Is Left Innominate Vein Ligation during Aortic Arch Surgery Always Safe? A Case Report.

Ligation of the left innominate vein (LIV) expands the surgeon's surgical field for ascending aorta and aortic arch procedures. Although it is considered a safe technique by most surgeons in that it is associated with only minor drawbacks, conflicting views exist regarding this method. We herein describe a 70-year-old woman who underwent ascending aorta replacement due to an aneurysm with subsequent cerebral dysfunction caused by extended brain edema, possibly related to LIV ligation, leading to her death.

Delayed disseminated intravascular coagulopathy post thoracic endovascular aortic repair (TEVAR).

Disseminated intravascular coagulopathy (DIC) is a very rare outcome post endovascular repair of aortic aneurysm dissections. We present a case of a 70-year-old male who presented with DIC post a thoracic endovascular aortic repair (TEVAR) procedure due to a type 1A endoleak. Initially, the patient was treated with red blood cells and blood products; however, when failing to improve, he underwent a hybrid arch replacement. In this study, we will analyze the management of DIC post TEVAR and look at its presentation more extensively, as it is currently a topic that is poorly studied.

Delayed Diagnosis and Treatment of a Critically Ill Patient with Infective Endocarditis Due to a False-Positive Molecular Diagnostic Test for SARS-CoV-2.

BACKGROUND The worldwide spread of the severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) has created unprecedented situations for healthcare professionals and healthcare systems. Although infection with this virus is considered the main health problem currently, other diseases are still prevalent. CASE REPORT This report describes a 59-year-old man who presented with symptoms of dyspnea and fever that were attributed to Covid-19 infection. His clinical condition deteriorated and further examinations revealed a subjacent severe aortic regurgitation due to acute infective endocarditis. Surgical treatment was successful. CONCLUSIONS The results of diagnostic tests for Covid-19 should be re-evaluated whenever there are clinical mismatches or doubts, as false-positive Covid-19 test results can occur. Clinical interpretation should not be determined exclusively by the Covid-19 pandemic. This case report highlights the importance of using validated and approved serological and molecular testing to detect infection with SARS-CoV-2, and to repeat tests when there is doubt about presenting symptoms.