Ventricular restoration in adults with huge congenital left ventricular aneurysm: report of two cases.

Congenital ventricular aneurysms (CVA) are rare cardiac anomalies that have been predominantly described in the Black population. They are characterized by an akinetic ventricular protrusion that is commonly located at the basal and apical segments. Although the diagnosis is often incidental and the majority of patients are asymptomatic, life-threatening events such as persistent ventricular arrhythmias, CVA rupture, and heart failure are not uncommon. However, no standardized therapy is currently available and good outcomes have been reported with both conservative and surgical management. We report the cases of two young Black African patients with huge symptomatic CVA lesions who underwent successful surgical repair with a ventricular restoration technique. Both cases were consulted for chest pain and dyspnea. Chest X-ray and transthoracic Doppler echocardiography suggested the diagnosis. Thoracic angioscanner and thoracic magnetic resonance imaging confirmed the diagnosis. Both patients underwent successful surgery. This case report aims to revisit the diagnostic and therapeutic approach to this rare pathology, in our professional environment.

[Anaesthesia in on-pump cardiac surgery for congenital heart diseases at the Cuomo Pediatric Cardiology Center (Senegal)]. / Prise en charge anesthésique des cardiopathies congénitales opérées sous circulation extra - corporelle au Centre de Chirurgie Cardiaque Pédiatrique Cuomo (Sénégal).

Congenital heart diseases account for 0.5-1% of births. The management of children with cardiac malformation requires treatment in a suitable center, adequate medical equipment and specific anesthetic and surgical knowledge. The purpose of this study was to evaluate the anesthetic management of patients with congenital heart diseases in our center after the first year of activity and to compare the obtained results with literature reported data. We conducted a retrospective, descriptive study over a 1-year period, from January to December 2017. All patients undergoing on-pump cardiac surgery for congenital heart disease during this period were included. We collected data from 80 records of patients undergoing surgery for congenital heart disease. Out of these 80 patients, 60 underwent on-pump cardiac surgery (75%). The average age of patients was 7.41 years, with a sex-ratio of 1.22. The mean duration of on-pump cardiac surgery was 82.82 min and the mean duration of aortic clamping was 58.31 min. At the end of the procedure catecholamine production was found in 70% of patients. The most common complication in the postoperative period was right-side heart failure (69%). The average length of stay in the Emergency room was 4.33 days. One patient died, bringing mortality to 1.6%. Congenital heart diseases are complex and highly variable. Improved management techniques have strongly reduced morbi-mortality.

A Case Report of Iatrogenic Pulmonary Artery Injury due to Chest-Tube Insertion Repaired under Cardiopulmonary Bypass.

The authors presented a case of a 50-year-old patient with multiple trauma who suffered from the inadvertent cannulation of the main pulmonary artery at the second attempt of left chest drainage. Pulmonary artery injury has been suspected because early chest tube production was 2300 mL of blood. CT scan showed injury of the trunk of the pulmonary artery, left hemothorax, and suspect damage of the right branch of the pulmonary artery. That chest tube touched the posterior wall of ascending aorta. Surgical approach was median sternotomy. Exploration showed a perforation of the trunk of pulmonary artery without lesion of the right pulmonary branch and the posterior wall of the ascending aorta. The lesion was repaired under normothermic partial cardiopulmonary bypass. Postoperative period was free of events. Review of the literatures for this rare case report has been done.