Left pulmonary artery stenting with glenn shunt: in-troducing a hybrid procedure

Complexity of some congenital heart diseases sometimes necessitates a combination of interventional procedures and surgery, amongst which intraoperative stent implantation is one of the most common. We herein report a successful hybrid procedure in a cyanotic adult patient who had undergone no procedure in childhood. The patient was a 24-year-old cyanotic male [oxygen saturation in the room air was 65%] who presented with dyspnea. According to echocardiography, catheterization, and cardiac magnetic resonance imaging data, the patient was amenable to the Fontan surgery. However, because of significant left pulmonary stenosis and his age, he first underwent a hybrid procedure [Glenn shunt and left pulmonary artery [LPA] stenting]. After the procedure, oxygen saturation rose to 83%. At six months follow-up of the patient, exercise capacity and cyanosis had improved significantly, with o[2] saturation having reached near 85% by pulse oximetry

Fungal endocarditis: review of our cases over a four-year period

Over a 4-year period, we studied six cases of fungal endocarditis, four of which were caused by Aspergillus sp. And the other two were candidal in origin. Both sides of the heart showed involvement by these infections. The vegetations of infective endocarditis tend to vary in size, but fungal lesions are often large. Our youngest patient was four months old and the oldest one was 62 years old. A high index of clinical suspicion, together with histopathological and microbiological studies, can be used as tools to diagnose and treat such patient in due course. It is important to send fresh specimens for tissue culture studies in sterile normal saline and not in fixatives such as formaladehyde. Pathologically, not only are the special staining methods such as Periodic acid-Schiff useful in the demonstration of fungal elements in tissue or vegetation sections, but also the routine hematoxylin and eosin stain is capable of showing these structures clearly

Device-induced perforation of right atrium following interventional closure of atrial septal defect [ASD]

This is a case presentation of a 26-year-old woman with a moderate-sized atrial septal secundum defect [17mm] who underwent catheterism, during which an Amplatzer Septal Occluder number 26 was inserted successfully. On the second postoperative day, she deteriorated and a clinical examination showed a typical tamponade. After a percutaneous aspiration of the pericardial cavity and transient improvement in vital signs, a pig-tail catheter was inserted percutaneously emergently, and the patient was transferred to the operating room in a preshock state. During the operation, an active bleeding point in the superoanterior aspect of the right atrium near the aortic root was detected, which was repaired by direct suture and pericardial patch reinforcement. The Amplatzer device was removed and the atrial septal defect was repaired with a pericardial patch. A lethal complication of the interventional closure of atrial septal defect, properly treated by an emergent intervention and operation, is presented and discussed herein