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1.
Ann Card Anaesth ; 22(2): 215-220, 2019.
Article in English | MEDLINE | ID: mdl-30971608

ABSTRACT

Double-orifice mitral valve (DOMV) is an unusual congenital anomaly characterized by a mitral valve with a single fibrous annulus with two orifices or rarely two orifices with two separate mitral annuli opening into the left ventricle. We present a first report of a patient with a DOMV with supramitral ring (SMR), subaortic membrane (SAM), a large ventricular septal defect (VSD) with more than 50% aortic override, and severe pulmonary arterial hypertrophy (PAH). This patient underwent excision of the SAM, and SMR, with closure of the VSD together under cardiopulmonary bypass (CPB). However postoperatively, the patient developed an irreversible fatal pulmonary hypertensive crisis (PHC), immediately after transferring the patient to the cardiac intensive care unit from the operating room (OR). The PHC was refractory to intravenous and inhaled milrinone and nitroglycerine and intravenous adrenaline, dobutamine, norepinephrine, vasopressin, patent foramen oval (PFO), and CPB support. The management of DOMV and perioperative pulmonary hypertension is discussed.


Subject(s)
Heart Septal Defects, Ventricular/complications , Heart Valve Diseases/complications , Hypertension, Pulmonary/complications , Mitral Valve/abnormalities , Perioperative Care/methods , Cardiac Catheterization , Child, Preschool , Echocardiography , Fatal Outcome , Heart Septal Defects, Ventricular/diagnostic imaging , Heart Septal Defects, Ventricular/surgery , Heart Valve Diseases/diagnostic imaging , Heart Valve Diseases/surgery , Humans , Male , Mitral Valve/surgery
2.
Ann Card Anaesth ; 21(2): 203-204, 2018.
Article in English | MEDLINE | ID: mdl-29652287

ABSTRACT

This report describes a patient with severe mitral stenosis who underwent mitral valve replacement. After completion of cardiopulmonary bypass, an unexpected finding of a right atrial mass was noticed on transesophageal echocardiography. The actual finding, possible differential diagnosis, and the management strategy are discussed.


Subject(s)
Cardiopulmonary Bypass/adverse effects , Heart Atria/diagnostic imaging , Thrombosis/diagnostic imaging , Diagnosis, Differential , Echocardiography, Transesophageal , Female , Heart Valve Prosthesis Implantation , Humans , Middle Aged , Mitral Valve Stenosis/surgery , Postoperative Complications/diagnosis , Postoperative Complications/diagnostic imaging , Sutures
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