RESUMEN
Cardio-cutaneous fistula is a very rare complication of cardiac surgery, and the optimal management strategy is unclear. We present a case of a right ventricle-to-pulmonary artery conduit (RV-PA) forming a cutaneous fistulate that was successfully surgically repaired. A 43-year-old male presented for an elective RV-PA conduit replacement with a cutaneous skin lesion and associated sub-sternal collection. The patient underwent redo-sternotomy for the previous surgical replacement RV-PA conduit, of pulmonary atresia, ventricular septal defect, and ligation of main aorto-pulmonary collateral arteries in childhood, with the subsequent upgrade of the RV-PA conduit using pulmonary homograft. Upon entry into the thoracic cavity, it was clear that there was a direct fistula formed from the RV-PA conduit that was responsible for the skin lesion and hence a direct communication to the PA. We discuss the surgical method and surrounding discussions regarding Cardio-cutaneous fistula in a successful surgical repair when the pathology is difficult to truly identify preoperatively.
Asunto(s)
Fístula Cutánea , Cardiopatías Congénitas , Defectos del Tabique Interventricular , Atresia Pulmonar , Masculino , Humanos , Lactante , Adulto , Fístula Cutánea/etiología , Fístula Cutánea/cirugía , Defectos del Tabique Interventricular/cirugía , Atresia Pulmonar/cirugía , Ventrículos Cardíacos/cirugía , Arteria Pulmonar/cirugía , Estudios RetrospectivosRESUMEN
INTRODUCTION: Coronary artery bypass surgery remains the gold standard in the treatment of patients with ischemic heart disease. However, the increased oxidative stress caused by the release of free radicals during the ischemia-reperfusion time is a well-known pathophysiological process during and after coronary revascularization procedures. It may lead to reversible and irreversible myocardial injury.
