ABSTRACT
A diagnosis of congenital long QT interval syndrome based on history and electrocardiogram was made in a child in the absence of readily available genetic testing. A genotype 3 (LQT3) was suspected after exclusion of other variants as the child was non-responsive to beta-blocker and sodium channel blocker medication. As the child continues to show episodic bradycardia, polymorphic ventricular ectopy, and T-wave alternans, a single-chamber automated implantable cardioverter-defibrillator implantation was done successfully. This report highlights how the diagnosis of LQT3 was arrived at as well as the anesthetic challenges in the management of patients with LQTS.
Subject(s)
Defibrillators, Implantable , Long QT Syndrome , Adrenergic beta-Antagonists/therapeutic use , Arrhythmias, Cardiac , Child , Electrocardiography , Humans , Long QT Syndrome/diagnosis , Long QT Syndrome/genetics , Long QT Syndrome/therapyABSTRACT
Secondary to leaflet injury, which is a well-known technical mistake, aortic regurgitation can occur during mitral valve replacement or repair. In most cases, the left or the non-coronary cusps are affected. For the first time, we report the case of a patient who had severe aortic regurgitation due to right coronary cusp perforation after mitral valve replacement. This complication was not identified until reoperation. Had transoesophageal echocardiography (TOE) been used during the first procedure, a delayed reoperation could have been avoided. During mitral surgery, every aortic cusp is at risk and peroperative TOE should be a mandatory procedure.
