RESUMO
Fast tracking after repair of congenital heart defects (CHD) is a process involving the reduction of perioperative period by timely admission, early extubation after surgery, short intensive care unit (ICU) stay, early mobilisation, and faster hospital discharge. It requires a coordinated multidisciplinary team involvement. In the last 2 decades, many centres have adopted the fast tracking strategy in paediatric cardiac population, safely and successfully extubating patients in the OR with reported benefits in terms of reduced morbidity and ICU/hospital stay. In this manuscript, we will review the literature available on early extubation after repair of CHD and share our experience with this approach.
RESUMO
Anomalous origin of a single coronary artery from the pulmonary artery is a rare and potentially fatal congenital heart malformation. Although the actual incidence is not known, it is rarer than anomalous left coronary artery from pulmonary artery. In the absence of other important congenital cardiac anomalies, patients with anomalous origin of a single coronary artery from the pulmonary artery typically experience myocardial ischemia in association with the physiological decrease in the pulmonary vascular resistance that typically occurs over the first few months of life. To our knowledge, there have been only three reported cases of successful surgical correction. We describe a very unusual case in which the diagnosis was made intraoperatively during surgery to close a ventricular septal defect.
