Chest
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In the case reported, a patient with severe right ventricular failure following coronary revascularization was successfully weaned from cardiopulmonary bypass following creation of an atrial septal defect. This technique facilitated rapid decompression of the failing right ventricle by shunting blood to the more compliant left ventricle, thus augmenting left ventricular preload and enhancing cardiac output. Recovery of right ventricular function was demonstrated by progressive hemodynamic improvement, as well as reduction of right-to-left intracardiac shunting and resolution of arterial hypoxemia.
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Aortic dissection uncommonly occurs in multiple family members, and this association is most commonly seen in kindreds with Marfan's syndrome. There is increasing evidence that such connective tissue disturbances may not always appear in their complete phenotypic pattern. This report describes two siblings with aortic dissection. It is proposed that this suggests underlying connective tissue disease and warrants investigation of close relatives.