Management of a protruding right coronary artery stent during aortic valve replacement for aortic stenosis.

We describe the successful management of a stent protruding from the right coronary ostium into the aortic root in the setting of aortic valve replacement for aortic stenosis. Due to advances in medical care more elderly patients present for aortic valve surgery after percutaneous coronary intervention. Therefore, with an aging population due to advances in medical care, more patients will present for aortic valve surgery after percutaneous coronary intervention.

A novel application of cerebral oximetry in cardiac surgery.

We report a novel use of cerebral oximetry in cardiac surgery using the Fore-Sight absolute cerebral oximeter (CAS Medical Systems Inc, Branford, CT). A patient with a persistent left superior vena cava underwent mitral and aortic valve replacement. We decided to tape and occlude the persistent left superior vena cava and used cerebral oximetry to compare left and right hemispheric oxygen saturation levels to ensure that cerebral perfusion was not impaired.

Accidental fracture of the tip of the Coopdech bronchial blocker during insertion for one lung ventilation.

Purpose: The distal tip of a Coopdech bronchial blocker has a preformed angulation to aid placement in the desired bronchus. We report two cases wherein this design may have resulted in distal tip fracture due to entanglement at the level of the Murphy's eye of the endotracheal tube or at the carina.

Clinical Features: A 49-yr-old female had a Coopdech bronchial blocker inserted into her right main bronchus for video-assisted thoracoscopic (VAT) lung biopsy.