of sudden cardiac death. She was referred to after experiencing a cardiogenic syncope, which led to the
placement of a bicameral pacemaker. Additionally, a fusiform aneurysm was detected in the descending aorta, near the left subclavian artery. Treatment was performed via endovascular intervention using a second-generation device with a branched stent in the left subclavian artery, yielding favorable good outcomes.