Transcatheter management of post-surgical superior vena cava obstruction

Obstruction of the superior vena cava (SVC) is a rare complication after cardiac surgery in infants and children. We present the case of a 2-year-old male child who underwent surgery to repair a mixed total anomalous pulmonary venous connection. After 18 months of surgery, the child developed SVC syndrome. Transcatheter stenting was performed to relieve the SVC obstruction detected with transthoracic echocardiography. The patient was discharged after 5 days of hospitalization. The patient was doing well at follow-up appointments, with good laminar flow through the stent. In conclusion, transcatheter management of post-surgical complications of SVC obstruction was successful in this patient.

Captopril in Congenital Chloride Diarrhoea: A Case Study.

An 11 months 22 days old girl presented with a history of watery diarrhoea since birth, failure to thrive, and developmental delay. Her diagnosis was congenital chloride diarrhoea (CCD) with raised level of chloride (>90 mmol/L) in stool in the absence of cystic fibrosis. Management of CCD included replacement of NaCl, KCl, and correction of dehydration. Diarrhoea of the patient was resolved with Captopril, which was initially provided to the patient for managing heart failure. To our knowledge, this is the first reported case of CCD that shows the beneficial effect of Captopril. Therefore, we suggest that further study is warranted as to the potential for Captopril as additional option in the treatment for CCD. We present this case report with the informed consent of the patient’s guardian.

Surgical Angioplasty for Left Main Coronary Artery Disease - A Case Report.

Conventional treatment of left main coronary artery (LMCA) disease includes coronary artery bypass graft (CABG) and more recently, in selective indications, percutaneous coronary intervention (PCI). Direct surgical patch angioplasty of the LMCA using fresh autologous pericardium, saphenous vein, or mammary artery patch can be proposed as an alternative treatment. We have successfully operated one patient with surgical angioplasty for isolated ostial left main coronary stenosis at National Heart Journal.

Surgical Ventricular Restoration (SVR) for Ischemic Heart Failure.

Surgical ventricular restoration (SVR) is a surgical procedure developed in an attempt to reverse the negative remodeling that occurs following myocardial infarction. SVR has evolved from a treatment for ventricular aneurysms and has become a treatment of ischemic heart failure.SVR procedure is usually performed after coronary artery bypass grafting (CABG) and may proceed or be followed by mitral valve repair or replacement. This article will review the procedure.

Occult Pneumonia: An Unusual but Perilous Entity Presenting with Severe Malnutrition and Dehydrating Diarrhoea.

A three-month old boy was admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh, with the problems of acute watery diarrhoea with some dehydration and suspected dyseletrolytaemia, severe malnutrition, and reduced activity. Occult pneumonia was added to the problem list after demonstration of radiologic consolidation in right upper lung, despite the lack of clinical signs, both on admission and after correction of dehydration. The problem list was further expanded to include bacteraemia due to Staphylococcus aureus when the blood culture report was available. Severely-malnourished children may not exhibit typical clinical signs of pneumonia, and the possibility of existence of such problems should be remembered in the assessment and provision of care to hospitalized young children with severe malnutrition.