Bombay blood and the 'Swab-Lite' method of blood conservation.

Bombay blood (hh blood) is a rare blood group (4 per million), with no expression of the H antigen present in blood group O. Bombay blood patients can only receive Bombay blood, with autodonation used for elective surgery. We present a Bombay patient (haemoglobin 12.

JAK 2-Positive Diseases and Spontaneous Coronary Artery Dissection: Case Series.

Introduction: Chronic myeloproliferative neoplasms (MPNs) such as polycythaemia vera (PV) and essential thrombocytosis are associated with atherosclerosis and cardiovascular events, especially if JAK2 mutation is there. In rare cases, also spontaneous coronary artery dissection (SCAD) can be seen.

Case Presentation: This case series describes two case reports of MPNs in which SCAD was found in both of them in addition to standard atherosclerosis.

Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure.

Background: Delayed sternal closure (DSC) can be a lifesaving approach for certain patients who have undergone cardiac surgery. The value of the type of prophylactic antibiotics in DSC is still debatable.

Aim: To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.

Radical sternectomy for osteomyelitis without reconstruction post-coronary artery bypass graft: 10 years on.

Radical sternectomy with sternal reconstruction using synthetic mesh or titanium plates has been described before with excellent results. However, radical removal of the sternum without reconstruction is a rare surgical treatment for complicated deep sternal wound infections (DSWI). The long-term outcome following this radical operation is not well-known due to the limited number of cases in the literature.

Infected Takayasu's arteritis presenting with aortic perforation.

We want to remind Physicians that unusual conditions can present in unusual ways and to keep an open mind always.

Left ventricular outflow tract cyst: What was it and where did it go?

Cyst or thrombus formation in the left ventricular outflow tract of a normal heart is very rare. We present a case of a male who presented with a major stroke and was found to have a freely mobile cystic mass in the left ventricular outflow tract, with an otherwise completely normal heart. He had some risks factors for hypercoagulability (reduced protein C activity and raised fibrinogen), but only received aspirin therapy due to his stroke severity (haemorrhagic transformation).

Delivery of Acute Rehabilitation to a Postcoronary Artery Bypass Graft COVID-19 Patient in a Pandemic Environment.

During the first wave of the coronavirus disease (COVID-19) pandemic, a 57-year-old COVID-19 male patient was diagnosed with non-ST-elevation myocardial infarction and required urgent coronary artery bypass graft. In-patient cardiac rehabilitation following cardiac surgery was inevitable to limit or prevent various postoperative complications. A routine rehabilitation program was not feasible because of the strict COVID-19 isolation procedures, the high risk of cross infections, and the lack of various resources.

Analysis of the Performance of Daily Cardiac Surgery Score (CASUS) in Patients with Mixed Racial Profile after Cardiac Surgery: A Single-Center Retrospective Study.

Objective: The aim was to look at the Cardiac Surgery Score (CASUS) assessment after cardiac surgery, and compare it with the intensive care unit (ICU) mortality and morbidity, in a racially diverse group of patients, in a single center.

Design: Clinical retrospective study analyzing data from 319 patients over a 1-year duration.

Setting: Cardiothoracic intensive care unit (CTICU) of a tertiary care center.

Right aortic arch with mirror image branching found incidentally during coronary surgery.

Right aortic arch with a left innominate (brachiocephalic) artery with mirror image branching (RAMI) is a rare congenital anomaly, and it is unusual to diagnose it in adulthood. There are very few cases of cardiac surgery being performed for acquired cardiac disease on a congenital RAMI patient. We present a patient who had an incidental finding of a RAMI anomaly found during coronary artery bypass surgery.

Successful Surgical Embolectomy for a Rapidly Deteriorating Patient with Pulmonary Embolism and Hemorrhagic Stroke.

Pulmonary embolism (PE) is a life-threatening condition. High-risk PE is defined as pulmonary embolism with either hemodynamic collapse, persistent hypotension, and/or organ hypoperfusion. The overall mortality rate associated with high-risk PE remains at approximately 30%.

SARS-CoV-2 (COVID-19) PCR cycle threshold: can it help in the timing of urgent cardiac surgery?

Background: The COVID-19 pandemic has resulted in a significant reduction in urgent cardiac surgery due to concerns about safety for both patients and care givers. The timing of safe cardiac surgery is yet to be clarified in the setting of COVID-19 diagnosis.

Methods: Due to the urgency of the cardiac conditions on presentation, we have operated on four patients who exhibited the spectrum of COVID-19 disease from asymptomatic to severe COVID-19 pneumonia.

A tale of three pumps and a mechanical heart.

Temporary mechanical circulatory support device (tMCS) failure could qualify patients with advanced heart failure to receive a long-term solution. We report on a patient who presented with cardiorespiratory arrest that required a tMCS and developed acute type A aortic dissection. Data Sources: our case adds further evidence regarding the support of a patient with a second (or more) incidence of tMCS.

Aspergillus aortitis: a cause for aortic perforation in a patient following combined aortic valve surgery and liver transplantation.

We report a case of aspergillus fumigatus aortitis in a patient following combined aortic valve replacement and orthotopic liver transplantation for significant aortic stenosis and alcoholic liver cirrhosis. At operation, a suspicious excavating lesion was found on the native aortic valve and specimen sent for culture. The ascending aorta and aortic sinuses were found to be normal.

Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome.

Endothelial dysfunction is a well established response to cardiovascular risk factors and precedes the development of atherosclerosis. Endothelial dysfunction is involved in lesion formation by the promotion of both the early and late mechanisms of atherosclerosis including up-regulation of adhesion molecules, increased chemokine secretion and leukocyte adherence, increased cell permeability, enhanced low-density lipoprotein oxidation, platelet activation, cytokine elaboration, and vascular smooth muscle cell proliferation and migration. Endothelial dysfunction is a term that covers diminished production/availability of nitric oxide and/or an imbalance in the relative contribution of endothelium-derived relaxing and contracting factors.

Off-pump coronary artery bypass grafting in a heparin-induced thrombocytopenia type II patient using hirudin.

Heparin is routinely used for anticoagulation during cardiopulmonary bypass; it is fast acting, is easily monitored, and has an antidote. Heparin-induced thrombocytopenia (HIT) can be a life-threatening condition requiring an alternative anticoagulant (hirudin) if cardiac surgical intervention is considered. At full anticoagulant doses, the effects of hirudin are difficult to monitor; therefore, we present a case in which off-pump coronary artery bypass grafting was performed in an HIT patient in whom the lower doses of hirudin could safely be monitored with easily available tests.