Aorto-left ventricular tunnel: the necessity of early surgical intervention.

Aorto-left ventricular tunnel, also known as aorto-left ventricular fistula, is a rare CHD characterised by an abnormal connection between the aorta and the left ventricle. This article presents a comprehensive case report on aorto-left ventricular tunnel, encompassing clinical presentation, diagnostic approaches, treatment options, and outcomes, with a specific focus on the necessity of early surgical intervention.

Evaluation of perioperative risk factors in pediatric patients with left ventricle outflow tract obstruction.

Introduction: Left ventricular outflow tract obstructions (LVOTO) presents as complex cardiac diseases accompanied by other cardiac anomalies in the pediatric age group. Postoperative complications, especially cardiac, pulmonary, and renal complications, that may develop after pediatric cardiac surgery can become life-threatening. If the perioperative risk factors for these complications are known in pediatric patients with LVOTO, anesthesiologists and surgeons may take precautions to eliminate undesirable outcomes. Aim: To evaluate the perioperative risk factors that may contribute to the development of postoperative complications in pediatric patients operated on for LVOTO in a pediatric cardiac surgery clinic. Material and methods: The study retrospectively investigated 58 patients who were operated on for LVOTO in a pediatric cardiac surgery clinic. The patients were divided into two groups, those with and without postoperative complications. Preoperative laboratory test results, anesthesia time, operation time, aortic cross-clamp time, cardiopulmonary bypass (CPB) time, postoperative inotropes, first postoperative laboratory tests, intraoperative and postoperative complications, mechanical ventilation time, intensive care unit stay, and hospital stay were recorded. Results: The most common postoperative complications were endocrine complications, followed by hepatic complications. The preoperative lymphocyte count was significantly higher (p < 0.05), and the neutrophil-to-lymphocyte ratio (NLR) was significantly lower (p < 0.05) in the group with postoperative complications. The postoperative pH, glucose, creatinine, and aspartate aminotransferase (AST) levels were significantly lower (p < 0.05), and the postoperative calcium level was significantly higher (p < 0.05) in the group without postoperative complications. Intraoperative platelet transfusion rate was found to be significantly lower (p < 0.05) in the group with postoperative complications. Conclusions: It is critical to identify predictive factors to prevent postoperative complications in pediatric patients undergoing surgery for LVOTO. Preoperative NLR, intraoperative platelet transfusion, and postoperative calcium, glucose, pH and AST levels may help in the prediction of complications.

Whole Lung Lavage in a Pulmonary Alveolar Proteinosis Patient with Severe Respiratory Failure.

Pulmonary alveolar proteinosis (PAP) is a rare interstitial lung disease that develops as a result of defects in the clearance of surfactant by alveolar macrophages. The accumulation of lipid- and protein-rich substances in the alveoli constitutes the main pathology of this disease. PAP has three types of aetiology: autoimmune (primary), congenital and secondary. The most common form in adults is autoimmune PAP. Whole lung lavage is a commonly performed method for treatment of this form of disease, especially in more severe cases. Performed under general anaesthesia, the material deposited in the alveoli is removed by washing. In this paper, we present a whole lung lavage under anaesthesia in a PAP patient who had severe respiratory failure.