Self-inflicted gunshot wound to the right coronary artery in a pediatric patient resulting in sternotomy and coronary artery stenting.

Penetrating gunshot wounds to the heart are rare in children but can lead to severe complications requiring urgent intervention. This report describes a case of a 14-year-old male who sustained a gunshot wound to the anterior chest from a high-velocity pellet rifle, resulting in hemopericardium, cardiac tamponade, and potential injury to the right coronary artery. Following emergency surgery and the successful evacuation of a clot containing the pellet, the patient experienced ventricular fibrillation and was subsequently taken for percutaneous coronary intervention due to a middle right coronary arterial occlusion.

When Air Strikes: A Pregnant Patient's Surprising Encounter With Pneumoperitoneum.

Pneumoperitoneum, characterized by free air in the peritoneal cavity, typically signals significant intra-abdominal pathology, often due to perforated hollow viscera requiring urgent surgical intervention. However, spontaneous idiopathic pneumoperitoneum, particularly in pregnant patients, is rare and poorly understood. This case report details a 41-year-old female, 24 weeks pregnant status post two rounds of cardiopulmonary resuscitation (CPR), who presented unresponsive after a suspected overdose.

Contralateral Thoracotomy With Extracorporeal Circulation for Reoperative Resection of a Kommerell Diverticulum.

Reoperative vascular ring surgery is uncommon. Standard redo ipsilateral thoracotomy may present technical challenges and risks. We describe a patient with right aortic arch, aberrant left subclavian artery, and a Kommerell diverticulum in whom previous vascular ring division via left thoracotomy did not relieve dysphagia.

Clinical outcomes of conduction system pacing compared to biventricular pacing in patients requiring cardiac resynchronization therapy.

Background: Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is well-established therapy in patients with reduced left ventricular ejection fraction (LVEF) and bundle branch block or indication for pacing. Conduction system pacing (CSP) using His-bundle pacing (HBP) or left bundle branch area pacing (LBBAP) has been shown to be a safe and more physiological alternative to BVP.

Objective: The purpose of this study was to compare the clinical outcomes between CSP and BVP among patients undergoing CRT.

Clinical outcomes of left bundle branch area pacing compared to His bundle pacing.

Introduction: His bundle pacing (HBP) is the most physiologic form of pacing and has been associated with reduced risk for heart failure hospitalization (HFH) and mortality compared to right ventricular pacing. Left bundle branch area pacing (LBBAP) is a safe and effective alternative option for patients needing ventricular pacing. The aim of this study was to compare the clinical outcomes between LBBAP and HBP among a large cohort of patients undergoing permanent pacemaker implantation.