The midterm outcomes of coronary artery bypass grafting for adult anomalous origin of the left coronary artery from the pulmonary artery.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. It presents as myocardial infarction in children; however, the presentation may vary between asymptomatic to progressive heart failure and also death. As a result, diagnosis in living adults is extremely rare.

Permacath: wrong pathway leading to a correct destination.

Permacath insertion using ultrasound has drastically reduced complications than those associated with blind puncture. We hereby report a case of entry of the permacath into the right femoral vein after through and through puncture of the right femoral artery. Use of real-time ultrasound, early clinical suspicion, timely diagnosis, and emergency surgery can avoid grave complications.

Dual ruptured sinus of Valsalva aneurysms.

Ruptured sinus of Valsalva (RSOV) aneurysm is a rare anomaly accounting for around 0.14-3.5% in patients undergoing open cardiac surgeries.

Is Deep Hypothermic Cardiac Arrest Mandatory in Aortic Arch Surgeries?

Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor.

Left handedness in cardiac surgery-boon or bane?

Left-handed individuals consist of around 11% of the population and true ambidextrous consists of only 2-3% of the total population. Almost a similar ratio is seen in medical profession also. Difficulties are obvious for left-handed cardiac surgeons in the operating room due to regular right-handed instruments, laterality, and positioning of the patients.

Midterm outcome of off-pump CABG for severe LV dysfunction-Does LV size and function predict their midterm outcome?

Background: The superiority of surgical revascularization in ischemic cardiomyopathy is established beyond doubt, and off-pump CABG (OP-CABG) is a safe way of revascularization in this high-risk subset. Data on the effect of postoperative ventricular function and size on their midterm outcome is scarce.

Materials And Methods: A retrospective study was done on 211 consecutive patients with severe LV dysfunction who underwent OP-CABG from January 2017 to December 2018.

Prognosis of aortic valve disease following mitral valve surgery.

Introduction: Little is known about the course of aortic valve disease in patients undergoing mitral valve surgery for rheumatic mitral valve disease. In addition, there are no guidelines regarding the appropriate treatment of mild aortic valve disease while replacing the mitral valve.

Aim: To evaluate the long-term outcome of aortic valve disease and the need for aortic valve surgery in patients with rheumatic mitral valve disease who underwent mitral valve surgery.

Surgical overview of cardiac echinococcosis: a rare entity.

Objectives: The purpose of this study was to describe our experience with the presentation and management of cardiac echinococcosis and the outcomes.

Methods: We performed a retrospective study from January 2012 to September 2017 in 10 patients operated on for cardiac echinococcosis. There were 6 men and 4 women; the age range was 17-55 years (mean age, 35.

Ascending aortic aneurysm and diaphragmatic hernia in a case of Marfan syndrome.

Marfan syndrome commonly affects the skeletal, ocular, and cardiovascular systems. Involvement of the gastrointestinal system is known but uncommon. Intervention depends upon the system involved and the severity of symptoms.

Invasive pericardial hydatid cyst: Excision of multiple huge cysts.

Cardiac hydatid cyst is rare even in endemic countries, and poses a therapeutic challenge due to varying presentation and unpredictable pre-, peri-, and postoperative complications. We herein present a case of multiple, multifocal, huge pericardial hydatid cyst, with invasion into the left ventricle and main pulmonary artery in a young male patient, presented with atypical chest pain.

Redo Mitral Valve Replacement for Prosthetic Valve Thrombosis: Single Center Experience.

Introduction: Prosthetic Valve Thrombosis (PVT) remains a significant cause of morbidity and mortality after valve replacement. Although surgical treatment is usually preferred as life-saving in cases of obstructive PVT, optimal treatment is yet to be decided.

Aim: To evaluate risk factors and outcome of the patients undergoing redo mitral valve surgery for acute PVT.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular a rrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion.

Recurrent Left Atrial Myxoma in a Young Patient: A Rare Entity.

Recurrence of atrial myxoma arising from the site other than inter-atrial septum is quite rare, which is more common in familial than sporadic cases. We here in present a case of 15-year-old young female who presented with recurrence of left atrial (LA) myxoma from unusual site - posterior LA wall after 3 years without any constitutional symptoms, which is the hallmark of recurrence. Complete removal of underlying atrial septum with atrial wall for recurrence prevention is the dictum in primary operation for tumour removal.

Clonidine and ketamine for stable hemodynamics in off-pump coronary artery bypass.

Background: The current era of fast-track extubation and faster recovery after cardiac surgery requires agents that provide perioperative sedation, suppress sympathetic response, reduce opioid requirement, and maintain hemodynamic stability.

Methods: In a prospective randomized double-blind study, 75 off-pump coronary artery bypass patients were divided into 3 groups of 25 each: group A had clonidine 1 µg·kg(-1), group B had clonidine 1 µg·kg(-1) and ketamine 1 mg·kg(-1), and group C had a saline placebo. Perioperative changes in heart rate, systolic and diastolic blood pressure, sedation score, pain score, and requirement of analgesics, beta blockers, fentanyl, propofol, and inotropes were recorded, as well time to extubation, intensive care unit stay, and 30-day mortality.

Surgical repair of multiple congenital left ventricular aneurysms with rupture into left atrium.

Congenital left ventricular aneurysm (CLVA) associated with multiple aneurysms with rupture into the left atrium (LA) is rare. We report a 17-year-old male with two CLVAs, one of which ruptured into the LA, and discuss the surgical management and review the literature of this rare disease.

Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients.

Background: The modification in technique is useful for successful right-sided internal jugular vein (IJV) cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients.

Materials And Methods: This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95) and female (n = 65) who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French) using Seldinger technique.

Results: Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred.

Effect of preoperative oral sildenafil on severe pulmonary artery hypertension in patients undergoing mitral valve replacement.

Aim: Long standing mitral valve disease is usually associated with severe pulmonary hypertension. Perioperative pulmonary hypertension is a risk factor for right ventricular (RV) failure and a cause for morbidity and mortality in patients undergoing mitral valve replacement. Phosphodiesterase 5 inhibitor-sildenafil citrate is widely used to treat primary pulmonary hypertension.

Ring annuloplasty for ischemic mitral regurgitation: a single center experience.

Background: Ischemic mitral regurgitation associated with coronary artery disease presents a management challenge to cardiac surgeons. We report our early and midterm results of chronic ischemic mitral regurgitation treated with concomitant mitral ring annuloplasty and coronary artery bypass grafting.

Methods: We performed a retrospective review of the medical records of patients who underwent coronary artery bypass grafting at our institute from January 2009 to December 2011.

Operative management of intracardiac myxomas: A single center experience.

Background: Cardiac myxomas are the most common benign intracardiac tumors. We studied the clinical presentation of cardiac myxomas, their morbidity, mortality and recurrence rate following surgery at our institution over a period of four years.

Methods: During August 2008 to November 2012, a total of 12023 cardiac surgeries were performed.