ABSTRACT
A 14-year-old male patient with a history of atypical Kawasaki disease at age 2 presents with triple vessel giant coronary aneurysms. Over the last several years, he began experiencing angina and dyspnea on exertion, which was a result of fully occluded right coronary and left circumflex arteries and 90% stenosis in the left anterior descending artery. He underwent off-pump coronary artery bypass using the left and right internal mammary arteries. At 18-month follow-up, there is no evidence of ischemia. Off-pump bypass is a feasible option for surgical management of the stenotic and occlusive complications of Kawasaki disease.
Subject(s)
Coronary Aneurysm/surgery , Coronary Artery Bypass, Off-Pump/methods , Electrocardiography/methods , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnostic imaging , Quality of Life , Adolescent , Angina Pectoris/diagnosis , Angina Pectoris/etiology , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/etiology , Dyspnea/diagnosis , Dyspnea/etiology , Follow-Up Studies , Humans , Male , Mammary Arteries/surgery , Mammary Arteries/transplantation , Recovery of Function , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
A 20-year-old man was transferred to our institution with multiple penetrating thoracoabdominal wounds from a shotgun. Imaging revealed several retained shotgun pellets, 1 of which appeared to be located in the left atrium. He was asymptomatic from a cardiac standpoint and was first taken to the operating room to manage his multiple abdominal injuries. Neither an intraoperative echocardiogram nor a formal postoperative echocardiogram definitively determined pellet location (myocardium versus chamber). Because of concerns for pellet embolus from left atrial positioning, the patient was returned to the operating room. After placing the patient on cardiopulmonary bypass, the pellet was identified within the wall of the left atrium and was successfully removed without complication.
Subject(s)
Cardiac Surgical Procedures/methods , Firearms , Heart Injuries/surgery , Multiple Trauma/surgery , Wounds, Gunshot/surgery , Abdominal Injuries/diagnosis , Abdominal Injuries/surgery , Echocardiography, Transesophageal/methods , Follow-Up Studies , Foreign Bodies/surgery , Heart Atria/injuries , Heart Atria/surgery , Heart Injuries/diagnosis , Humans , Injury Severity Score , Laparotomy/methods , Magnetic Resonance Imaging/methods , Male , Multiple Trauma/diagnosis , Risk Assessment , Thoracic Injuries/diagnosis , Thoracic Injuries/surgery , Tomography, X-Ray Computed/methods , Treatment Outcome , Wounds, Gunshot/diagnosis , Young AdultABSTRACT
A 24-year-old male pedestrian with situs inversus and dextrocardia was struck by a car and sustained multiple injuries, including a pseudoaneurysm of the proximal descending thoracic aorta. A thoracic endograft was deployed to exclude the blunt aortic injury. We are not aware of any report of endovascular repair of blunt aortic injury in a patient with this congenital finding. A brief review of the literature is also included.
