Vertical vascular ring around right mainstem bronchus.

An 18-year-old male patient was referred with an atypical form of vascular ring consisting of a right aortic arch, a right descending aorta, a persistent right ligamentum arteriosum, and a dilated right pulmonary artery in the setting of discontinuous pulmonary arteries with a single functional right lung. The initial presentation was that of pneumonia of the right lung and later evaluation revealed the right mainstem bronchus was squeezed between the descending aorta and the dilated right pulmonary artery. Surgical exploration disclosed the right-sided ligamentum arteriosum was running under the right mainstem bronchus and hereby was completing a vertical vascular ring.

How a left-to-right shunt may protect against haemodynamic deterioration in restrictive cardiomyopathy.

Today, more and more children with complex heart lesions and underlying cardiomyopathies reach adulthood. This results in a wide range of new clinical problems encountered in later life. In particular, idiopathic restrictive cardiomyopathy is initially treated by medication to reduce symptoms, but at end-stage disease, heart or heart-lung transplantation becomes unavoidable.

Transcatheter closure of a Potts' shunt with subsequent surgical repair of tetralogy of fallot.

Closure of a Potts' aortopulmonary anastomosis during repair of a congenital heart malformation has been associated with high morbidity and mortality, especially due to technical problems encountered at closure of the shunt. A case is presented of a 40-year-old patient with tetralogy of Fallot and pulmonary atresia after palliation during infancy with a Potts' shunt. The anastomosis was successfully occluded using an Amplatzer ventricular septal defect occluder, immediately followed by complete surgical repair of his tetralogy of Fallot.

Bridging procedures to heart transplantation.

Ventricular assist devices are used to support the failing circulation and consequently bridge patients with end-stage heart disease to heart transplantation. From 1988 through 2000 we mechanically supported 47 patients with a bridge to heart transplantation. Within the same time frame 118 patients were mechanically supported for recovery of the heart.