Distinct alterations in sublingual microcirculatory blood flow and hemoglobin oxygenation in on-pump and off-pump coronary artery bypass graft surgery.

Objective: The authors hypothesized that cardiopulmonary bypass (CPB) (on-pump) is associated with more severe changes in the microcirculatory blood flow and tissue oxygenation as compared with off-pump coronary artery bypass surgery.

Design: An observational study.

Setting: A university hospital and teaching hospital.

A combined surgical and percutaneous approach through the axillary artery to introduce the Impella LP5.0 for short-term circulatory support.

We describe a novel axillary approach for insertion and usage of the Impella LP5.0, a low cost micro-axial flow pump, in five patients requiring circulatory support after acute ST-segment elevation myocardial infarction (STEMI). This alternative approach for implantation of the Impella LP5.

Pulmonary arterial stent implantation in an adult with Williams syndrome.

We report a 38-year-old patient who presented with pulmonary hypertension and right ventricular dysfunction due to pulmonary artery stenoses as a manifestation of Williams syndrome, mimicking chronic thromboembolic pulmonary hypertension. The patient was treated with balloon angioplasty and stent implantation. Short-term follow-up showed a good clinical result with excellent patency of the stents but early restenosis of the segments in which only balloon angioplasty was performed.