ABSTRACT
Anomalous aortic origin of the right coronary artery (RCA) is a rare anatomic anomaly that is present in ~1% of the general population, and is often discovered incidentally through imaging performed for another purpose. Despite being an uncommon phenomenon, aberrant right coronary arterial origins can have devastating manifestations in half of affected patients. These include myocardial infarction, arrhythmias, heart failure, syncope, and sudden cardiac death secondary to ischemia of the cardiac tissue. This report describes a case of a 48-year-old female patient that was initially found to have ST-elevation myocardial infarction. During cardiac catheterization, the patient was discovered to have a type A aortic dissection. Cardiothoracic surgery was consulted, and she was immediately transferred to the operating room for repair. During the procedure, an anomalous RCA was discovered with its origin in the dissected tissue, which was initially ligated and then bypassed using greater saphenous vein graft.
ABSTRACT
Penetrating rebar injuries are extremely rare occurrences, but they are very life-threatening, particularly when involving the thoracic and abdominal cavities. The surgical approach to these traumatic injuries depends upon the length and diameter of the rebar as well as the path of penetration into the abdominal and thoracic regions. Due to the highly uncommon occurrence of penetrating rebar injuries, there is very limited information and studies pertaining to this topic in the literature. In this case report, we present a 43-year-old male patient sustaining a rebar penetrating injury, with the entry site being the left flank and the exit site being the anterior left chest. Upon arrival, the patient was emergently taken to the operating room and underwent simultaneous exploratory laparotomy and a left thoracotomy. The operation was successful in removing the rebar and the patient survived.
