Splenic artery aneurysm and infarction during pregnancy from infective endocarditis.

Rheumatic heart disease (RHD) remains the leading cardiac problem affecting pregnant women, especially in low- to middle-income countries. In nearly one-third of the cases, it is detected during pregnancy when they present with complications. Infective endocarditis (IE) in pregnancy is rare, with an incidence of 1 in 100 000 pregnancies, and carries high maternal and fetal morbidity and mortality.

Clinical predictors of warfarin-associated bleeding: A case-control study.

Despite the advent of directly acting oral anticoagulants, warfarin is still widely used in resource-poor settings. Bleeding as a result of warfarin overdosage is common and risk factors seem to vary between patient populations. Predictors of bleeding in patients using warfarin were studied using a case-control design.

Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study.

Background And Aims: Anxiety plays a distressing role in cardiothoracic operations. It may trigger hemodynamic instability, increased morbidity, and very crucially, postoperative pain and analgesic use. Our aim is to look at the association between anxiety, postoperative pain, and analgesic use.

Congenital bilio-bronchial fistula in an adult: a review of literature and video demonstration of laparoscopic fistula tract excision.

This article presents a review of the literature on congenital bilio-bronchial fistula (BBF), a rare anomaly characterized by abnormal communication between the bile duct and respiratory tract. Congenital BBF often presents with bilioptysis in early neonates and infants; however, patients with no overt symptoms may occasionally present in adulthood. Our literature search in Medline from 1850 to 2023 revealed 42 reported cases of congenital BBF, primarily managed with thoracotomy and excision of the fistula tract.

Concurrent valve replacement and caesarean section for rheumatic mitral valve disease with refractory heart failure in late pregnancy.

Objective: To assess clinical characteristics and outcomes of women who underwent concurrent valve replacement with caesarean section for severe rheumatic mitral valve disease with refractory heart failure.

Methods: All women admitted to a single centre from 2011 to 2020 with severe rheumatic mitral valve disease, having recurrent episodes of pulmonary edema on optimal medical therapy and contraindication to percutaneous balloon mitral valvotomy, who underwent concurrent valve replacement (for native valve disease) along with caesarean section, were included.

Results: Among 1300 pregnancies with rheumatic heart disease, six underwent the concurrent procedure.

Guillain-Barre Syndrome-A Rare Cause of Quadriparesis after the Bentall Procedure for Type A Aortic Dissection.

Neurological complications following aortic surgery are most often cerebrovascular accidents due to embolism, or spinal infarcts resulting in hemiparesis or hemiplegia. Guillain-Barre syndrome is a rare cause of quadriparesis. Here, we report a 49-year old male who presented with acute aortic dissection and underwent the Bentall procedure following which he developed quadriparesis, subsequently diagnosed to be a case of Guillain-Barre syndrome.

Primary Ewings Sarcoma of the Inferior Vena Cava.

Introduction: Sarcomas of vascular origin are rare. A case of Ewings sarcoma of Inferior Vena Cava [IVC] is reported here.

Report: A 36-year-old lady presented with a 6-month history of bilateral pitting lower limb swelling and 1-month history of vaginal bleeding.

Comparison of efficacy of autologous blood patch pleurodesis versus doxycycline pleurodesis in the management of persistent air leak in patients with secondary spontaneous pneumothorax. A randomized control trial.

Secondary spontaneous pneumothorax (SSP) patients sometimes have a persistent air leak (PAL) that leads to increased morbidity and increased hospital stay. Further, these patients also need pleurodesis to prevent a recurrence. Autologous blood patch pleurodesis (ABPP) has been successfully tried in post lobectomy air leak cases.

A Giant Right Atrial Hemangioma- Case Report.

A primary cardiac tumor is sporadic. Most cardiac tumors are benign, with cardiac myxoma being the most common tumor. The incidence of cardiac hemangioma is extremely low.

Alternatives to Low Molecular Weight Heparin for Anticoagulation in Pregnant Women with Mechanical Heart Valves in Middle-Income Countries: A Cohort Study.

Objective: To compare cardiac complications and pregnancy outcomes in women with mechanical heart valves (MHVs) on two different anticoagulation regimens in a middle-income country.

Methods: We conducted a retrospective cohort study comparing outcomes in pregnant women with MHVs that received vitamin K antagonists (VKAs) throughout pregnancy versus sequential anticoagulation (heparins in the first trimester and peripartum period and VKAs for the remainder of pregnancy), at a tertiary centre in South India, from January 2011 to August 2020.

Results: We identified 138 pregnancies in 121 women, of whom 32 received VKAs while 106 were on sequential anticoagulation.

Thoracic mucormycosis in immunocompetent patients.

Background: Mucormycosis is an invasive fungal infection. It is rare and commonly associated with fatal outcomes.

Methods: We report two cases of thoracic mucormycosis in immunocompetent patients.

Leiomyosarcoma of the inferior vena cava posing as an adrenal incidentaloma.

Adrenal incidentalomas are incidentally detected adrenal lesions on imaging, which have a variety of differential diagnoses, the most common being a non-functioning adenoma. Surgical intervention for these lesions is needed when there is hypersecretion, for lesions larger than 4 cm and smaller lesions with suspicious characteristics. Here we present a young woman who was incidentally found to have a right suprarenal mass with loss of fat planes with the inferior vena cava (IVC).

Tracheo-innominate Artery Fistula in a Complicated Penetrating Neck Trauma: A Successfully Managed Rare Complication of Low Tracheotomy.

Tracheo-innominate artery fistula is a rare complication of tracheotomy with very high mortality rate. Only a few patients survive this complication as reported in the literature. Here we report the case of a 54-year-old gentleman who presented to the emergency department with a history of penetrating neck trauma following a road traffic accident.

Growing teratoma syndrome in primary mediastinal germ cell tumor: our experience.

Background: Growing teratoma syndrome is a rare phenomenon seen in nonseminomatous germ cell tumors after chemotherapy, where the tumor grows paradoxically despite normalization of tumor markers. It has been found in various locations, most commonly, the retroperitoneum in association with metastatic disease. The occurrence of growing teratoma syndrome in a mediastinal primary is very rare and there are only a few reports in the literature.

Acute severe mitral regurgitation with cardiogenic shock following balloon mitral valvuloplasty: echocardiographic findings and outcomes following surgery.

Acute severe mitral regurgitation (MR) is the commonest indication for emergency surgery following a balloon mitral valvuloplasty (BMV). It results in hemodynamic compromise with cardiogenic shock and or acute pulmonary edema. These patients deteriorate fast and often require respiratory and critical care support, followed by urgent mitral valve replacement (MVR).

Spectrum of morphological abnormalities and treatment outcomes in ostium secundum type of atrial septal defects: Single center experience in >500 cases.

Background: Transcatheter closure (TCC) has emerged as the first line treatment option for secundum type of atrial septal defects (ASD). Outcomes of TCC depend upon proper delineation of defect anatomy by transesophageal echocardiography (TEE). Stability and proper placement of the device mandates adequate rims and proper alignment to the septum.

Acenocoumarol as an alternative anticoagulant in a patient with warfarin-related nephropathy.

Adverse Event: Warfarin-related nephropathy.

Drug Implicated: Warfarin.

The Patient: A 31-year-old female, managed with warfarin for rheumatic heart disease with atrial fibrillation.

Left Ventricular Pseudoaneurysms in Children-A Case Series.

Left ventricular pseudoaneurysms are very rare in children. In children, left ventricular pseudoaneurysms can occur following infection, trauma, ischemia, or cardiac surgery. The authors report a series of three cases treated at our hospital with two of the cases having a history of extrapulmonary tuberculosis and one patient with a history of varicella zoster infection.