Journal of cardiac surgery
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Adults with congenital heart disease (CHD) and coronary artery disease (CAD) have unique clinical manifestation due to the coexistence of intracardiac anomalies and CAD. Case reports are rare in surgical management of CHD combined with CAD. Our goal is to study the outcome of surgical intervention of CHD and CAD concomitantly. ⋯ Surgery for adult patients who had CHD with CAD was a safe and effective management. OPCAB with intraoperative device closure of ASD was a reasonable approach for some selective patients.
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Takotsubo cardiomyopathy is increasingly being recognized in the perioperative period. To date, there have been only three previous cases involving cardiac surgery reported and this represents the fourth case. ⋯ It appears that the syndromes course in cardiac surgical patients is self-limited. This syndrome must now be considered in the differential diagnosis of postcardiotomy cardiac failure.
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Paraplegia is a serious complication of descending thoracic or thoraco-abdominal aortic aneurysm (DTAA or TAAA, respectively) surgery. The functional integrity of the spinal cord can be monitored with intraoperative motor-evoked potentials (MEPs). Herein, we evaluated the results and adequacy of MEP monitoring. ⋯ Although intraoperative monitoring of MEP has been shown to be effective in detecting cord ischemia during DTAA or TAAA surgery, it is not definitive and cannot predict all neurologic deficits. Other postoperative preventive strategies such as CSF drainage and maintaining a high blood pressure are important to prevent paraplegia.