Successful Surgical Correction Research Articles

Successful Surgical Correction of Anomalous Origin of the Right Pulmonary Artery from the Aorta in an Adult

We report an adult patient with anomalous right pulmonary artery (RPA) from the ascending aorta with origin stenosis, a secundum type of atrial septal defect (ASD) with severe pulmonary arterial hypertension (PAH) in the left lung, and a protected right lung. Restoration of the continuity between the RPA and the left pulmonary arterial system was achieved without cardiopulmonary bypass.

From partial anomalous pulmonary venous drainage to chronic thromboembolic pulmonary hypertension: successful surgical correction of a 14 year misinterpreted clinical feature

From partial anomalous pulmonary venous drainage to chronic thromboembolic pulmonary hypertension: successful surgical correction of a 14 year misinterpreted clinical feature

Repair of Left Subclavian Artery and Aberrant Right Subclavian Artery Aneurysms

Left subclavian artery aneurysm with an aneurysm of the aberrant right subclavian artery is a rare condition with a reported incidence of 0.13% to 1%. We report the successful surgical correction of both conditions in a 34-year-old man.

Pharmacological test with sildenafil at pulmonary hypertension assessing in children with congenital heart diseases

The paper considers the devised author’s method of pulmonary hypertension assessment in children with congenital heart diseases. 51 patients were made the test. According to the ECG data two types of reaction were noted after sildenafil intake: positive and negative. Positive reaction indicates pulmonary hypertension reversibility. This fact is the main condition for successful surgical heart disease correction.

Biatrial drainage of Inferior Vena Cava through Fossa Ovalis Atrial Septal Defect via atrial septal gutter

A successful surgical correction of biatrial drainage of inferior vena cava through Fossa Ovalis Atrial Septal Defect via atrial septal gutter in a patient surviving to adulthood is reported. Relevant literature is briefly reviewed. The usefulness of contrast echocardiography in resolving the diagnostic dilemmas in such cases is highlighted.

Extrathoracic heart in northern Cameroon: a case report

Sternal clefts, ectopia cordis, and Cantrell's pentalogy continue to be very rare congenital anomalies in pediatric surgery. The prenatal diagnosis is easily made with ultrasound by visualizing the heart outside the thoracic cavity. Ectopia cordis is frequently associated with other congenital defects involving multiple organ systems. We report a case of ectopia cordis with successful surgical correction on a 7 months old child from northern Cameroon.

Successful surgical correction of an extreme form of ectopic penis

Reported here is the successful multi-staged repair of a rare case of complete penoscrotal transposition with ectopic penis. The need to evaluate for associated anomalies is discussed.

324 Multimodal imaging assessment of arterial stiffness in patients with repaired aortic coarctation versus normal subjects

Despite successful surgical correction, morbidity of patients with coarctation of the aorta(CoAo) is high. The increased large arteries stiffness may be related to their impaired prognosis. The aim of the study is to asses the relationship between aortic stiffness parameters (2D echo), aortic wall velocities (tissue Doppler imaging, TDI) and carotid stiffness parameters (e-tracking) in pts. with repaired CoAo. Study group consisted of 23 pts. with repaired CoAo (mean age 28,6 ± 9,9 yrs) and 20 matched healthy subjects. Aortic elasticity was assessed using M-mode evaluation of aortic diameters, then calculating accepted indexes: aortic strain (Ao Strain), distensibility (Ao Dis), stiffness index (Ao SI). Systolic maximum expansion velocity (SW) of aortic wall was assesed using TDI.E-tracking determined parameters were: pulse wave velocity (PWV), stiffness index (β), elastic modulus (Ep), arterial compliance (AC). When correlating (table) the parameters derived from the 3 methods, statistical significant association (*) was obtained for Ao M-mode derived stiffness parameters and SW. Only PWV correlated with Ao Dis and Ao Strain, while PWV and β correlated with SW. Ao Dis Ao Strain Ao SI SW PWV -,343(*) -,349(*) 0,01 -,388(*) AI -0,12 -0,16 0,08 -0,2 Beta -0,22 -0,22 0,09 -,373(*) Ep -0,26 -0,26 -0,03 -0,29 AC 0,17 0,13 0,08 -0,12 SW ,554(**) ,578(**) -,494(**) Precoarctational bed arteries stiffness parameters assessed by different techniques showed partly concordant results. While M-mode derived parameters of aortic elasticity are time-consuming, they could be replaced in daily practice by aortic wall TDI evaluation. Carotid stiffness indexes measured by e-tracking are complementary to aortic stiffness parameters.

Prenatal double aortic arch presenting with a right aortic arch and an anomalous artery arising from the ascending aorta

Double aortic arch is a rare anomaly of the aortic arch and this may cause tracheal damage by compressing the trachea during the first year of life. We report here on three fetal cases of double aortic arch and their outcomes. These malformations presented as an isolated right aortic arch or as a typical vascular ring form on the prenatal echocardiography that was obtained between 22 and 24 weeks gestation. In two of the three patients, the major intracardiac anomaly was a ventricular septal defect, and this was associated with the aortic malformation. A more detailed evaluation of the branching pattern of the aorta, and particularly whether the aorta gives off a left-sided limb of the double arch, could suggest the diagnosis of a double aortic arch in utero. Two patients underwent successful surgical correction and they showed good clinical outcomes. Fetal double aortic arch can be prenatally suspected after performing fetal echocardiography for those fetuses that show a right side aortic arch, and this can help to avoid delaying the postnatal management of this rare anomaly.

Consecutive exotropia after surgical treatment of childhood esotropia: a 40-year follow-up study

To determine the incidence of consecutive exotropia (XT) following successful surgical correction of childhood esotropia (ET) and identify factors associated with its development. This is a retrospective study of 85 patients with ET, aged 2-24, who underwent strabismus surgery by a single surgeon between 1958 and 1969 in Sweden, until they were successfully aligned to ET within 10 prism dioptre, after primary or reoperation(s). The charts of these patients were reviewed, and data regarding age at onset of strabismus, surgery performed and outcome were recorded. The patients were recalled for a complete orthoptic examination in 2001-2003. The incidence of consecutive XT in this cohort was 21% (18/85). Patients who had undergone multiple surgeries had a higher risk of developing consecutive XT compared to those successfully aligned with one surgery (p = 0.00036). Restriction of adduction and convergence postoperatively was associated with a high risk of consecutive XT (p = 0.0437). The incidence of consecutive XT did not vary with the level of visual acuity in the operated eye (p = 0.6428). Age of onset, age at surgery and amount of surgery did not appear to influence the risk for developing consecutive XT (p > 0.05). This 40-year postoperative follow-up of patients with childhood ET who underwent strabismus surgery by a single surgeon in Sweden showed that multiple surgeries and presence of postoperative adduction deficit were the most important factors influencing the incidence of consecutive XT after surgery. Presence of uncorrected amblyopia did not alter the prognosis for long-term development of consecutive XT.

Syphilitic Aortitis: An Uncommon Cause of Acquired Aortopulmonary Fistula

Cardiovascular syphilis has become a medical curiosity with the advent of widespread use of penicillin for the treatment of early syphilis. We report a case of a 37-year-old man who presented with sudden onset breathlessness that worsened insidiously for 1 year. Diagnosis of syphilitic aortopulmonary fistula was confirmed by aortography, contrast computed tomography, and histopathology. The patient underwent successful surgical correction. A high level of suspicion and awareness is needed for the diagnosis of this now rare disease. This entity is only amenable to surgical correction, even as existing surgical techniques need constant improvisation and individualization to each patient.

Asthma as a clinical presentation of cor triatriatum sinister in a Brazilian Amazon child: a case report

Cor triatriatum sinister (CTS) is an extremely rare congenital cardiac malformation characterized by the presence of a fibromuscular membrane subdividing the left atrium into two chambers. Although respiratory symptoms are often observed in patients with this anomaly, wheezing is an unusual clinical presentation. We report on a child, born and resident in the Brazilian Amazonia, with a history of recurrent episodes of 'asthma' who was subsequently found to have CTS. After successful surgical correction of the cardiac congenital malformation, the child became symptom free. This case highlights the importance of investigating by cardiologic assessment children with worsening wheezing that do not respond well to appropriate medical management.

Anomalous left coronary artery origin from the pulmonary artery: an unusual late presentation of Bland–Garland–White syndrome

A 43-year-old woman presented with exertional dyspnea. On investigation, she was found to have ischemic left ventricular dysfunction on the basis of an anomalous left coronary artery originating from the pulmonary artery. She underwent successful surgical correction of this congenital anomaly that usually presents in childhood.

Total Anomalous Pulmonary Venous Connection in an Adult: Comprehensive Multimodality Evaluation

An unusual case of total anomalous pulmonary venous connection surviving to adulthood without surgical correction is presented. Transthoracic echocardiography first led to this diagnosis and magnetic resonance imaging refined the anatomic diagnosis leading to successful surgical correction.

Distal Aortopulmonary Window: A Morphological Variation

Several variations in the morphology of aortopulmonary window have been documented. We describe a unique variation of a large aortopulmonary window, and its successful surgical correction.

Young child with recurrent stridor

Stridor is a serious clinical sign that warrants immediate attention. We report a young child who presented with recurrent stridor. The diagnosis was confirmed by bronchoscopy, and computed tomography of the thorax showed that tracheal compression at the lower half portion with an anomalous left pulmonary artery arising from the right main pulmonary artery formed a ‘sling’ around the trachea (i.e. left pulmonary artery sling). She had two severe episodes of noisy respiration. The acute respiratory symptoms appeared because of oedema of the airway associated with infection and was aggravated by bronchial secretions. She underwent successful surgical correction of both lesions. Early diagnosis and expert management of airway problems can reduce morbidity and mortality of this potentially lethal clinical scenario.

Total Anomalous Systemic Venous Drainage to the Left Atrium

We present an unusual case of total anomalous systemic venous drainage in which the right superior vena cava, persistent left superior vena cava, inferior vena cava, and coronary sinus were present and unusually connected to the left atrium. Successful surgical correction was achieved, and the patient's recovery was uneventful. Various types of total anomalous systemic venous drainage are discussed, and classification of total anomalous systemic venous drainage is made under the consideration of creation of cardiopulmonary bypass.

Anomalous Origin of Left Circumflex Coronary Artery from the Right Pulmonary Artery in Adult

Anomalous coronary arteries occur in less than 2% of the general population. The left circumflex (LCx) artery's origin from the pulmonary artery as a cause of classic angina in adults is extremely uncommon. We report a case of ischemic heart disease due to an origin of the LCx artery from the right main pulmonary artery in a 33-year-old man. Successful surgical correction of this defect was performed with total cardiopulmonary bypass and cardioplegic arrest.

Successful Surgical Correction of Supravalvular Pulmonary Stenosis under Beating Heart using a Cardiopulmonary Bypass System in a Dog

A male Pomeranian dog aged 1 year and 8 months was presented for evaluation of severe systolic ejection, cardiac murmur and syncope on excitation. Supravalvular pulmonary stenosis was diagnosed. An echocardiogram showed a supravalvular membranous stricture and a severely increased pulmonary arterial velocity in the stricture (6.49 m/s, pressure gradient of 169 mmHg). The supravalvular stricture was surgically removed by pulmonary arteriotomy with the heart beating using a cardiopulmonary bypass system. The postoperative pulmonary arterial velocity at the narrow area decreased to 3.80 m/s, and the pressure gradient decreased to 57.7 mmHg. Six months after the operation, there were no signs of restenosis, and the dog was in good condition without syncope. Surgical correction of pulmonary stenosis with the heart beating using a cardiopulmonary bypass system is useful because of the improvement it brings in safety and reliability.

Repair of Coarctation in Right Circumflex Retroesophageal Arch

A right-sided circumflex retroesophageal aortic arch combined with a ventricular septal defect and severe coarctation is an extremely rare condition. Moreover, surgical correction is significant when performing an anatomical reconstruction of the left aortic arch by end-to-side and native tissue-to-tissue anastomosis instead of using a bypass graft. The authors describe an unusual case of a 1 month-old neonate with a ventricular septal defect and coarctation of a right-sided circumflex retroesophageal aortic arch who underwent successful surgical correction.