RESUMEN
Ebstein's anomaly is a rare congenital cardiac disease which is often associated with various other cardiac anomalies. However, its association with total anomalous pulmonary venous connection is extremely rare with only one case reported so far in the English literature. We report the first successful surgical correction of both Ebstein's anomaly and total anomalous pulmonary venous connection in an adult patient. Such complex scenarios may pose unique challenges in management which require a judicious approach. Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01664-8.
RESUMEN
Anomalous origin of a branch pulmonary artery from the aorta is a rare congenital anomaly that requires early surgery to prevent pulmonary vascular disease. The rate of reintervention after surgery remains high. Many aspects of the management could be improved such as assessment of operability in late presenters, selection of suitable surgical technique in each case, and prevention of anastomotic complications. We report the series of 10 patients who were operated for this anomaly. We aim to focus on the current challenges in the management of this condition.
RESUMEN
Aneurysm of the aberrant left subclavian artery arising from Kommerell's diverticulum is very rare. Early intervention is recommended in such a case to avoid complications. Rarely, such an aneurysm may present with a concomitant cardiac pathology. Surgical approach in this complex scenario is difficult as anatomically distant areas have to be exposed and usually a staged approach is preferred. There are only a few published reports about the same. We report, for the first time, successful single-stage intervention in a patient with aortic regurgitation, right aortic arch, and aneurysmal aberrant left subclavian artery from Kommerell's diverticulum, exclusively through median sternotomy. A 37-year-old gentleman presented with the complaints of palpitations (New York Heart Association grade II) and left-sided neck swelling of 4 months' duration. He also had history of hoarseness of voice for 2 weeks. He was diagnosed to have aortic regurgitation, right aortic arch, and aneurysmal aberrant left subclavian artery from Kommerell's diverticulum and was treated by single-stage repair of the aneurysm and aortic valve replacement with mechanical prosthesis via median sternotomy. Single-stage intervention through midline sternotomy provides excellent outcomes and can be a feasible option for such a complex aortic anomaly.
RESUMEN
BACKGROUND: Immune system aberrations have been postulated to play a role in the pathophysiology of Obsessive-compulsive disorder (OCD). This study was aimed to examine the profile of immune cell subsets in peripheral blood of un-medicated OCD patients. METHOD: Thirteen drug-naïve/free OCD patients and twenty-six age & sex matched healthy controls were recruited. Immunophenotyping was carried out by staining the whole blood specimens with fluorescent monoclonal antibodies against the cell surface markers such as CD45, CD3, CD16, CD56, CD8, CD4, CD28, CD25 and CD127, followed by data acquisition on BD FACSVerse™ flow cytometer. The proportions of CD4 and CD8 T cells; T regulatory (Tregs), Natural Killer (NK) cells and NK-T cells were compared between patients with OCD and healthy control subjects. RESULTS: Significantly reduced percentage of T regulatory (Treg) cells was observed in individuals with OCD compared to healthy control subjects [1.0 ± 0.7 vs. 1.9 ± 1.4; p = 0.03, r = 0.33]. CONCLUSION: Treg cells play a crucial role in regulating the immune response, especially by suppressing the functional activities of T cells. In this study, decreased population of Treg cells essentially indicates a dysregulated T cell and/or T cell mediated immune activation in drug-naïve OCD patients. This preliminary observation might form the basis of further studies examining the immuno-inflammatory/autoimmune origin of OCD.
