Heat shock protein 27 is increased in cyanotic tetralogy of Fallot myocardium and is associated with improved cardiac output and contraction.

Tetralogy of Fallot (TOF) is a congenital heart condition in which the right ventricle is exposed to cyanosis and pressure overload. Patients have an increased risk of right ventricle dysfunction following corrective surgery. Whether the cyanotic myocardium is less tolerant of injury compared to non-cyanotic is unclear.

Acute B-type natriuretic peptide response and early postoperative right ventricular physiology following tetralogy of Fallot's repair.

B-type natriuretic peptide (BNP) response early after a tetralogy of Fallot's repair remains unclear. BNP was measured pre- and post-operatively (immediately, day 1) in 18 children undergoing corrective repair with concurrent echocardiography (pre-, post-op day 1) to assess right ventricular (RV) systolic dysfunction, restrictive physiology, wall motion and pulmonary regurgitation (PR). In the first 24 h postoperatively, BNP rose acutely in all patients (mean 34.

Comprehensive preassessment form for adult cardiac surgery.

Comprehensive evaluation of our patients before putting them under "the knife" can never be overemphasized. It is our duty to care for the patients. Detailed history-taking, clinical examination, and investigations are mandatory prior to surgery.

Conduits for coronary artery bypass surgery: the quest for second best.

Coronary artery bypass grafting is one of the most outstanding surgical achievements of the 20th century. Over its 50-year history patient outcomes have become excellent owing to technical refinements, myocardial protection, the use of antiplatelet and anticholesterol drugs, and the continued search for better conduits. The performance of conduits used for bypass remains the most important prognostic factor, with the left internal mammary artery being the conduit of choice due to its excellent patency rates.

Myocardial expression of heat shock protein 70i protects early postoperative right ventricular function in cyanotic tetralogy of Fallot.

Background: Right ventricular dysfunction occurs after tetralogy of Fallot repair and may relate to greater myocardial vulnerability to ischemia-reperfusion injury in cyanotic patients. The inducible form of heat shock protein 70 (HSP-70i), a molecular chaperone, is upregulated in response to cellular stress and limits myocardial injury against ischemia-reperfusion. We evaluated the myocardial expression of HSP-70i and its relation to right ventricular function and clinical outcome in patients with tetralogy of Fallot undergoing corrective surgery.

'Scoop and run' strategy for a resuscitative sternotomy following unstable penetrating chest injury.

The optimal management strategy of an unstable penetrating thoracic trauma remains a debate. It is unclear whether a 'stay and treat' or 'scoop and run' to the nearest operating theatre with cardiothoracic expertise is the best strategy. We describe a successful outcome of a young patient with injuries to the left internal mammary artery, upper lobe and main pulmonary artery following a stab injury to his left chest.

Synergistic interaction between right ventricular mechanical dyssynchrony and pulmonary regurgitation determines early outcome following tetralogy of Fallot repair.

Objective: The ability of the right ventricle to tolerate acute pulmonary regurgitation (PR) following tetralogy of Fallot (TOF) repair is variable and the mechanisms that underlie this are not completely understood. We hypothesise that dyssynchronous wall mechanics affects the RV tolerance to postoperative PR with adverse effect on early surgical outcome.

Methods: Twenty-four TOFs (mean age 19.

The risk of fatal re-expansion pulmonary oedema in poor left ventricular reserve.

Re-expansion pulmonary oedema (REPO) is an uncommon complication which may be encountered following drainage of pneumothorax, pleural effusion or haemopneumothorax. Treatment is usually supportive and some patients may require positive pressure ventilation. We provide a novel description of the mechanism of a fatal REPO in a patient with a small and non-compliant left ventricle (LV).

Mediastinal irradiation and its effect on the cardiovascular system.

Mediastinal irradiation for various malignancies can cause radiation injury to mediastinal structures, most importantly the cardiovascular system. This article reviews the effect of radiation on cardiovascular structures and the manifestations of various radiation-induced heart diseases.

Septic arthritis of the manubriosternal joint.

Pyarthrosis of the manubriosternal joint is exceedingly rare. Its rarity defies an early diagnosis, and other causes of chest pain would normally be ruled out first. We describe a patient with a short history of chest pain, pyrexia, and raised inflammatory markers.

Ascending aortic origin of a branch pulmonary artery--surgical management and long-term outcome.

Objective: Ascending aortic origin of a branch pulmonary artery (AOPA, hemitruncus arteriosus) is a rare congenital malformation. While there have been isolated case reports, larger series, relating to long-term outcomes following surgery are few. This article analyses the surgical results of a series of nine patients, over a period of 29 years.