The fantastic journey of a bullet: out with a snare.

Bullet embolus is a rare complication of penetrating missile trauma. Removal of the bullet previously required surgery. We report the case of a 14-year-old with an hepatic vein bullet embolus following a gunshot wound to the left buttock.

Fludrocortisone in the management of an infant with a single ventricle and an overly tightened pulmonary artery band.

We describe a 2-month-old female infant with a univentricular heart and overly tightened pulmonary artery band (PAB) resulting in hypercyanotic episodes. Despite adequate doses of morphine and a beta-blocker, she continued to have multiple hypercyanotic events per day. Treatment with fludrocortisone resulted in resolution of these episodes and allowed performance of a Glenn shunt at 3 half months of age.

Early renal benefit of rapamycin combined with reduced calcineurin inhibitor dose in pediatric heart transplantation patients.

Background: Calcineurin inhibitors such as cyclosporine are effective in preventing rejection in recipients of solid organ transplants. Unfortunately, the prolonged use of calcineurin inhibitors may result in progressive renal injury.

Methods: We studied the renal function of 15 pediatric heart transplant recipients who were taking calcineurin inhibitors.

An alternative method to fenestrate the extracardiac fontan conduit in a patient with atrial situs inversus and levocardia.

This report describes the technique to fenestrate the extracardiac Fontan conduit without cardiopulmonary bypass in a patient with levocardia and atrial situs inversus.

Comparison of angioplasty and surgery for neonatal aortic coarctation.

Background: The efficacy of balloon dilatation as primary treatment for neonatal aortic coarctation remains controversial.

Methods: A retrospective comparison between balloon angioplasty and surgery for the treatment of neonatal aortic coarctation was undertaken on 57 neonates younger than 40 days of age (angioplasty, 23 patients; surgery, 34 patients) treated between 1994 and 2004.

Results: Cohorts were similar with respect to the preinterventional variables of age, weight, upper extremity systolic blood pressure, coarctation gradient, degree of aortic arch hypoplasia, associated conditions, and mean follow-up (angioplasty, 36 months; surgery, 38 months).