Doxorubicin is an effective chemotherapeutic agent widely used in veterinary oncology, particularly as part of the CHOP protocol for canine lymphoma. Despite its therapeutic benefit, cardiotoxicity remains a serious dose-limiting adverse effect. Although clinically significant cardiotoxicity is typically reported at cumulative doses of 150-240 mg/m 2 in dogs, functional cardiac deterioration has been observed at lower doses, with progression to congestive heart failure rarely reported. This case report describes doxorubicin-induced cardiotoxicity below the established cumulative threshold in a dog with multicentric lymphoma, which presented with overt clinical signs of congestive heart failure, including coughing, syncope, and pleural effusion. The dog also exhibited marked echocardiographic changes, including right atrial enlargement and a reduction in fractional shortening from 33% to 21% over 2 weeks, ultimately resulting in death 53 days after symptom onset. The clinical diagnosis was supported by the temporal relationship with doxorubicin administration and serial cardiac imaging findings. This case highlights that severe cardiotoxicity can occur even below traditionally accepted cumulative thresholds, reinforcing the importance of individualized, ongoing cardiac monitoring and early intervention, regardless of dose.

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a lifesaving technique for patients experiencing respiratory failure. When VV ECMO fails to provide adequate support despite optimal settings, alternative strategies may be employed. One option is to add another venous cannula to increase venous drainage, while another is to insert an additional arterial return cannula to assist cardiac function. Alternatively, a separate ECMO circuit can be implemented to function in parallel with the existing circuit. We present a case in which the parallel ECMO method was used in a 63-year-old man with respiratory failure due to coronavirus disease 2019, combined with cardiac dysfunction. We installed an additional venoarterial ECMO circuit alongside the existing VV ECMO circuit and successfully weaned the patient from both types of ECMO. In this report, we share our experience and discuss this method.

Pulmonary artery sling is a rare congenital cardiac anomaly, in which the left pulmonary artery originates from the right pulmonary artery and courses leftward between the trachea and the esophagus. Tetralogy of Fallot associated with pulmonary artery sling is even rarer, and only a few cases have been reported in the literature. We present a case of tetralogy of Fallot associated with pulmonary artery sling that was repaired successfully.
Esophagus ; Pulmonary Artery* ; Tetralogy of Fallot* ; Trachea

BACKGROUND: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. METHODS: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%). RESULTS: Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality. CONCLUSION: Nonintubated uniportal VATS appears to be a feasible and valid surgical option, depending on the surgeon’s experience, for appropriately selected patients.
Anesthesia ; Anesthesia, Local ; Anoxia ; Arteries ; Chest Tubes ; Chylothorax ; Hospital Mortality ; Humans ; Intercostal Nerves ; Intubation ; Ion Transport* ; Length of Stay ; Lung Diseases ; Lung Neoplasms ; Mastectomy, Segmental ; Minimally Invasive Surgical Procedures ; Neoplasm Metastasis ; Pleural Diseases ; Pleural Effusion ; Pneumonia ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted*