Journal of cardiac surgery
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Isolated coronary artery fistula in the newborn is a very rare congenital anomaly. When symptomatic, treatment options include surgical management with ligation and/or patch closure or transcatheter coil embolization. We describe the case of a newborn with symptomatic left coronary-right ventricular fistula, which was managed operatively with off-pump ligation and on-table angiogram for confirmation of fistula obliteration and normal distribution of flow in the coronary artery. We point out the advantages of on-table angiography to evaluate and potentially treat residual structural pathology after cardiac surgery.
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In this article, the hemodynamic, humoral, and immunological perturbations following brain death (BD) are going to be discussed in a stepwise manner. ⋯ Delineation of the mechanisms responsible for donor heart dysfunction (DHD) would be presented. Furthermore, an attempt would be made to apply this knowledge into the clinical practice in order to increase the suitability of donor hearts for transplantation.
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Case Reports
Unexpected persistent left superior vena cava and absent right superior vena cava in situs solitus patient.
We, herein, report a patient with persistent left superior vena cava with enlarged coronary sinus and absent right superior vena cava. This anomaly, diagnosed intraoperatively during the third open-heart surgery in the course of transesophageal echocardiography examination, was not mentioned during the patient's previous two cardiac operations. Challenges in intraoperative management and implications for subsequent treatments are discussed.
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It is well known by now that during open heart surgery many detrimental factors are involved in lung injury. The influence mainly of cardiopulmonary bypass (CPB), anesthesia, hypothermia, operation itself, as well as medication and transfusion, can cause a diffuse injury in the lungs, which most often leads to a postoperative pulmonary edema and abnormal gas exchange. ⋯ In this review we highlight the possible pathophysiological mechanisms implicated in the observed postoperative lung dysfunction.