Coronary artery augmentation with the right subclavian artery for single coronary artery variants of dextro transposition of the great arteries treated by an arterial switch operation.

Objective: Single coronary artery variants in dextro transposition of the great arteries increase the technical demands of performing coronary translocations during the arterial switch operation (ASO). Coronary augmentation using the right subclavian artery as an interposition graft is a viable option in certain cases. The aim of this study is to describe this operative technique and review outcomes. Methods: Of 59 patients who underwent an ASO, from July 2015 to May 2021, 6 had single coronary variants in which the right subclavian artery was used as an interposition graft. Mean follow-up was 21.5 months. Results: Patients mean age and weight at the time of surgery were 7.1 ± 3.8 days and 2.84 ± 0.76 kg, respectively. Four patients had the left anterior descending coronary artery and right coronary artery coming from the left sinus and the circumflex coronary artery coming from the right sinus. One patient had a single ostium arising from the left sinus and another patient had a single ostium coming from the right sinus. All patients are alive and free of cardiac symptoms at follow-up. Conclusions: Single coronary artery variants in dextro transposition of the great arteries can pose technical challenges for coronary translocation during ASO. The augmentation of coronary buttons using a segment of the right subclavian artery is an option which should be considered in selective cases.

Preoperative Evaluation of Refugee Children With Heart Disease.

The objective of this report is to identify nutritional deficiencies and health concerns in Canadian paediatric refugee patients with heart disease before cardiac surgery. A retrospective case study was conducted with 4 refugee children, aged 0-18 years, with heart disease referred to Cardiac Surgery. A total of 75% of patients had low vitamin D levels, 50% had selenium deficiency, 50% had iron deficiency anaemia, 75% were below the third percentile for height and weight for age, and 75% had dental caries. Early laboratory, nutritional, and dental screening of paediatric refugee patients at the time of heart disease diagnosis can optimize general and cardiovascular health before surgical intervention.

Notre étude visait à dépister des carences nutritionnelles et des problèmes de santé présents chez les enfants réfugiés au Canada atteints de cardiopathie, avant une intervention chirurgicale cardiaque. Une étude de cas rétrospective a été menée auprès de quatre enfants réfugiés, âgés de 0 à 18 ans, souffrant de cardiopathie et orientés vers la chirurgie cardiaque. Au total, 75 % des patients présentaient un faible taux de vitamine D, 50 % avaient une carence en sélénium, 50 % souffraient d'anémie ferriprive, 75 % avaient une taille et un poids inférieurs au troisième percentile pour leur âge et 75 % présentaient des caries dentaires. Un dépistage précoce comprenant des analyses de laboratoire, une évaluation nutritionnelle et un examen dentaire, au moment d'un diagnostic de cardiopathie chez les enfants réfugiés, pourrait permettre d'améliorer leur état de santé général et cardiovasculaire avant une intervention chirurgicale.