Anomalies in development of the pulmonary valve, pulmonary trunk and peripheral pulmonary arteries are typical accompanying pathologies in patients with tetralogy of Fallot (ToF). Demanding for diagnostics and borderline for treatment is a condition colloquially called “discontinuous pulmonary arteries”, while the main branches are supplied with systemic blood from the ascending aorta, aortic arch or descending thoracic aorta.We present a case of a one-year-old girl with ToF and anomalous origin of the left pulmonary artery (LPA) from Kommerell's diverticulum who underwent two-stage surgical therapy with the support of interventional cardiology.We conclude that early diagnosis of discontinuous pulmonary artery is crucial for choosing the optimal operative strategy. In our opinion, simultaneous anatomic intracardiac correction with direct pulmonary reconstruction seems reasonable and effective, particularly when the result is achieved after joint efforts of cardiac surgery and interventional cardiology.

No abstract

No abstract

Myocardial protection is one of the most important factors ensuring patient safety during cardiac surgery with the application of cardiopulmonary bypass. Infusion of cardioplegic solution into the coronary circulation protects the heart and provides a standstill operating field for the surgeon. Cold blood cardioplegia and crystalloid cardioplegia are the two main types of solutions with a long history of use and a large amount of research proving their efficacy and safety. Relatively new del Nido cardioplegia seems to be an interesting alternative. We reviewed the literature comparing del Nido cardioplegia with two other types of cardioplegic solutions. We took into consideration many different clinical and biochemical aspects may indicate the quality of cardioprotection.