Vascular compression syndromes represent a group of rare conditions caused by extrinsic compression of veins or arteries by surrounding anatomical structures. These disorders are often underdiagnosed due to nonspecific symptoms, and the coexistence of multiple syndromes in a single patient is extremely rare. We report an 18-year-old woman with no past medical history who presented with intermittent abdominal and lumbar pain and progressive weight loss, without haematuria. Initial ultrasonography and contrast-enhanced computed tomography revealed the coexistence of Nutcracker, Dunbar (median arcuate ligament), and May-Thurner syndromes. The patient underwent open surgical management via median laparotomy, involving median arcuate ligament section to relieve coeliac trunk compression, transposition of the left renal vein, and decompression of the left common iliac vein by mobilisation of the right common iliac artery. The postoperative course was uneventful, with significant symptom relief and favourable long-term outcomes. This case highlights the diagnostic challenges and therapeutic complexity associated with combined vascular compression syndromes, emphasising the importance of a multidisciplinary surgical approach.

Cardiovascular disease is an increasingly significant cause of morbidity and mortality in sub-Saharan Africa, driven by demographic growth, population ageing, and epidemiological transition. Despite the growing burden of ischaemic heart disease and other cardiovascular conditions, access to interventional cardiology services remains severely limited across the region. Critical shortages of percutaneous coronary intervention facilities, catheterisation laboratories, and trained interventional cardiologists contribute to delayed treatment and preventable mortality. Additional barriers include high infrastructure and equipment costs, limited financing mechanisms, inadequate insurance coverage, workforce shortages, and geographic inequities in access to care. Nevertheless, emerging programs in Uganda, Kenya, and Ethiopia demonstrate that sustainable progress is achievable through strategic partnerships, local workforce development, public-private collaboration, and regional professional networks. Expanding interventional cardiology capacity will require coordinated investments in infrastructure, training, financing, referral systems, and policy prioritisation. Strengthening these systems is essential to achieving equitable cardiovascular care and improving outcomes across sub-Saharan Africa.

Cardiovascular disease is an increasingly significant cause of morbidity and mortality in sub-Saharan Africa, driven by demographic growth, population ageing, and epidemiological transition. Despite the growing burden of ischaemic heart disease and other cardiovascular conditions, access to interventional cardiology services remains severely limited across the region. Critical shortages of percutaneous coronary intervention facilities, catheterisation laboratories, and trained interventional cardiologists contribute to delayed treatment and preventable mortality. Additional barriers include high infrastructure and equipment costs, limited financing mechanisms, inadequate insurance coverage, workforce shortages, and geographic inequities in access to care. Nevertheless, emerging programs in Uganda, Kenya, and Ethiopia demonstrate that sustainable progress is achievable through strategic partnerships, local workforce development, public-private collaboration, and regional professional networks. Expanding interventional cardiology capacity will require coordinated investments in infrastructure, training, financing, referral systems, and policy prioritisation. Strengthening these systems is essential to achieving equitable cardiovascular care and improving outcomes across sub-Saharan Africa.

Traumatic rupture of the thoracic aorta is most frequently caused by rapid deceleration during road traffic accidents, with the aortic isthmus representing the most common site of injury. Isolated post-traumatic distal aortic haematomas remain rare. Their clinical management is highly challenging, particularly when the regional aortic diameter is narrow. We report the case of a 26-year-old man who survived a violent motor vehicle collision involving a two-vehicle impact. Upon presentation, he was haemodynamically and neurologically stable. A thoraco-abdominal computed tomography scan revealed an intramural haematoma in the subdiaphragmatic aorta, along with a hepatic contusion, a splenic contusion, and a spinal fracture. Post-processing image analysis performed on a workstation determined the aortic diameters above and below the lesion to be 16.3 mm and 14.7 mm, respectively. The patient was successfully managed conservatively with structured clinical and radiological follow-up.

This study aimed to evaluate postoperative neurological and neurocognitive changes in patients undergoing ascending aortic and aortic root aneurysm surgery using the deep hypothermic circulatory arrest technique with open distal anastomosis performed without cerebral perfusion. Thirty-six patients (83.3% male, n = 30; 16.7% female, n = 6) were included. Demographic, operative, and postoperative data were recorded. Each patient underwent the Mini-Mental State Examination (MMSE), the Oktem Verbal Memory Processes Test (OVMPT), and the Wechsler Memory Scale-Visual Reproduction Test (WMS-VR) before and one week after surgery. Cerebral oxygen saturation levels were continuously monitored using near-infrared spectroscopy. Postoperative OVMPT scores showed significant improvement (p < 0.001). No significant change was observed in the WMS-VR, while MMSE scores showed a slight but significant postoperative decline (p < 0.001). No associations were found between neurocognitive outcomes and operative variables. These findings indicate that this procedure can be performed with acceptable early neurological outcomes.

Familial hypercholesterolaemia (FH) is a genetic disorder characterised by elevated levels of circulating low-density lipoprotein cholesterol. Serious presentations are challenging to treat. We report a case of complex cardiovascular outcomes in a 28-year-old man with diabetes mellitus and untreated FH. The diagnostic workup was compatible with a homozygous phenotype. The patient presented with a non-ST-elevation myocardial infarction, which revealed severe premature three-vessel coronary artery disease with significant proximal blockages, including severe ostial left main stenosis, as well as severe valvular and supravalvular aortic stenosis. Aortic computed tomography angiography (CTA) confirmed the presence of a porcelain aorta and guided the surgical repair. Despite the porcelain aorta, the patient underwent conventional cardiac and aortic surgery with an uneventful post-operative course. This case highlights a rare case of successful cardiac and aortic surgery in the context of a porcelain aorta, performed safely by experienced surgeons using current perfusion and operative techniques guided by CTA imaging. Ongoing efforts are required to improve early detection and prompt management of FH.