Pulmonary artery aneurysm: Harbinger of an ominous disease.

An 11-year-old girl presented with chronic cough and recurrent hemoptysis. On examination, she had features of right heart failure and cyanosis, with severe pulmonary hypertension on echocardiogram. Computed tomography pulmonary angiography showed aneurysmal dilatations of the pulmonary artery with elevated erythrocyte sedimentation rate and C-reactive protein and positive human leukocyte antigen B51. A diagnosis of Hughes-Stovin syndrome (vascular variant of Behcet's syndrome) was confirmed, and she was started on immunosuppression, on which there was improvement.

Intracardiac relation of extrahepatic persistent right umbilical vein.

Persistent extrahepatic right umbilical vein without ductus venosus is a rare anomaly of systemic venous drainage and is reported to be associated with cardiac anomalies. We report the case of an 8-year-old boy diagnosed to have an ostium secundum atrial septal defect, in whom an abnormal vascular channel and its opening in the right atrium in close relationship to the inferior vena cava and coronary sinus opening was identified at operation. Post-operative evaluation of this vascular channel was diagnosed to be an extrahepatic persistent right umbilical vein.

Midterm results of homografts in pulmonary position: a retrospective single-center study.

OBJECTIVE: Valved conduits play a pivotal role in the right ventricular outflow tract (RVOT) reconstruction in patients with congenital heart disease (CHD), and valved homografts have become the most commonly used conduits in pediatric cardiac surgery. This study aimed to assess the midterm performance of aortic and pulmonary homografts used in pulmonary position in patients with CHD. METHODS: Ninety-eight patients underwent surgical RVOT reconstruction with a homograft from January 2012 to December 2017. We collected all patient details from the institute patient record system. Echocardiographic data were obtained from the records. Postoperative data included survival and follow-up echocardiography. The primary endpoints of the study were homograft failure, homograft dysfunction, and freedom from re-intervention. RESULTS: We observed allograft failure in two patients (2%), one each due to pseudo-aneurysm formation and infective endocarditis. There were 8 early deaths (8/98, 8.2%) and 9 late deaths (9/98, 9.2%). The mean survival time was 6.1 years, and the postoperative survival rate at 1 and 5 years was 89.73% and 82.65%, respectively. Homograft regurgitation and homograft dysfunction were higher in the pulmonary homograft group. However, the re-intervention rates were more in the aortic homograft (24.24%) group due to the higher incidence of calcification associated with them. CONCLUSION: Homografts used for RVOT reconstruction provide excellent intermediate-term outcomes, irrespective of the type of homograft used. Pulmonary homografts are more durable than aortic homografts and provide satisfactory results even in infants.

Correction to: Midterm results of homografts in pulmonary position: a retrospective single-center study.

[This corrects the article DOI: 10.1007/s12055-020-01065-1.].

Overdrive suppression of postoperative sustained ventricular tachycardia by atrial pacing and its hemodynamic effect.

Sustained ventricular tachycardia (VT) in the early postoperative period following intracardiac repair for tetralogy of Fallot is rare. In stable VT, amiodarone forms the mainstay of management. However, where amiodarone and other antiarrhythmic drugs are contraindicated, suppressive overdrive atrial pacing can be used as a safe and efficient alternative to maintain cardiac output. We present a case of 1-year 5-month-old child who developed VT with low cardiac output syndrome with deranged hepatic function, who was managed efficiently using suppressive atrial pacing to ameliorate the effects of sustained VT.

Secondary infection of chylothorax with Serratia marcescens: a rare scenario post-cardiac surgery.

Infection of chylothorax is considered rare because chyle is inherently bacteriostatic. We report a case of an infected chylothorax occurring in a post-cardiac surgery patient caused by Serratia marcescens. Once considered a harmless saprophyte, Serratia marcescens is now recognized as an important opportunistic pathogen causing healthcare-associated infection with a propensity for antimicrobial resistance.

Anomalous origin of left coronary artery from right pulmonary artery in an infant with coarctation of the aorta.

Anomalous origin of the left coronary artery from the right pulmonary artery is a very rare congenital anomaly, and its occurrence with coarctation of the aorta has been reported in very few patients. We report a neonate where the coronary anomaly was missed preoperatively and diagnosed after repair of the coarctation. The patient thereafter underwent ligation of the left anomalous coronary artery and had an uneventful convalescence.