PMC4648563_01
Cardiothoracic manifestations. The parasternal long-axis view of the echocardiogram with Doppler color flow mapping (A) demonstrated the bidirectional shunt with predominant left-to-right shunting (arrow heads) through the VSD, while the axial view of the chest CT (B) scan revealed right pulmonary artery origin stenosis (arrow heads).
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Transthoracic echocardiography disclosed a perimembranous VSD (maximum diameter of 21 mm), a bidirectional shunt with left-to-right shunting (2.55 m/second) predominance, and well contracting left ventricle (LV) with an LV ejection fraction of 63.8% (Fig. 1A), while chest computed tomography (CT) scans demonstrated right pulmonary artery stenosis (Fig. 1B).
The changes in the BUN, sCr, Ca, Pi, K, and Hb values during the observation period. After five sessions of HD (arrows), PD was initiated. The number "0" is designated as the point of admission. Note that the patient's sCr and BUN levels finally settled around 6 and 60 mg/dL, respectively.
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PD catheter was placed on hospital day 17 through a classic transverse surgical incision with a favorable postoperative course. PD using two daily exchanges (1.5 L of Midperiq 135 x 2, Terumo Co..) with a total dwell of 12 hours was then initiated (Fig. 2).