Parietal Peritoneum Interposition Tube Graft as an Autologous Substitute for the Reconstruction of Inferior Vena cava Following Resection of Retroperitoneal Sarcoma.

Complete resection of large retroperitoneal tumors often requires vascular resection and reconstruction, which is frequently performed using prosthetic grafts. We report our experience with inferior vena cava reconstruction utilizing a large peritoneal interposition tube graft performed during en bloc resection of retroperitoneal sarcoma and multiorgan resection. This study aimed to increase the awareness of surgical oncologists about the venous reconstruction technique using a large autologous peritoneal graft.

Surgical retrieval of an embolized patent ductus arteriosus closure device in an infant weighing 1050 G.

The dislodgement of device during transcatheter procedure is a rare complication and the device can be retrieved by transcatheter techniques in most cases. In case of failed attempts, the surgery may be required and in haemodynamically unstable patients cardiopulmonary bypass (CPB) may be unavoidable. A case of surgical retrieving of patent ductus arteriosus (PDA) occlusion device (OD) from the right pulmonary artery (PA) in a 1050 g baby on CPB was presented.

Stuck pericardial pigtail catheter in purulent pericarditis: early surgery?

Pyopericardium is rare in the modern antibiotic era but is still infrequently seen in the setting of immunosuppression, recent thoracic surgery and sepsis. Although classically an extension of a thoracic gram-positive bacterial infection, gram-negative bacterial purulent pericarditis may be encountered in the setting of nosocomial infections. Emergent pericardial drainage allows for prompt definitive management and planning for further intervention.

Circumflex aortic arch: presentation across various age groups: a case series.

Circumflex aortic arch (CAA) is a rare congenital anomaly where the aortic arch crosses the midline, posterior to the esophagus and trachea, and descends on the contralateral side. If patent ductus arteriosus (PDA) is present, this forms a true vascular ring. CAA can compress the trachea and esophagus leading to a myriad of symptoms which can present at any age.

Asymptomatic Giant Aneurysm of the Arteria Lusoria Treated by Debranching and Aneurysmal Resection.

The aberrant right subclavian artery (ARSA, arteria lusoria) is the most common intrathoracic vascular anomaly, affecting up to 2% of the population. However, aneurysms of congenital anomalies are extremely unusual and often present with dysphagia, dysphonia, or dyspnea due to compression of the surrounding structures. We report a case of an asymptomatic 57-year-old male with chronic kidney disease who was incidentally found to have a large aneurysm of the ARSA on preoperative computed tomography for laparoscopic nephrectomy.

Distal tracheal resection and reconstruction through right posterolateral thoracotomy.

Many retrospective series have been reported on the outcomes of tracheal resection for adenoid cystic carcinoma. However, demonstration on techniques of surgery and ventilatory management during the procedure are rare. We, herewith demonstrate a surgical video, wherein a distal tracheal resection was performed through right posterolateral thoracotomy.

Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group.

Background: Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness.

Emergency brachial artery ligation for ruptured infected pseudoaneurysm of haemodialysis access is a possible option.

Background: For patients with end-stage renal disease, a good vascular access is essential for chronic haemodialysis. Surgically created access arteriovenous fistula for haemodialysis is associated with multiple complications, and ruptured pseudoaneurysm being the most life threatening and dreaded of all. The management of this complication warrants emergency procedure, although timely diagnosis and arteriovenous fistula salvage has been emphasised.

Damus-Kaye-Stansel: Valuable Option for Retraining of Left Ventricle in Late Arterial Switch for Transposition of the Great Arteries.

Management of dextro-transposition of the great arteries with intact interventricular septum along with regression of the left ventricle remains a challenge. Atrial switch always raises concerns about the fate of the right ventricle as a systemic ventricle in the long run. A two-stage repair with pulmonary artery banding and a modified Blalock-Taussig shunt or a single-stage arterial switch with mechanical support has a higher mortality and morbidity.

Effect of Red Blood Cell Storage Duration on Outcome After Paediatric Cardiac Surgery: A Prospective Observational Study.

Background: Retrospective reviews have found the use of stored packed red blood cells (PRBCs) in priming to be associated with increased risk of postoperative complications. The purpose of study was to prospectively investigate the influence of duration of storage of PRBCs used in priming the cardiopulmonary bypass (CPB) circuit on the metabolic profile of the patients, and postoperative outcome after paediatric cardiac surgery.

Methods: Between January 2015 and December 2015, 198 consecutive children operated for cardiac surgery using CPB and received blood for priming the circuit were included.

Transverse Sternal Split: a Safe Mini-invasive Approach for Perventricular Device Closure of Ventricular Septal Defect.

Objective:: Perventricular device closure of ventricular septal defect through midline sternotomy avoids the cardiopulmonary bypass, however, lacks the cosmetic advantage. Perventricular device closure of ventricular septal defect with transverse split sternotomy was performed to add the cosmetic advantage of mini-invasive technique.

Methods:: Thirty-six pediatric patients with mean age 7.

Transverse Split Sternotomy: A Mini-Invasive Approach for Repair of Congenital Cardiac Defects.

Objective: In this article, we aim to review our mini-invasive technique of transverse sternal split (TSS) with or without cervical cannulation for cardiopulmonary bypass (CPB), its usefulness, and efficiency for repair of congenital cardiac defects.

Methods: Between January 2013 and June 2015, 34 infants and small children were operated through TSS in third or fourth intercostal space [Tetralogy of Fallot 11, perventricular ventricular septal defect (VSD) device closure 23]. Cardiopulmonary bypass was established through cervical (common carotid artery [CCA] and internal juglar vein [IJV]) and inferior vena cava cannulation.

Cervical Cannulation for Surgical Repair of Congenital Cardiac Defects in Infants and Small Children.

Introduction:: The biggest challenge faced in minimally invasive pediatric cardiac surgery is cannulation for cardiopulmonary bypass. Our technique and experience of cervical cannulation in infants and small children for repair of congenital cardiac defects is reported in this study.

Methods:: From January 2013 to June 2015, 37 children (22 males) with mean age of 17.

Effect of Prime Blood Storage Duration on Clinical Outcome After Pediatric Cardiac Surgery.

Background: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients.

Methods: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime. To study the effect of storage duration of PRBCs on postoperative morbidity, mortality, and metabolic profile, patients were divided into four groups (based on storage duration of PRBCs used in prime).

Dialyzer-based cell salvage system: a superior alternative to conventional cell salvage in off-pump coronary artery bypass grafting.

Objectives: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters.

Methods: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) ( n  = 75), (2) conventional cell salvage (CCS) ( n  = 73) and (3) without cell salvage (WCS) ( n  = 74). Salvaged blood was transfused at the end of the operation.

Hemodiafiltration-A Technique for Physiological Correction of Priming Solution in Pediatric Cardiac Surgery: An In Vitro Study.

Pediatric cardiopulmonary bypass (CPB) circuit invariably requires priming with packed red blood cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological and becomes worse with increasing duration of storage. It is recommended to correct these abnormalities before initiation of CPB.

Dumb-bell in the heart: rare case of biatrial myxoma with mitral regurgitation.

Cardiac myxomas are rare intracardiac tumors, and the majority are benign myxomas involving the left atrium. We report a case of the very rare occurrence of biatrial myxoma associated with mitral regurgitation, which was successfully treated.

Pretransfusion Comparison of Dialyser-Based Hemoconcentrator With Cell Saver System for Perioperative Cell Salvage.

Objective: Cell Saver system is the method of choice for red blood cell salvage from the surgical field; however, cost is a limiting factor. We at our institute have devised a cost-effective version of dialyser-based autotransfusion system. We performed pretransfusion comparison of our autotransfusion system with conventional cell saver system.

Fluorescein dye-guided intraoperative identification and closure of muscular ventricular septal defect.

Objective: Various techniques for intraoperative identification of muscular ventricular septal defects (VSDs) are cumbersome, difficult to use in infants, and inefficient in confirming the completeness of closure. We used simple technique of intraoperative fluorescein saline injection into the left ventricle to locate the muscular VSDs and to confirm their closure.

Methods: This is a prospective observational study conducted between April 2013 to December 2013, involving 22 patients with multiple VSDs either in isolated form or in association with other congenital cardiac anomalies.

Is steel wire closure of sternotomy better than polyester suture closure?

Introduction: Median sternotomy is the preferred approach for open heart surgeries. The sternotomy incision is predominantly closed with either steel wire or polyester suture. The type of material used is primarily based on the surgeon's choice, and both materials achieve a good result.

Ventral aorta repair for retroesophageal circumflex aortic arch in an adult.

We present the surgical management of an adult patient with circumflex aortic arch (CAA). We performed a ventral aorta repair with transposition of the left subclavian artery (LSCA) and resection of the arch. The usefulness of sternotomy and cardiopulmonary bypass in the management of these patients is described.