Entrapment or device loss during percutaneous coronary intervention is a rare but potentially fatal complication. Percutaneous retrieval is possible but surgery can be required on an emergency basis. We present the case of an entrapped balloon catheter in the left anterior descending coronary artery during an elective percutaneous coronary intervention. The patient developed acute myocardial ischaemia and cardiac arrest. Emergency surgical intervention with device retrieval and distal bypass grafting was life-saving.

Obstructive total anomalous pulmonary venous return (TAPVR) is a potentially life-threatening clinical condition and a surgical emergency. Left-sided partial anomalous pulmonary venous return (PAPVR) in association with a subdivided left atrium, also known as cor triatriatum sinister (CTS), is a very rare malformation that can mimic obstructive TAPVR. We present a case of a newborn with clinical manifestation of cardiogenic shock caused by CTS and PAPVR.

Pediatric cardiac surgery induces an increased oxidative stress (OS) response. Increased OS is associated with poor neurologic outcomes in neonatal populations with similar patterns of brain injury. We investigated OS and brain injury in infants undergoing heart surgery. Patients 6 months or younger, undergoing cardiac surgery with or without cardiopulmonary bypass (CPB), were included in this prospective, observational study. Patients were divided into infant (30 days–6 months) and neonatal (<30 days) groups for analysis. Urine OS biomarker 8-iso-prostaglandin F2α (8-iso-PGF2α) was quantified pre-surgery and at 0 and 24 h post-surgery. A serum brain damage biomarker S100B protein was also measured pre-surgery and at 0 and 72 h post-surgery. Amplitude-integrated electroencephalography during surgery was analyzed. Neuropsychological evaluation using the Bayley III or Vineland test was performed in all patients at 24 months of age. Sixty-two patients were included, 44 of whom underwent follow-up neurologic evaluation. 8-iso-PGF2α and S100B levels were increased after surgery. Postoperative levels of S100B were positively correlated with 8-iso-PGF2α levels 24 h after surgery (rho = 0.5224; p = 0.0261). There was also a correlation between immediate post-surgery levels of 8-iso-PGF2α and intra-surgery seizure burden (rho = 0.4285, p = 0.0205). Patients with an abnormal neurological evaluation had increased levels of S100B 72 h after surgery (p = 0.048). 8-iso-PGF2α levels 24 h after surgery were also related to abnormal neurologic outcomes. Levels of 8-iso-PGF2α following pediatric cardiac surgery are associated with several indicators of brain injury including brain damage biomarkers, intra-operative seizures, and abnormal neurological evaluation at follow-up, suggesting the importance of oxidative stress response in the origin of brain damage in this population.

No abstract