A customized multimodality approach for prolonged air leaks (PAL) in mechanically ventilated patients.

ARDS in general and severe COVID ARDS (CARDS) is particularly associated with high rates of barotrauma. Two cases with severe CARDS developed bilateral pneumothorax with persistent air leak (PAL). Conservative management with prolonged chest tube drainage did not help in PAL resolution and both patients continued to be on high-end ventilatory support.

Minimally invasive surgery in the treatment of triple vessel coronary artery disease with coexisting coronary artery fistula.

Coexistence of triple vessel coronary artery disease with coronary-pulmonary artery fistula is extremely rare. Minimally invasive cardiac surgery in the treatment of such coexisting disease is so far not reported. This case report emphasizes the feasibility of performing complete revascularization of the coronaries with coronary artery fistula ligation through a minimally invasive anterior thoracotomy, obviating full sternotomy.

Venoarterial Extracorporeal Membrane Oxygenation is Effective in Severe Aluminum Phosphide Overdose Despite Delayed Presentation.

Unlabelled: Aluminum phosphide (ALP) is a potentially lethal poison. The mortality rate in ALP overdose is close to 100%. ALP has no specific antidote, and only supportive therapy is possible, with timely extracorporeal support mentioned as a modality.

Extraction of Right-Sided Vegetation With Use of an Aspiration Catheter System.

Indications for surgical management of active right-sided endocarditis are under debate. In the presence of vegetation without valvular or surrounding tissue involvement, the mass may be removed with a suction device introduced via a transcatheter path. Herein, we report the successful removal of right-sided vegetation using the AngioVac Cannula, a percutaneous mechanical suction device, in three patients who presented with active endocarditis.

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: role of transesophageal echocardiography.

Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare cardiac surgical condition. P-MAIVF commonly occurs as a complication of aortic and mitral valve replacement surgeries. The surgical trauma during replacement of the valves weakens the avascular mitral and aortic intervalvular area.

Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery.

Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF) is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm.

Aorto-left ventricular tunnel: uncommon site of origin and management.

Cases of aorto-ventricular tunnel involving the right ventricle and more commonly, the left ventricle have been described. The site of origin is located above the right coronary cusp and occasionally, the left. We describe an aorto-left ventricular tunnel in a 16-year-old girl, with aneurysmal expansion into the right ventricular outflow tract.

Pulmonary artery bypass for in-stent stenosis following angioplasty for isolated pulmonary Takayasu arteritis.

Pulmonary artery (PA) stenosis due to Takayasu Arteritis (TA) is usually managed by angioplasty techniques. We present a patient with isolated PA stenosis with TA with in-stent stenosis. The surgical management and pathophysiology of this disease are reviewed.

A technique for repair of atrioventricular canal defect in dextrocardia.

Congenital heart disease with dextrocardia, situs solitus, is not uncommonly seen in paediatric cardiac surgery. An approach through the right atrium for correction of associated cardiac anomalies is needed in most of these cases. We present a technique for operating on this subset of patients wherein the heart can be displaced into the left pleural space allowing for surgery in an anatomical orientation that is familiar to the surgeon and emphasize the precautions to be taken following surgery.

Right ventricular outflow tract aneurysm with thrombus.

Right ventricular outflow tract (RVOT) aneurysm is a known complication of tetralogy of Fallot repair when a ventriculotomy is done. It leads to RV dysfunction and may require re-operation. We describe a rare instance of a patient who developed an RVOT aneurysm after trans-ventricular repair of tetralogy of Fallot, which was complicated with the formation of a thrombus in the aneurysm sac.

Calcified unruptured sinus of Valsalva aneurysm in a child.

Sinus of Valsalva aneurysms (SOVAs) might be congenital or acquired in origin. They might present as a rupture or as a consequence of compression on adjacent structures. The treatment of such aneurysms in adults is well documented.

Infected pseudoaneurysm involving a drug-eluting stent.

Stent infection following percutaneous transluminal coronary angioplasty is rare. We present such a case involving a drug-eluting stent placed in the left anterior descending coronary artery that was managed surgically with removal of the stent with concomitant coronary artery bypass grafting. Early surgical intervention directed at removal of the infected stent, debridement and distal vessel revascularisation is recommended to deal with the infection and prevent myocardial compromise.

Paradoxical embolus across atrial septal defect and posterior circulation infarct in neurosurgical patients.

Paradoxical embolism through a patent foramen ovale or atrial septal defect is increasingly recognized in association with embolic strokes, with the advent of modern echocardiography. The authors describe two neurosurgical cases with such an anomaly that suffered nonfatal embolic stroke in the cerebellum. The patients developed posterior inferior cerebellar artery infarcts, which were managed conservatively and had no neurological deficits.