The Annals of thoracic surgery
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Comparative Study
Coronary artery disease in adult congenital heart disease: outcome after coronary artery bypass grafting.
Atherosclerotic coronary artery disease may be seen during repair of adult congenital heart disease (ACHD). There are few data outlining outcomes of concomitant coronary artery bypass grafting (CABG) in these patients. ⋯ Concomitant CABG may be required at the time of correction of ACHD. Survival is higher when a LIMA graft is used, and late functional outcome is good, with a low incidence of late angina and need for reintervention.
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We conducted a study to determine factors associated with the occurrence of mediastinitis in patients hospitalized for cervical necrotizing fasciitis (CNF). ⋯ The present study is the first to describe three independent factors associated with extension of cervical fasciitis to the thoracic cavity, including glucocorticoid intake before admission, and confirms previous reports of a high incidence of mediastinitis in patients with CNF.
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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.