John Santosh Kumar Murala

Anomalous Origin of Left Coronary Artery from Pulmonary Artery in Adults

Various techniques have been described for management of anomalous origin of the left coronary artery from the pulmonary artery presenting in adults. Three patients, 1 male and 2 females, aged 27–37 years, underwent transpulmonary pericardial patch closure with concomitant left internal thoracic artery anastomosis to the left anterior descending artery, under standard cardiopulmonary bypass, thus creating a two-coronary system. One patient had concomitant mitral valve repair. All 3 survived the operation. Postoperative angiography in 2 patients revealed good antegrade flow with decreased collaterals in one and competitive inhibition with increased collaterals in the other. This procedure is considered to be the safest and simplest in this subset of patients.

Porcine small intestine submucosa cylinder valve for mitral and tricuspid valve replacement

From the Departments of Cardiac Surgery, and Pediatrics, University of Michigan, Ann Arbor, Mich. Disclosures: Authors have nothing to disclose with regard to commercial support. Received for publication Jan 20, 2017; revisions received March 15, 2017; accepted for publication March 26, 2017; available ahead of print April 22, 2017. Address for reprints: Richard G. Ohye, MD, Room 11-742, 1540 E Hospital Drive/SPC 4204, Ann Arbor, MI 48109-4204 (E-mail: ohye@med.umich.edu). J Thorac Cardiovasc Surg 2017;154:e57-9 0022-5223/

A review of the Nunn modified single patch technique for atrioventricular septal defect repair

36.00 Copyright 2017 by The American Association for Thoracic Surgery http://dx.doi.org/10.1016/j.jtcvs.2017.03.129

Right ventricular outflow tract obstruction: a quest for ideal management:

Atrioventricular septal defect (AVSD) is a common congenital cardiac surgical problem. Over the years, younger and smaller infants are having operations for this condition before irreversible cardio pulmonary changes occur. Traditionally a single or two patch techniques have been used to repair this defect. However, in the past two decades an innovative method of modified single patch technique popularized by Dr. Graham Nunn has gained worldwide popularity. This review discusses the origin, surgical principles, technique and outcomes of this method, popularly known as Nunn or Australian technique. Research comparing the modified single patch technique to classic single and double patch techniques has shown good preservation of atrioventricular valve function, no residual ventricular septal defect (VSDs), low incidence of left ventricular outflow obstruction, preserved conduction, easy reproducibility, and improved perioperative and long-term mortality.

Mechanical circulatory support for the failing functional single ventricle

Management of right ventricular outflow tract obstruction has undergone much change over the last century. Techniques described in the literature include anatomical repairs and the use of various patches, conduits, and innovative grafts. However, many of these approaches require reoperations or catheter-based interventions, leading to increased morbidity, mortality, and cost. The search for the ideal long-lasting conduit continues and there are new techniques on the horizon, using genetic engineering and nanotechnology. This review discusses the evolution of various techniques for repair of right ventricular outflow tract obstruction, past and current conduits, as well as ongoing research.

'Near death' thromboembolic episode following device closure of atrial septal defect.

The advent of surgical palliation for functional single ventricle (FSV) heart defects was an impressive feat for pediatric cardiovascular surgery and medicine just a few decades ago. Parents were given hope for what would have been uniformly fatal congenital heart disease, and today, substantial survival is expected by both families and care providers for neonates with many types of FSV defects. However, decades have since past and these very same patients who were successfully palliated are now facing despair themselves as they encounter significant cardiovascular issues. These issues can be classified as Fontan failure (as evidenced by protein losing enteropathy and plastic bronchitis) and contractile failure (systolic or diastolic) of their single ventricle.

Management of traumatic manubriosternal dislocation in children.

Life-threatening pulmonary thromboembolism is a rare complication following device closure of an atrial septal defect (ASD). Our case is a 17-year old female who presented with a sudden cardiorespiratory arrest due to pulmonary thromboembolism, 5 months following a device closure of her ASD. She was successfully resuscitated and then underwent removal of the device with the associated clots and patch closure of the ASD. She made an uneventful recovery. We report this case to highlight that life-threatening thromboembolic complications can occur with ASD device closure.

Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery

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