Difficulty Weaning From Cardiopulmonary Bypass Following an Aortic Valve Replacement.

Aortic valve replacement (AVR) remains the treatment of choice for severe aortic stenosis. Despite the growing number of transcatheter AVR (TAVR) in younger and intermediate-to-low-risk patients, surgical AVR (SAVR) is widely used and retains low operative mortality, low rate of complications, and predictable long-term valve durability. Although it is a straightforward procedure, on some occasions, a surgeon could face challenging situations, such as compromised coronary flow and an inability to wean the patient from cardiopulmonary bypass (CPB). Our patient required concomitant coronary artery bypass grafting to overcome biventricular failure and facilitate successful weaning from CPB.

Supradiaphragmatic accessory liver tissue mimicking pleural tumour: excision by transdiaphragmatic uniportal video-assisted thoracoscopic surgery (U-VATS).

We describe a case of an extremely rare intrathoracic supradiaphragmatic accessory liver tissue that was excised via transdiaphragmatic uniportal video-assisted thoracoscopic surgery. The intrathoracic mass that was radiologically detected was found to be mimicking a pleural tumour because of its supradiaphragmatic location as well as the presence of a clear cleavage plane separating the mass and the liver completely. This, to our knowledge, is the first described case that was resected via transdiaphragmatic uniportal approach in the literature.