Combination of slide tracheoplasty and side-to-side bronchoplasty for complex congenital tracheobronchial stenosis.

Congenital tracheal stenosis is a rare but serious condition with high mortality and morbidity. We present a 6-month-old patient with complex congenital tracheal stenosis involving the trachea, carina and right bronchus intermedius, which was corrected with a combination of slide tracheoplasty and side-to-side bronchoplasty.

Modified ultrafiltration reduces postoperative blood loss and transfusions in adult cardiac surgery: a meta-analysis of randomized controlled trials.

Objectives: Cardiopulmonary bypass in cardiac surgery has been associated with several deleterious effects including haemodilution and systemic inflammation. Modified ultrafiltration (MUF) has been well established in paediatric cardiac surgery in counteracting postperfusion syndrome. However, MUF is less commonly used in adult cardiac surgery.

Congenital diaphragmatic hernia repair in patients requiring extracorporeal membrane oxygenation: are outcomes better with repair on ECMO or after decannulation?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether congenital diaphragmatic hernia repair outcomes are better before or after decannulation in infants requiring extracorporeal membrane oxygenation (ECMO). A total of 884 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question.

Congenital left atrial appendage aneurysm with unexpected course of left anterior descending coronary artery.

The left atrial appendage (LAA) aneurysm is a rare condition that can produce local compressive effects and complications including supraventricular tachyarrhythmias, thromboembolic events and myocardial ischaemia. We present a rare case of a neonate with a congenital LAA aneurysm which resulted in local compressive effects on the left ventricle, severe mitral regurgitation and malposition of the left anterior descending (LAD) coronary artery. Intraoperatively, the LAD was found to be within the aneurysmal wall exterior to the left ventricular epicardium and was inadvertently injured during LAA aneurysm resection.

Does concurrent use of intra-aortic balloon pumps improve survival in patients with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Does concurrent use of intra-aortic balloon pump (IABP) improve survival in patients with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO)?'. Altogether 472 papers were found using the reported search, of which 3 level 2 systematic reviews represented the best evidence to answer the clinical question.

Homemade Candy Plug Using a Zenith Alpha Thoracic Stent-Graft for False Lumen Distal Occlusion in Acute-on-Chronic Type B Aortic Dissection.

To report a candy-plug technique using a Zenith Alpha stent-graft to occlude the distal false lumen in a patient with a complicated chronic type B aortic dissection. A 50-year-old male smoker presented with chest pain due to rapidly growing complicated chronic type B aortic dissection. Computed tomography angiography (CTA) showed the dissection extending from distal to the origin of the left subclavian artery (LSA) down to the left femoral artery.

The safe volume threshold for chest drain removal following pulmonary resection.

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients undergoing pulmonary resection, is there a safe drainage volume threshold for chest drain removal?' Altogether 1054 papers were found, of which 5 papers represented the best evidence. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Is it possible to predict the risk of ischaemic bowel after cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is it possible to predict the risk of ischaemic bowel after cardiac surgery?' Altogether 80 papers were found as a result of the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Carney complex: fourth time excision of recurrent atrial myxoma via left thoracotomy.

We report a case of a 51-year-old male patient with a known history of Carney complex, who was operated on for the fourth time due to recurrent left atrial myxomas. Despite surgical challenge, the operation was uneventful. The patient had a difficult postoperative period and needed further treatment for complications.

Transcranial Doppler ultrasound: a review of the physical principles and major applications in critical care.

Transcranial Doppler (TCD) is a noninvasive ultrasound (US) study used to measure cerebral blood flow velocity (CBF-V) in the major intracranial arteries. It involves use of low-frequency (≤2 MHz) US waves to insonate the basal cerebral arteries through relatively thin bone windows. TCD allows dynamic monitoring of CBF-V and vessel pulsatility, with a high temporal resolution.

Is cryoanalgesia effective for post-thoracotomy pain?

A best evidence topic was written according to a structured protocol. The question addressed was whether cryoanalgesia improves post-thoracotomy pain and recovery. Twelve articles were identified that provided the best evidence to answer the question.

Isolated pulmonary infective endocarditis with septic pulmonary embolism complicating a right ventricular outflow tract obstruction: scarce and devious presentation.

We present a case of a fifty-three-year-old male who presented with severe sepsis. He had been treated as a pneumonia patient for five months before the admission. Investigations revealed isolated pulmonary valve endocarditis and septic pulmonary embolism in addition to undiagnosed right ventricular outflow tract (RVOT) obstruction.

Dissection of the pulmonary ligament during upper lobectomy: is it necessary?

A best evidence topic was written according to a structured protocol. The question addressed was whether dissection of the pulmonary ligament during an upper lobectomy would result in improved outcomes. A total of 85 articles were found using the reported search, of which eight represented the best evidence to answer the clinical question.

Late presentation of congenital diaphragmatic hernia after a diagnostic laparoscopic surgery (a case report).

The authors report a rare case of 17-year-old lady with late presentation of congenital diaphragmatic hernia. She presented with vague abdominal pain and was thought to have urinary tract infection, ruptured ovarian cyst, and appendicitis by different medical teams in the first few days. She eventually underwent a diagnostic laparoscopy with no significant findings.

Aortic valve replacement: is porcine or bovine valve better?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Is porcine or bovine valve better for aortic valve replacement?' Altogether, 562 papers were found using the reported search, of which 15 represented the best evidence to answer the question. All papers represent either level 1 or 2 evidence.