Critical Cyanosis in a Neonate With Unusual Congenital Tricuspid Valve Lesion.

We describe a case of a low birth weight neonate who presented on second day of life with progressive cyanosis and oxygen saturation of 60% by pulse oximetry. The echocardiography examination revealed a large tumor-like mass connected to the tricuspid valve, with severe obstruction of the right ventricular inflow and massive right-to-left shunt through the distended foramen ovale. A large vegetation-like lesion with calcifications was discovered intraoperatively and was debrided by shave excision technique under deep hypothermic circulatory arrest.

Phrenic nerve injury after paediatric heart surgery: is aggressive plication of the diaphragm beneficial?

Objectives: Phrenic nerve injury after paediatric heart surgery is associated with significant morbidity. Surgical plication of the diaphragm is believed to be beneficial to the patient, with difficult weaning from ventilation; however, the optimal timing remains unclear. We aimed to compare the outcome after two different strategies for treating hemidiaphragmatic paresis.

[Quality of clinical diagnosis: pathological-anatomical criteria].

In addition to discrepancy of clinical and anatomopathological diagnosis the author proposes several other criteria for assessment of quality of clinical diagnosis: hypo- and hyperdiagnosis, diagnosis of lethal complications, late diagnosis of the basic disease and fatal complications, diagnosis of iatrogenic complications, accuracy of formulation of the fanal diagnosis, use of biopsies for specification of clinical diagnosis and control of the patients' treatment. Complete computerization of the pathologist's workplace makes all these criteria most effective.