Congenital heart disease is an interesting area which present a great various arrangement of the cardiac stucture. We present a rare case of 11 months old male with complex congenital heart disease consisted of Double Inlet Left Ventricle (DILV), Double Outlet Left Ventricle (DOLV) with Malposition of Great Arteries, Inlet Ventricle Septal Defect (VSD) and Patent Ductus Arteriosus (PDA).Patient was an eleven months old male who was admitted in our institution for cardiac operation. He was diagnosed with congenital heart disease since three days old with initial presentation of cyanosis when he was crying. His physical growth was retarded but his developmental Milestones was considered normal. On admission, his oxygen saturation was 88% with ambient air. The diagnosis was confirmed by echocardiography. He was planned to undergo staging surgery which would end to Fontan Procedure. Pulmonary Artery (PA) banding was performed to reduce blood flow to pulmonary circulation, distribute more blood from the left ventricle to aorta and systemic circulation and prepare for bidirectional Glenn Shunt procedure one year later and Fontan procedure a year after that.

Tuberculosis (TB) is a global health problem, in which the majority of cases occur in population-dense developing countries. Despite advances in various diagnostic TB modalities, extrapulmonary TB remains a challenge due to complexities related to its diagnostic approach. Hereby, we present a rare case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis (MTB). This case report highlighted the challenges faced in diagnosing blood culture-negative infective endocarditis (BCNIE). We also emphasized the importance of considering MTB as etiology of BCNIE, particularly in endemic TB areas.

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The outcomes of coronary artery bypass grafting (CABG) surgery are determined by numerous factors. This study aimed to analyze the factors contributing to short-term outcomes of patients undergoing isolated CABG. This retrospective analysis enrolled all adult patients undergoing isolated CABG at our center between January 2013 and December 2016. Clinical characteristics and postoperative events were recorded and analyzed. Overall, 242 patients (mean age, 59.7 ± 9.5 years) were included. The majority of the patients (88.4%) were men. The median left ventricular ejection fraction (LVEF) was 50% ± 15%, with 38% patients having an LVEF lower than 40% and 9.1% having an LVEF lower than 25%. The mean preoperative creatinine level was 1.25 ± 0.73, and the estimated glomerular filtration rate was 68.55 ± 23 ml/min/1.73 m2. The intensive cardiac care unit stay and total in-hospital stay were 70 ± 59 h and 8 ± 4 days, respectively. The in-hospital mortality rate was 2.1%. The most common major adverse events were new-onset atrial fibrillation (31.8%) and significant worsening of renal function (21.5%). Stroke occurred in 3.7% patients, for which preexisting chronic kidney disease (CKD) and dyslipidemia were strong predictors (P < 0.05; area under the curve [AUC], 87.7%). Advanced age and hypertension were considered significant risk factors for developing new-onset atrial fibrillation (P < 0.05; AUC 65%). Worsening renal function and new-onset atrial fibrillation were the most frequent complications that occurred during hospitalization following CABG. Preexisting CKD and dyslipidemia were the major risk factors for developing acute stroke post surgery. KEYWORDS Acute cerebrovascular events, Chronic kidney disease, Coronary artery bypass grafting, Dyslipidemia.