Jacob, Samuel

Abstract Transesophageal echocardiography (TEE) has become an indispensable part of cardiac surgery, but its potential for assessing coronary anatomy and blood flow remains underutilised. This case report presents a case of acute iatrogenic left main coronary artery obstruction following re-operative aortic valve replacement that was promptly diagnosed by intraoperative TEE and managed successfully by Bentall operation. We also emphasise the technique of TEE for coronary evaluation, its caveats and its clinical application during cardiac surgery.

Abstract Concomitant lung transplantation and coronary artery bypass grafting operation became more prevalent over the last decade due to the advanced age of recipients. Median sternotomy approach is traditionally used when internal thoracic artery is utilized. Here we report a technique of harvesting the left internal thoracic artery via a clamshell incision for a combined coronary artery bypass and bilateral lung transplant operation in a 71-year-old male with terminal respiratory failure and coronary artery disease.

ABSTRACT Recent years have witnessed evolution of lung allocation strategies to prioritize sicker recipients. In the pre-transplant period, this has translated into increased utilization of invasive extracorporeal or mechanical ventilatory support as a bridge to lung transplantation. The morbidity associated with these strategies warrants consideration to less invasive respiratory support modalities. Herein, we present a case highlighting successful bridge to lung transplantation with a relatively non-invasive negative pressure ventilator.