Extended septal myectomy using a combined trans-aortic and apical approach for long basal and mid-cavity hypertrophic cardiomyopathy.

Unlabelled: Surgical septal myectomy is the treatment of choice for patients of hypertrophic cardiomyopathy who are symptomatic despite maximal medical therapy. Residual obstruction results in the persistence of symptoms and poorer outcomes. The length (depth) of the septum excised as far towards the apex is important.

Hardware Failure as a Rare Complication of Percutaneous Coronary Intervention: A Case Report.

Percutaneous coronary intervention (PCI) is increasingly employed in the treatment of complex coronary artery disease. The entrapment or fracture of a coronary angioplasty guidewire is a rare complication of PCI. We herein describe a 61-year-old man who presented with chronic stable angina.

Infections of the aorta.

Infection of the aorta continues to be a clinical challenge with high morbidity and mortality. The incidence varies between 0.6 and 2.

IACTS position statement on "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization": section 7.1-a consensus document.

American College of Cardiology (ACC), American Heart Association (AHA) and Society for Cardiovascular Angiography and Interventions (SCAI) recently released the Clinical Practice Guidelines for myocardial revascularization [1]. The guidelines were the felt need of the fraternity and this single all-encompassing document, relegating the previous six guidelines on the subject to archives, is indeed welcome. However, the downgrading of coronary artery bypass surgery for stable multivessel coronary artery disease and its bracketing with percutaneous coronary interventions has caused a lot of anguish in the surgical fraternity.

An unusual cause of acute mitral regurgitation in TTK Chitra heart valve prosthesis.

Structural failure of mechanical heart valve was a known feature when it was evolving in the 1960s and 1970s. With the advent of pyrolytic carbon and a better design, it is a rare entity with present valves. We report a case of disc fracture leading to acute mitral regurgitation in TTK Chitra heart valve prosthesis (CHVP) (TTK Healthcare Limited, India) heart valve, 6 years after its implantation in mitral position.

Alternative Uses of the Ozaki Technique: Aortic Valved Conduit in a Bentall Operation and Right Ventricle-to-Pulmonary Artery Conduit.

The modified Ozaki technique within a conduit is reproducible and is an alternative to the use of homografts and commercially available conduits which may have special appeal in a low resource setting.

Primary spindle cell sarcoma of heart: case report and review of literature.

Primary spindle cell sarcoma of the heart is a rare malignant tumor of the heart. A 65-year-old woman was admitted under our care with complaints of shortness of breath. Echocardiogram showed pedunculated mass in the left atrium.

Intra-operative trans-esophageal echocardiography in heart valve disease.

Peri-operative echocardiography is widely used because it provides information that significantly influences clinical/surgical management and improves outcome in patients undergoing cardiac surgery. The role of intra-operative trans-esophageal echocardiography (TEE) in valvular heart disease cannot be emphasized enough. Increasing use of newer surgical techniques-valve repairs and minimal invasive cardiac surgery also warrants intra-operative TEE.

One-year outcomes of off- and on-pump coronary artery bypass grafting: PROMOTE patency trial.

Purpose: Earlier we reported 3-month graft patency and clinical outcomes of prospective randomized comparison of off-pump and on-pump multivessel coronary artery bypass surgery to evaluate outcomes and graft patency (PROMOTE patency) trial. We now report major adverse cardiac and cerebrovascular events (MACCE) at 1 year of patients who underwent coronary artery bypass grafting (CABG) using either off-pump technique or on-pump technique.

Methods: The PROMOTE patency trial is a two-arm, prospective, randomized, multicentre trial, and enrolled 320 patients with multivessel coronary artery disease from March 2016 through March 2017 at 6 centres and were randomly assigned to undergo either off-pump CABG (OPCAB) ( = 158 patients) or on-pump CABG ( = 162 patients).

Graft patency at 3 months after off- and on-pump coronary bypass surgery: a randomized trial.

Purpose: Coronary artery bypass grafting (CABG) is performed either with the aid of cardiopulmonary bypass (on-pump) or without cardiopulmonary bypass (off-pump). There is a scarcity of angiographic data to support the non-inferiority of off-pump technique to on-pump technique. The objective of this study is to ascertain the non-inferiority of off-pump CABG when compared to on-pump CABG in terms of angiographically assessed graft patency at 3 months.

An Indian study: impact of COVID-19 on clinical decision-making and consensus in cardiac surgery practice across the country.

Purpose: There is a paucity of evidence and guidelines to support clinical decisions in the present unprecedented time. We aimed to use the experience and consensus of the cardiac surgeons for clinical decisions until evidence-based guidelines are formed.

Methods: An electronic questionnaire was emailed to all the 1434 members of the Indian Association of Cardiovascular and Thoracic Surgery, starting from May 13, 2020, and the members were followed up with reminder emails.

Five-Year Outcomes after Off-Pump or On-Pump Coronary-Artery Bypass Grafting.

Background: We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial).

Methods: A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG.

Giant solitary fibrous tumor of the pleura.

Solitary fibrous tumors are rare mesenchymal tumors accounting for <5% of all neoplasms in the pleura and other sites. A 45-year-old man reported to us with cough and dyspnea. Radiological investigations revealed a giant mass displacing the mediastinum to the left.

Unusual case of chondroblastic osteosarcoma of the rib in an adult.

Primary osteosarcoma arising from the ribs is very rare. An unusual case of a primary chondroblastic osteosarcoma of the rib in a 30-year-old woman is described here. The patient underwent wide excision of the tumor along with the involved rib, followed by chemotherapy.

Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year.

Background: Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year.

Methods: We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump.

Off-pump or on-pump coronary-artery bypass grafting at 30 days.

Background: The relative benefits and risks of performing coronary-artery bypass grafting (CABG) with a beating-heart technique (off-pump CABG), as compared with cardiopulmonary bypass (on-pump CABG), are not clearly established.

Methods: At 79 centers in 19 countries, we randomly assigned 4752 patients in whom CABG was planned to undergo the procedure off-pump or on-pump. The first coprimary outcome was a composite of death, nonfatal stroke, nonfatal myocardial infarction, or new renal failure requiring dialysis at 30 days after randomization.

Idiopathic pulmonary artery aneurysm with pulmonary regurgitation.

Idiopathic pulmonary artery aneurysms are rare and need a multidisciplinary approach to diagnosis and treatment. Surgery is the treatment of choice, especially when the aneurysms are large and when they are associated with pulmonary regurgitation. This report highlights a case in which successful surgical repair preserved the native pulmonary valve after pulmonary artery reconstruction.

Effect of chordal preservation on left ventricular function.

Chordopapillary apparatus preservation was compared with valve-excising mitral valve replacement in a retrospective analysis of 360 patients, of whom 98 had total or partial chordal preservation and 262 had the conventional operation. No significant differences were seen in age, sex, pathology, crossclamp or cardiopulmonary bypass times between the 3 groups. Left ventricular fractional shortening decreased significantly in patients whose valves had been excised completely, whereas it remained unchanged in patients with either partial or total chordal conservation.