Highlights. The paper presents a unique clinical case of patient with congenital heart defect known as Bland-White-Garland syndrome diagnosed in the adulthood. Takeuchi repair (creation an intrapulmonary tunnel) was carried out to treat this defect.Background. An anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome) is an uncommon but severe pathology that requires immediate surgical treatment. The use of modern diagnostic methods (both non-invasive and invasive) has resulted in higher prevalence of this syndrome, diagnosed not only in an early childhood, but also in adulthood. Recording each medical case and choosing an optimal treatment strategy will increase knowledge of this pathology and reduce the high risk of mortality. The paper presents a clinical case of this syndrome in an adult patient who had remained undiagnosed for a long time as the syndrome was masked under the clinical features of chronic heart failure. Takeuchi repair (creation an intrapulmonary tunnel) was carried out to treat this extremely rare defect for a patient of this age group.
An increase in life expectancy contributes to a steady growth of diseases of the cardiovascular system. In recent years, there has been a stable increase in the prevalence of rhythm disturbances in the population. Fibrillation and atrial flutter are among the most common causes of a decrease in the quality of life and an increase in mortality. However, the effectiveness of various methods of treatment is not absolute, and therefore the development and introduction of new antiarrhythmic drugs is particularly relevant. Thus, the use of a class III antiarrhythmic drug (niferidil) is of unconditional interest, and literature data describing the effectiveness of its use for the relief of atypical atrial flutter are extremely few. The article presents a case of successful relief of a persistent form of atypical atrial flutter in a 79-year-old patient using three consecutive intravenous injections of niferidil at a dose of 10 mcg/kg with a 15-minute interval in 19 hours after the start of therapy. The presented clinical case confirms the effectiveness of drug cardioversion with the use of niferidil and makes it possible to consider it as an alternative to electrical cardioversion in patients with atypical atrial flutter.
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