A simple, ingenious approach for intra-operative detection of coronary cameral fistula.

A 56-year-old female presented to us with rheumatic mitral stenosis with a left atrial clot. We found one coronary cameral fistula on the coronary angiography from the posterior left ventricular branch to the left ventricle. She was taken up for surgical mitral valve replacement and clot removal. A residual coronary fistula may increase the risk of infective endocarditis, especially in the presence of mechanical prosthesis. Henceforth, intra-operatively, we used the methylene blue dye injection as an easy technique to detect and safely close the coronary fistula from inside the left ventricular chamber. She recovered smoothly with a successful outcome.

Emergency retrieval of embolised patent ductus arteriosus device from the right pulmonary artery.

Percutaneous closure of patent ductus arteriosus using a duct occluder has become standard of care in its management especially in children more than 6 months of age, weighing more than 6 kg but device embolisation is a potential life-threatening complication and may require immediate open-heart surgery. We describe a case of successful surgical management of a patient in early childhood, in which device has embolised deep into the right pulmonary artery.

Successful management of delayed postoperative lung collapse secondary to spillage of aspergilloma.

Aspergilloma usually grows in lung cavities, although some may present with intrabronchial masses. Bronchial spillage during surgery is a known and disastrous complication of cavitary aspergilloma with bronchial communication. We present a case of a man in his 40s who developed a cavitary aspergilloma with recurrent haemoptysis almost a decade after his pulmonary tuberculosis. Following a segmentectomy for the same, the patient was extubated on table with well-expanded lung fields. Six hours later, he developed respiratory distress, and X-ray showed a complete lung collapse. An emergency bronchoscopy revealed a fungal ball obstructing the left main bronchus. The mass was successfully removed through bronchoscope, and the patient had lung expansion and uneventful recovery.

A Case of Late Presentation of Supracardiac Total Anomalous Pulmonary Venous Connection in an Adult.

Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic congenital heart disease and their survival into adulthood is even rarer. Here, we present the case of a 26-year-old female who was incidentally diagnosed with a case of supracardiac TAPVC during her pregnancy. All four pulmonary veins were joining to form a common venous confluence which drained into a left-sided vertical vein which drained into the innominate vein.