Impairment of mitochondrial respiratory chain enzyme activities in tetralogy of Fallot.

Background: During the last decade, disorders of the respiratory chain, so-called mitochondrial disorders, have emerged as a major clinical entity. Tetralogy of fallot (TOF) children>2 month of age are at risk for postoperative myocardial contractile failure. Myocardial ischemia is associated with a reduction in mitochondrial enzyme activity and have impaired metabolism resulting in decreased postoperative myocardial adenosine triphosphate (ATP) concentrations and increased lactate levels.

Technique of lung retraction during internal mammary artery harvesting.

We describe a novel technique for lung retraction during dissection of the internal mammary artery for its use in coronary artery bypass grafting. The lung is retracted using the blades of the Octopus (Medtronic Inc, Minneapolis, MN) suction stabilizer, without the suction connected. This technique can be used when the internal mammary artery is harvested by widely opening the pleura or by the extrapleural approach.

Unexplained systemic hypertension after closure of ductus arteriosus.

Immediately after surgical closure of a patent ductus arteriosus, a 12-year-old boy developed severe systemic arterial hypertension refractory to medication. The cause of hypertension could not be found, but it came under control 3 weeks postoperatively with a combination of angiotensin-converting enzyme inhibitor and chlorothiazide.