Unusual presentation of ruptured non coronary sinus of valsalva with new onset heart failure.

Rupture of sinus of Valsalva is a rare cardiac condition which is associated with severe left to right shunting. Symptoms may include breathlessness, chest pain and fatigue or even cardiogenic shock and when untreated, this condition carries a grave prognosis. We report a case of a 57-year-old gentleman without any past comorbidities who presented to our hospital with features of acute heart failure due to rupture of sinus of Valsalva which was diagnosed by echocardiogram and further confirmed by cardiac computed tomography scan.

Review of current status of cardiovascular and thoracic surgery in Nepal: An analysis from collection of institutional database.

Objective: Data collected from various institutions around the country was analyzed to assess the current status of cardiovascular and thoracic surgery in the country.

Methods: We collected data from institutions performing cardiovascular and thoracic surgery from all over the country through direct correspondence for the year 2019. Individual institution data on the number of surgeries performed for cardiac, vascular, and thoracic surgery and its outcome in terms of mortality were compiled.

Coronary Artery Bypass Grafting Following COVID-19 Infection: Difficulties and Challenges.

The COVID-19 pandemic has raised challenges and dilemmas to perform cardiac surgery in the patients following COVID-19 infection due to lasting adverse impacts of the disease on the lungs. A 74-years-old patient, recently infected by COVID-19, with previous myocardial infarction and multiple percutaneous coronary interventions, in-stent thrombosis to the left anterior descending artery, and low resting saturation, presented with chest pain and underwent urgent coronary artery bypass grafting. His postoperative period remained challenging due to high oxygen requirements.

Double Aortic Arch with Coarctation of Aorta in an Adolescent: Unraveling the Vascular Ring.

We report the case of a 12-year-old girl with balanced double aortic arch with coarctation of the aorta presenting with symptoms of respiratory and swallowing difficulty. On investigation, the patient had a double aortic arch with coarctation and clinically nonsignificant disease in the infrarenal aorta. Division of the nondominant aortic arch was done through a left thoracotomy, along with resection of the coarctation segment and placement of an interposition Dacron tube graft.

Submitral Aneurysm: An Unusual Aneurysm of the Left Ventricle.

We report a case of a 42-year-old man with a submitral aneurysm who presented to the emergency room in circulatory collapse, with left ventricular obstruction and severe mitral valve stenosis and regurgitation secondary to the aneurysm. Resection of the aneurysm and mitral valve replacement were performed through a median sternotomy without any complication and with good results.

Primary surgical repair of coarctation of the aorta in adolescents and adults: intermediate results and consequences of hypertension.

Objectives: Coarctation of the aorta is known to present with hypertension in older patients; we reviewed our experience and assessed the outcome of hypertension following surgical correction.

Methods: From April 2004 to date, 43 patients above the age of 12 underwent coarctation of the aorta repair. The mean age was 20.

Complex Cervical Aortic Arch With Hypoplasia: A Simple Solution to a Complex Problem.

We report a rare case of a 6-year-old boy with a complex right-sided cervical aortic arch, with retroesophageal hypoplastic transverse arch, left subclavian artery arising from the Kommerell diverticulum of the descending aorta, and a vascular ring formed by the ductus ligament. An extraanatomic ascending-to-descending aorta bypass was done through a median sternotomy along with division of the ductus ligament, without any complications and good results.

Lipoblastoma: an unusual tumour of the left ventricle.

Lipoblastoma is a rare benign tumour of infancy originating from white foetal adipose tissue. Most commonly located in the extremities, intrathoracic and mediastinal involvement of this tumour is rare, and an intracardiac location is even rarer, with only one reported case. Herein, we present a 2-month old asymptomatic boy diagnosed with an echogenic mass in the left ventricular outflow tract.

Current Experience With Acute Type B Aortic Dissection: Validity of the Complication-Specific Approach in the Present Era.

Background: Our group proposed in 1992 a "complication-specific approach" for the management of acute aortic dissection type B (TBAD), with uncomplicated cases being treated with medical therapy. In this study, we evaluate the efficacy of this management in in-hospital and postdischarge survival.

Methods: Between 1999 and 2014, 123 consecutive acute TBAD patients were treated at our institution.

Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms.

Background: The combination of descending aortic aneurysm (DAA) with concomitant coronary artery disease (CAD) is associated with increased morbidity and mortality. We review the surgical management for patients with this combined disease.

Methods: From January 2000 to January 2014, we performed 268 elective surgeries on the descending or thoracoabdominal aorta.

Straight deep hypothermic circulatory arrest for cerebral protection during aortic arch surgery: Safe and effective.

Objective: To evaluate our extensive clinical experience using deep hypothermic circulatory arrest (DHCA) as a sole method of cerebral protection during aortic arch surgery, with an emphasis on determining the safe duration of DHCA.

Methods: A total of 490 consecutive patients (303 males [61.8%], mean age, 62.

Influence of mitral valve repair versus replacement on the development of late functional tricuspid regurgitation.

Objectives: To study the determinants of functional tricuspid regurgitation (TR) progression after surgical correction of mitral regurgitation, including the influence of mitral valve (MV) repair (MVr) versus replacement (MVR) for degenerative mitral regurgitation.

Methods: From January 1995 to January 2006, 747 adults with MV prolapse underwent isolated MVr (n=683) or MVR (n=64; mechanical in 32). The mean age was 60.

Surgical strategies for anomalous origin of coronary artery from pulmonary artery in adults.

Objectives: Limited data are available regarding the surgical strategies for an anomalous origin of the coronary artery from the pulmonary artery (ACAPA) in adulthood. We reviewed our surgical experience with ACAPA in adults.

Methods: From January 1960 to July 2011, 10 adults (30% men), aged 18 to 78 years (median, 43), underwent surgical repair of ACAPA.

Coronary artery spasm after Cryo Maze III procedure.

The Cox Maze III procedure has been simplified with the availability of tissue ablation devices; however, complications related to their use are recognized. We report a case of 45-year-old woman who underwent mitral valve repair and concomitant Cryo-Maze procedure. She had reversible right coronary artery spasm develop after the procedure demonstrated by ST-segment elevation changes and coronary angiography, which was reversed with intracoronary nitroglycerin.