Review of current status of cardiovascular and thoracic surgery in Nepal: An analysis from collection of institutional database.

Objective: Data collected from various institutions around the country was analyzed to assess the current status of cardiovascular and thoracic surgery in the country.

Methods: We collected data from institutions performing cardiovascular and thoracic surgery from all over the country through direct correspondence for the year 2019. Individual institution data on the number of surgeries performed for cardiac, vascular, and thoracic surgery and its outcome in terms of mortality were compiled.

Pericardial cyst in a one-year-old boy with ventricular septal defect and patent ductus arteriosus.

Background: Pericardial cysts are rare, with the most common etiology being congenital. Ventricular septal defect is the most common congenital heart disease in children. However, the combination of pericardial cyst, ventricular septal defect, and patent ductus arteriosus is extremely rare.

Elective re-intubation to treat complete left lung collapse following Tetralogy of Fallot repair in a very young child.

An 18-month-old boy weighing 6 kilograms developed complete collapse of left lung following total correction of Tetralogy of Fallot on the next day of extubation. He received extensive chest physiotherapy, along with lung recruitment maneuver by using bubble CPAP, which failed to show any improvement in lung expansion in 2 days. He was then electively intubated on 3rd postoperative day (POD3) for the purpose of suctioning tracheobronchial secretions and maintaining positive airway pressure to open up the left lung.

Thrombus straddling patent foramen ovale and massive pulmonary embolism.

A thrombus straddling the foramen ovale is rare; and optimal management is controversial. Most of the literature on this topic is available only in the form of case reports. Here, we present a case of 30-year-old female with recent history of fibular fracture and thrombus in transit through patent foramen ovale and massive pulmonary embolism who was successfully managed with pulmonary embolectomy, extraction of serpentine thrombus straddling patent foramen ovale, and closure of patent foramen ovale.

Evaluation of spinal cord protective threshold of serum memantine, an NMDA receptor antagonist, in a rabbit model of paraplegia.

Purpose: To evaluate the threshold of serum memantine for prevention of spinal cord injury (SCI) in a rabbit paraplegic model.

Methods: Forty-two New Zealand white rabbits were divided into 7 groups. Preoperatively, oral memantine was given starting from 60 mg OD for 7 days in the initial group, then reducing the dose and/or duration to 60 mg OD for 5 days, 30 mg OD for 5 days, 30 mg OD for 3 days, 15 mg OD for 3 days, 30 mg single dose, and 60 mg single dose, in subsequent 6 groups.

Deceiving spindle cell sarcoma of the heart.

Primary cardiac tumors are rare and when they occur, 75% are benign. Atrial myxomas having a good prognosis compromise 50% of all primary cardiac tumors. Only 25% of the primary cardiac tumors are malignant and 75% of these malignant tumors are sarcomas.

Negative pressure wound therapy induces early wound healing by increased and accelerated expression of vascular endothelial growth factor receptors.

Background: Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially following thoracic surgery; however, the mechanism remains elusive. Given the important role of vasculogenesis in wound healing, we evaluated whether NPWT might accelerate vasculogenesis in the wound area. Toward this end, we investigated the temporal expression of vascular endothelial growth factor receptors (VEGFRs) in an NPWT-wound healing rabbit model.

A New Suturing Device for Small Arteries.

Endoscope-assisted surgery and robot-assisted surgery are not common in cardiac surgery, particularly coronary artery bypass grafting, because of the complex nature of the procedures. We developed a new suturing device that allows for easy performance of such cardiac surgeries in comparison with conventional suturing methods. A total of 63 rabbits were used in this study.

Tailor-made heart simulation predicts the effect of cardiac resynchronization therapy in a canine model of heart failure.

Despite extensive studies on clinical indices for the selection of patient candidates for cardiac resynchronization therapy (CRT), approximately 30% of selected patients do not respond to this therapy. Herein, we examined whether CRT simulations based on individualized realistic three-dimensional heart models can predict the therapeutic effect of CRT in a canine model of heart failure with left bundle branch block. In four canine models of failing heart with dyssynchrony, individualized three-dimensional heart models reproducing the electromechanical activity of each animal were created based on the computer tomographic images.

Novel Anastomotic Device for Distal Coronary Anastomosis: Preclinical Results From Swine Off-Pump Coronary Artery Bypass Model.

Purpose: We evaluated the safety and feasibility of a new anastomotic device that simplifies coronary distal anastomosis during minimally invasive and robotically assisted coronary artery bypass graft surgery (CABG).

Description: Fourteen miniature pigs underwent off-pump CABG using bilateral internal thoracic arteries (ITA), namely, left ITA to left anterior descending artery and right ITA to right coronary artery. The device was used for distal anastomosis in a device group (n = 11), and conventional 7-0 polypropylene suture in a control group (n = 3).

Spinal cord injury following thoracic and thoracoabdominal aortic repairs.

Objective: To discuss the currently available approaches to prevent spinal cord injury during thoracic and thoracoabdominal aortic repairs.

Methods: We carried out a PubMed search up to 2013 using the Medical Subject Headings: "aortic aneurysm/surgery" and "spinal cord ischemia"; "aortic aneurysm, thoracic/surgery" and "spinal cord ischemia"; "aneurysm/surgery" and "spinal cord ischemia/cerebrospinal fluid"; "aortic aneurysm/surgery" and "paraplegia". All 190 original articles satisfying our inclusion criteria were analyzed for incidence, predictors, and other pertinent variables related to spinal cord injury, and we compared the results in recent publications with those in earlier reports.

Paraplegia prevention by oral pretreatment with memantine in a rabbit model.

Objective: To evaluate the role of memantine (N-methyl-d-aspartate receptor antagonist) pretreatment for the prevention of spinal cord ischemia after infrarenal aortic clamping in a rabbit model.

Methods: Thirty New Zealand White rabbits were divided into 5 different groups of 6 rabbits. Groups 60-7 and 60-5 received oral memantine 60 mg once a day for 7 and 5 days, respectively, and groups 30-5 and 30-3 received oral memantine 30 mg once a day for 5 and 3 days, respectively, all before surgery.

Development of a suturing device for anastomosis for small caliber arteries.

The use of minimally invasive and robotic operations has been increasing for coronary artery bypass surgery; however, no suturing devices have been universally adopted for use in these procedures. We developed a new suturing device that enables omission of manual ligation after a running suture. Twenty-two rabbits were used in this study.

Aortic valve replacement for aortic stenosis caused by alkaptonuria.

We report a case of aortic stenosis associated with ochronosis in a 70-year-old man who underwent biologic aortic valve replacement. Intraoperative findings included ochronosis of a severely calcified pigmented aortic valve along with pigmentation of the intima of the aorta.

Nepalese pharmacy students' perceptions regarding mental disorders and pharmacy education.

Objective: To determine Nepalese pharmacy students' perceptions of whether mental disorders impact performance in pharmacy school.

Method: All first- and third-year undergraduate pharmacy students (n=226) in Nepal were invited to complete a modified version of the Mental Illness Performance Scale.

Results: Among the 200 respondents (response rate 88.