ower extremity compartment syndrome is a rare complication after on-pump coronary artery bypass grafting (CABG). It is associated with fasciotomy wound-related morbidity, occasional amputation, and universal occurrence of permanent foot drop. Compartment syndrome after off-pump CABG has not been reported so far. We report a case of lower limb compartment syndrome after off-pump CABG.

atrial ablation purposes. 3 However, it is a known fact that patients with long-standing AF, giant atria, or both have a much smaller chance to revert back to sinus rhythm after these ablation procedures. 4 Our findings, herein reported, might provide an explanation to understand this fact. As we have described, the morphologic consequences of chronic AF on the normal SN can be synthesized in 3 main features: (1) progressive tissue fibrosis, (2) progressive myocardial cell loss (including P cells), and (3) myocardial cell degeneration (including P cells). These SN morphologic abnormalities must inevitably lead to an impairment of its function. Thus normal sinus rhythm is less likely to be restored in patients with long-standing AF, regardless of the atrial lesion pattern used to interrupt re-entry or the energy source used to create these lesions because their SN is morphologically and functionally abnormal. Conversely, surgical treatment of AF during its early stages, with minimal SN damage, is more likely to be successful.

SUMMARY Volume therapy and maintenance of stable hemodynamics is crucial in children undergoing cardiac surgery on cardiopulmonary bypass (CPB). The clinical use of hydroxyethyl starch (HES) 130/0.4 is limited by the possibility of adverse hemostatic effects which could potentially increase the risk of perioperative bleeding and transfusion requirements. We conducted this study to evaluate the safety and efficacy of HES in comparison with modified succinylated gelatin (MSG). Forty‐nine children were randomly assigned to receive either HES (n = 28) or MSG (n = 21) during the pre‐bypass period. Coagulation was assessed with thromboelastography (TEG) and the transfusion requirements up to the first postoperative day were documented. Both groups were comparable with respect to age, weight, CPB duration as well as hematological and biochemical laboratory investigations. TEG parameters were not deranged up to the first postoperative period in either group and there was a trend of reduced blood loss and transfusion requirements in HES groups although there was no statistically significant difference. Our study shows that HES 130/0.4 is safe and effective for volume replacement in pediatric cardiac surgery patients.