Exploring Recidivism in Cardiac Surgical ICU: Can this Understanding Translate to Enhanced Patient Outcomes?

Objective: The need for reinstitution of intensive care unit (ICU) care ("recidivism") in post-cardiac surgery patients is associated with increased morbidity, mortality, resource use, and healthcare costs. Recidivism is propounded as a quality indicator of ICU care. There is a paucity of studies from India regarding cardiac surgical ICU readmissions, their outcomes, and risk factors.

A natural systemic to pulmonary artery shunt.

Isolation of the left subclavian artery is a rare anomaly associated with right aortic arch. We report a case in which this subclavian artery was supplying the pulmonary circulation in a patient with tetralogy of Fallot (TOF) which effectively acted as a natural systemic to pulmonary artery shunt. The patient had good room air saturation and no features of vertebrobasilar insufficiency or left upper limb ischemia.

Complications of trans-catheter closure of atrial septal defects.

Trans-catheter device closure of atrial septal defects (ASD) is considered to be safe with minimal complications. But, there are certain complications that arise after these device closures which might require urgent or late surgical intervention. We have retrospectively analysed our experience.

Does tuberculosis affect surgical outcomes following pericardiectomy for chronic constrictive pericarditis? Twelve years' experience from a tertiary care center in India.

Introduction And Purpose: Tuberculosis (TB) is the commonest cause of chronic constrictive pericarditis (CCP) in India, unlike in the western countries. Pericardiectomy is the treatment of choice for CCP. Surgery in TB CCP is considerably more difficult than it is for other etiologies.

Myocardial protection in cardiac surgery: Del Nido versus blood cardioplegia.

Objectives: del Nido cardioplegia which was traditionally used for myocardial protection in pediatric congenital heart surgery is now being extensively utilized in adult cardiac surgery. The aim of this study was to compare the safety and efficacy of del Nido cardioplegia (DNC) with blood cardioplegia (BC).

Materials And Methods: This is a historical cohort study using secondary data.

Hyperlactatemia in patients undergoing adult cardiac surgery under cardiopulmonary bypass: Causative factors and its effect on surgical outcome.

Objectives Of The Study: To identify the factors causing high lactate levels in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) and to assess the association between high blood lactate levels and postoperative morbidity and mortality.

Methods: A retrospective observational study including 370 patients who underwent cardiac surgeries under cardiopulmonary bypass. The patients were divided into 2 groups based on serum lactate levels; those with serum lactate levels greater than or equal to 4 mmol/L considered as hyperlactatemia and those with serum lactate levels less than 4 mmol/L.

Combined mitral and aortic valve replacement for rheumatic heart disease: fifteen-year follow up and long-term results.

Background And Aim Of The Study: Rheumatic heart disease is the most common cause of multivalvular disease in developing countries. Unless aggressive and timely intervention in the form of valve replacement is pursued, the condition progresses rapidly to disability and death. Combined mitral-aortic valve replacement represents a major technical challenge, and carries high early and late mortality rates.

Bronchovenous fistula - leading to fatal massive systemic air embolism during cardiopulmonary bypass.

Objectives: We report a case of a bronchovenous fistula in an adult who could not be resuscitated following a mitral valve replacement.

Methods: A 39-year-old man underwent a mitral valve replacement for severe mitral stenosis and regurgitation. Following uneventful valve replacement surgery, and while attempting to wean the patient off bypass, we encounted a bronchovenous fistula following mechanical ventilation.

Anomalous left anterior descending coronary artery from pulmonary artery with ventricular septal defect.

Anomalous origin of the left anterior descending coronary artery with associated congenital defects is very rare. An angiogram of a 47-year-old woman admitted for a ventricular septal defect closure revealed an anomalous left anterior descending coronary artery arising from the left posterior sinus of the pulmonary artery. During the surgical procedure, the origin of the left anterior descending coronary artery was closed with pledgetted polypropylene sutures through the pulmonary artery.

Large clear cell tumor of the lung mimicking malignant behavior.

An 18-year-old man presented with a large (12 x 10 cm) cystic mass involving the lower lobe and lingula of the left lung on computed tomography. Intraoperatively a large cystic mass was seen densely adherent to the left lung and the chest wall. A left pneumonectomy was performed because of the dense adhesions and extreme vascularity.

Pseudoaneurysm of ascending aorta after aortic valve replacement.

A pseudoaneurysm of the ascending aorta is an unusual and potentially fatal complication after aortic surgical procedures. A contrast computed tomographic scan is the investigation of choice. Surgical treatment is mandatory.