The Annals of thoracic surgery
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Case Reports
Reimplantation of anomalous single coronary artery from pulmonary artery: diagnosis and surgical management.
A newborn presented in cardiogenic shock with the diagnosis of anomalous single coronary artery from pulmonary artery and was successfully revived with prostaglandin (PGE1) infusion. She underwent surgical implantation of her coronary arteries while receiving PGE1 infusion to maintain high oxygen tension for the coronaries during cardiopulmonary bypass. She was discharged in 2 weeks with good biventricular function and moderate mitral regurgitation. At 2 months follow-up, she was gaining weight with preserved ventricular function and moderate mitral regurgitation.
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Up to 66% of giant pulmonary artery aneurysms are associated with severe pulmonary hypertension. For these patients, lung or heart-lung en bloc transplantation is the only definitive therapy available. To date, there have been only two reports of concomitant double lung transplant and resection of a giant pulmonary artery aneurysm. We report a case of combined mitral and pulmonary valve repair, resection of a giant pulmonary artery aneurysm, and double lung transplant in a patient with primary pulmonary hypertension.
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This case describes issues related to left ventricular assist device placement in an adult with ischemic heart disease with well-compensated Ebstein's anomaly who subsequently developed severe right heart dysfunction. We discuss strategies for dealing with this rare but structurally important congenital heart defect.
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The Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS) have intermittently surveyed their combined membership. These manpower surveys have provided snapshots of thoracic surgery, documenting practice changes over time. At this critical time in US health care reform the physician workforce is of critical importance. This survey updates the data obtained from the 2000 and 2005 surveys. ⋯ These data give a clear profile of the specialty at this time. The major challenges remain length of training and educational debt of the thoracic surgeon. Case volume, scope of practice, malpractice costs, and career satisfaction remain major elements to provide a positive environment to recruit new surgeons in to the specialty. The resident pool has contracted while the workforce ages and retirement looms. Significant shortages may develop as the US population ages in the environment of health care reform.