Aortopulmonary window is a rare but well identified and surgically correctable anomaly. Operative repair should be offered as soon as the diagnosis is established, regardless of the patient's age. Irreversible pulmonary hypertension with a right to left shunt despite oxygen administration is the only contraindication for surgery. Various surgical techniques can be applied depending on the size of the communication. Associated arch anomalies may require technically challenging approaches and surgical strategies. Early and long-term outcomes after surgical correction are excellent regardless of age or pulmonary vascular resistance.
Chronic instability of anterior chest wall is a known complication following the minimally invasive right parasternal approach for valvular heart operations. The exact incidence of this condition, as well as the need for reoperation, has not been well documented. We report the first case of successful correction of unstable anterior chest wall in a 33-year-old lady after she underwent atrial septal defect closure through right paramedian approach eight years ago. The repair consisted of interposing iliac crest bone graft in the defect created by deficiency of the 3rd and 4th costal cartilages and anchoring the graft using steel wires.
Mishaps, near misses, and lethal incidents are known to occur during cardiopulmonary bypass. We share one such rare case of break in polycarbonate connector because of the use of isoflurane in extracorporeal circuit and its successful management.
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