ABSTRACT
We described a case of a neonate of 13 trisomy with hypoplastic aortic arch and multiple ventricular septal defect (VSD). The patient presented symptoms of congestive heart failure due to pulmonary high flow. Because of ductal patency without prostaglandin infusion, bilateral pulmonary artery banding was performed for regulation of pulmonary high flow. Surgical intervention improved the clinical symptoms of the patient and permitted the patient to be discharged. We concluded that palliative surgery for the patient contributes to improve the quality of life both the patient and the family. This is the 1st report of bilateral pulmonary artery banding for a patient with 13 trisomy.
Subject(s)
Aorta, Thoracic/abnormalities , Chromosome Disorders/complications , Heart Septal Defects, Ventricular/surgery , Pulmonary Artery/surgery , Chromosomes, Human, Pair 13 , Humans , Infant, Newborn , Male , Trisomy , Trisomy 13 SyndromeABSTRACT
A 46-year-old woman with homozygous familial hypercholesterolemia was referred due to aortic regurgitation. The patient was introduced selective low density lipoprotein cholesterol(LDL)apheresis 20 years ago. Echocardiogram revealed severe aortic regurgitation, and computed tomography revealed thoracoabdominal aortic aneurysm. We considered 2 staged operations were necessitated. Firstly, aortic valve replacement was performed. Emergent coronary artery bypass grafting was also done because intraoperative myocardial ischemia was strongly suspected from left ventricular hypokinesis. One year later, replacement of thoracoabdominal aorta was performed. Post-operative course was uneventful and the patient was discharged at post-operative day 21. The patients with homozygous familial hypercholesterolemia must be strictly followed up because systemic atherosclerosis frequently exacerbates despite selective LDL apheresis.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Aortic Valve Insufficiency/surgery , Hyperlipoproteinemia Type II/complications , Female , Homozygote , Humans , Hyperlipoproteinemia Type II/genetics , Middle AgedABSTRACT
The Cabrol technique has been used to reimplant coronary arteries at the time of aortic root replacement. We describe a case of coronary stenosis after Cabrol procedure. A 42-year-old female with Marfan syndrome and chronic type B dissection who underwent aortic root replacement with Cabrol procedure complained of chest pain. Computed tomography( CT) showed extended thoraco-abdominal aortic aneurysm. Angiography revealed bilateral Cabrol limb stenosis at anastomotic sites. Re-do operation was performed under median re-sternotomy. Pannus around the coronary anastomosis was resected and patch extension using bovine pericardium was performed. Reconstruction of coronary arteries was completed by Piehler procedure and total arch replacement with elephant trunk technique was concomitantly performed. Post-operative course was uneventful. CT revealed the release from coronary stenosis.
