Authors

M Adamek¹;  ¹ University Hospital Southampton, UK

Discusssion

Southampton Cardiothoracic centre is one of the largest and most reputable centres in the UK which serves a population of 3.5 million. This equates to around 1600 operations a year including routine, specialist and emergency surgery. Of these, we see a number of interesting and complicated cases which often require unique and advanced perfusion techniques to allow for surgical repair. In this short presentation, I will report a couple of the interesting cases that I have seen during the last year of my training at University Hospital Southampton. Case 1- Chicken Bone Pseudo-aneurysm
A 55-year-old presented with dysphagia and chest pain following a chicken meal. A CT scan showed a pseudo-aneurysm of the left carotid artery at the origin of the aorta. Surgical repair included cooling to 28oC with a period of circulatory arrest to dissect the inflamed tissue and haematoma and repair the left carotid artery.
Case 2- A Case of Heparin Resistance in an AAR
A 26-year-old septic patient developed vegetations on the aortic valve which lead to severe aortic regurgitation and a serious CVA. This deteriorated into a complex aortic root abscess which required surgical repair after the multi-disciplinary team decided the risk/benefit of anticoagulation required for surgery outweighed the risk of haemorrhagic transformation of the CVA. An ARR and TVR was planned, however the start of the case was plagued with difficulties in establishing adequate levels of anticoagulation. Anti-Xa levels were used to assess anticoagulation levels- a grey area for CPB anticoagulation management, and an area I aim to do my MSc project in.