Comparative study of cardiac output measurement by regional impedance cardiography and thermodilution method in patients undergoing off pump coronary artery bypass graft surgery.

Background: An ideal CO monitor should be noninvasive, cost effective, reproducible, reliable during various physiological states. Limited literature is available regarding the noninvasive CO monitoring in open chest surgeries.

Aim: The aim of this study was to compare the CO measurement by Regional Impedance Cardiography (RIC) and Thermodilution (TD) method in patients undergoing off pump coronary artery bypass graft surgery (OPCAB).

Recurrent cardiac myxoma: A case report.

Cardiac myxomas are the most common benign tumors of the heart. They are most commonly found in the left atrium, followed by a right atrium and rarely in the left ventricle. Herein, we report a rare case of left ventricular myxoma in a patient who had twice undergone removal of left atrial myxoma.

Left ventricle pseudoaneurysm-recurrence following surgical repair.

Left ventricular (LV) pseudoaneurysm is a rare complication following free wall rupture post transmural myocardial infarction or left ventricular surgery. A lot of imaging modalities like echocardiography, computerised tomography and cardiac magnetic resonance imaging are available to diagnose it. Echocardiography plays a significant role in delineating the cavity, orifice and impact on the surrounding structures.

A case of left atrial dissection after mitral valve replacement.

Left atrial dissection (LatD) is a rare complication of cardiac surgery due to creation of a false chamber through a tear in the mitral valve annulus that extends into the left atrium wall. It is primarily associated with mitral valve surgery although other etiologies have also been defined. Perioperative transesophageal echocardiography (TEE) is a key to the diagnosis.

Cardiac surgery in a patient with implanted vagal nerve stimulator.

The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy.

Nonanalgesic benefits of combined thoracic epidural analgesia with general anesthesia in high risk elderly off pump coronary artery bypass patients.

Objective: Epidural anesthesia is a central neuraxial block technique with many applications. It is a versatile anesthetic technique, with applications in surgery, obstetrics and pain control. Its versatility means it can be used as an anesthetic, as an analgesic adjuvant to general anesthesia, and for postoperative analgesia.

Newer methods of cardiac output monitoring.

Cardiac output (CO) is the volume of blood ejected by each ventricle per minute and is the product of stroke volume and heart rate. CO can thus be manipulated by alteration in heart rate or rhythm, preload, contractility and afterload. Moreover it gives important information about tissue perfusion and oxygen delivery.

Asymptomatic type B right atrial thrombus in a case with protein S deficiency.

Thirty seven year old asymptomatic male underwent routine medical examination which revealed an abnormal mass in the right atrium. Family history was not suggestive of any cardiac or malignant disease. Detailed investigation detected deficiency of protein S, which is a vitamin K dependent protein and a cofactor for activated protein C mediated cleavage of factor Va and VIIIa.

Headache and seizures after cervical epidural injection in a patient undergoing coronary artery bypass grafting.

Epidural analgesia is widely used in cardiothoracic surgery. Most of the complications associated with epidural analgesia are related to the insertion techniques of epidural catheter. A 68-year-old obese patient posted for coronary artery bypass grafting surgery developed headache followed by seizures after insertion of the thoracic epidural catheter.

Peri-operative Considerations in Total Endoscopic Atrial Septal Defect Repair with Robotic Assistance.

The development of minimally invasive techniques represents a significant improvement in the repair of atrial septal defect by total endoscopy. Robot-assisted repair obviates the need for a sternotomy or thoracotomy. This is the case report of a 45-year-old male, who underwent atrial septal defect repair through the total endoscopic technique.

Comparison of continuous thoracic epidural and paravertebral block for postoperative analgesia after robotic-assisted coronary artery bypass surgery.

Minimally invasive surgery with robotic assistance should elicit minimal pain. Regional analgesic techniques have shown excellent analgesia after thoracotomy. Thus the aim of this study was to compare thoracic epidural analgesia (TEA) technique with paravertebral block (PVB) technique in these patients with regard to quality of analgesia, complications, and haemodynamic and respiratory parameters.

Pulmonary artery catheter placement in high-risk coronary artery bypass grafting: should it be done before or after induction of anaesthesia?

Pulmonary artery catheter (PAC) is generally inserted after induction of general anaesthesia (GA). However, in high-risk coronary artery disease patients (left main disease / ejection fraction (35%), it may be desirable to insert it before the induction of GA. Thirty patients with left main coronary artery disease and / or left ventricular ejection fraction < 35% undergoing coronary artery bypass grafting (CABG) surgery were prospectively randomized into 2 groups of 15 each.