Asymptomatic giant hiatal hernia with double heart shadow.

Giant hiatal hernias are rare, accounting for 0.3% of all hiatal hernias. We report a case of giant hiatal hernia in an elderly male diagnosed incidentally on evaluation of polytrauma.

Four-decade-old benign tracheomediastinal fistula.

A 70-year-old male with a nagging cough of 40-year duration was evaluated and found to have a tracheomediastinal fistula. He gave history of rigid bronchoscopy 40 years back. He underwent successful resection of the fistula and was fully relieved of his symptom.

Combined approach for a left pneumonectomy and carinal reconstruction.

Tumor involving the carina is a real challenge to thoracic surgeons due to the complexity of airway reconstruction and management. Carinal resection is a safe procedure in highly selected patients with acceptable morbidity and mortality and good long-term survival. A 32-year-old lady with adenoid cystic carcinoma arising from the left main bronchus underwent carinal pneumonectomy using a combined thoracotomy and midline sternotomy approach without the use of cardiopulmonary bypass.

In-stent restenosis: surgical and histopathological perspective.

Background In-stent restenosis has been recognized as a distinct clinical entity that warrants a repeat procedure either in the form of percutaneous reintervention or coronary artery bypass grafting. Multivessel grafting with endarterectomy and explantation of the stent is rarely performed, with few cases reported in the literature. We aim to study the pathomorphology of the stent-vascular interface in coronary vessels undergoing in-stent restenosis.

MitraClip and mitral annuloplasty device as a bridge to transplantation.

A 42-year-old man with dilated cardiomyopathy and endstage heart failure was evaluated for heart transplantation. He received a MitraClip and Carillon annuloplasty device for functional mitral regurgitation as palliation for his heart failure. Subsequently, he underwent successful heart transplantation.

Intralobar sequestration with situs inversus totalis.

Pulmonary sequestration is a relatively rare congenital lesion of the lung. The occurrence of intralobar pulmonary sequestration coincidentally with situs inversus totalis is an interesting combination. We report a case of intralobar sequestration with situs inversus totalis a 30-year-old lady, which was treated successfully in our institution.

Congenital complete heart block in Klippel-Feil syndrome.

A 36-year-old man with a short neck, low hairline, and mild kyphoscoliosis, presented with history of syncope. Chest radiography revealed a diaphragmatic hernia. Computed tomography demonstrated fusion of C2-C6 vertebral bodies, Electrocardiography indicated complete heart block.

Aneurysm of sinus of Valsalva: uncommon presentation.

A 28-year-old man presented with acute onset of chest pain. Transthoracic echocardiography confirmed an aneurysm of the sinus of Valsalva dissecting into the interventricular septum. During the next 12 h, the aneurysm enlarged to involve the entire interventricular septum, and the patient developed features of cardiac tamponade.

Left main disease associated with an anomalous left anterior descending artery.

Background: Coronary artery anomalies are very rare. Recognizing these anomalies are clinically relevant as they can mimic symptoms of coronary artery disease, and sporadic cases of sudden death have been described in these patients.

Method: This report describes a 55-year-old patient with left main disease and an anomalous left anterior descending artery arising from anterior coronary sinus who presented with palpitations.

Takayasu's arteritis mimicking acute aortic dissection.

A 17-year-old girl presented with a history of dyspnea on exertion and fever of 1-week duration. She was evaluated elsewhere with transesophageal echocardiography and helical computed tomographic scan, and she had been diagnosed with an acute type I dissection of the aorta. She had also been diagnosed with severe aortic regurgitation and a suspected aortic root abscess.

Repair of tuberculous aneurysm of distal aortic arch.

A 65 year old female patient presented with one episode of massive haemoptysis requiring transfusion and subsequently cough with streaky haemoptysis. Computerized tomographic scan and angiogram revealed aneurysm of the distal aortic arch. She underwent elective repair of the pseudoaneurysm through median sternotomy and the bronchial communication was closed through left thoracotomy.

Right pulmonary artery-to-left atrial fistula.

Right pulmonary artery-to-left atrial fistula is a rare congenital anomaly. Contrast echocardiography and cardiac catheterization diagnosed a right pulmonary artery-to-left atrial fistula in a 24-year-old female with a history of cyanosis since childhood, and recurrent thromboembolism. She underwent successful surgical closure of the fistula.