Radial Artery Harvesting With Skin Bridge Technique Among Patients Undergoing Coronary Artery Bypass Grafting: An Approach For Developing Countries.

The risk of wound dehiscence and sternal infections remains high after coronary artery bypass grafting, especially in patients with diabetes. Radial artery is a potential alternative which has shown good post-operative outcomes with least complications. Open and endoscopic techniques for harvesting have been used till now.

Mesenchymal Stem Cell Therapy in Ischaemic Heart Failure: Hope or Hype?

Ischaemic heart diseases (IHDs) are the leading contributor to mortality worldwide and more than 60% occur in low-to-middle-income countries (LMICs) and 40% of these are specified as premature. Despite notable improvements in treatment options, premature deaths due to IHDs including ischaemic heart failure (IHF) continue to rise in the South Asian population due to prevalent conventional and inherent cardiovascular risk profiles. Stem cell (SCs) therapy has emerged as a potential frontier in regenerative therapy for acute and chronic illnesses.

Dysregulation of metalloproteins in ischemic heart disease patients with systolic dysfunction.

Ischemic heart disease (IHD) is the leading cause of mortality worldwide. Metalloproteins have been linked to human health and diseases. The molecular functions of metalloproteins in IHD is not well understood and require further exploration.

Paradigm shift in the surgical training: The era of innovation, simulation and beyond.

This is an era of transformation of surgical education and training. Modern methods of training are being introduced at a rapid pace and are being adopted in surgical practice not only to improve the outcomes and patient satisfaction, but also to provide an opportunity to develop a new well-structured training curriculum by integrating both traditional and modern approaches to teach and learn surgical skills. Various surgical simulators are in use as training aids and are constantly undergoing further refinement and development.

Pericardial fluid proteomic label-free quantification of differentially expressed proteins in ischemic heart disease patients with systolic dysfunction by nano-LC-ESI-MS/MS analysis.

Left ventricular systolic dysfunction (LVSD) is common in patients with pre-existing ischemic heart disease (IHD) and myocardial infarction. An untargeted proteomic approach is used to improve the understanding of the molecular mechanisms associated with LVSD and to find out potential proteomic signatures in pericardial fluid. The pericardial fluid of IHD ( = 45) patients was grouped into two categories according to the left ventricular ejection fraction, LVEF ≥45 ( = 33) and LVEF <45 ( = 12), and analyzed by using nano-liquid chromatography-mass spectrometry (nano-LC-MS/MS) technique.

Comparing Outcomes in Patients Undergoing Coronary Artery Bypass Grafting With and Without Using the Internal Mammary Artery in a Tertiary Care Hospital.

Purpose The left internal mammary artery in coronary artery bypass grafting (CABG) is considered to be an important intraoperative quality indicator with excellent long-term results. The purpose of this study is to compare the early outcomes of CABG with and without the left internal mammary artery (LIMA) in the South Asian population and to look for the utilization of LIMA as per the recommendations of the Society of Thoracic Surgeons in a developing country. Materials and methods A retrospective review was carried out for all patients who underwent CABG from 2010 to 2015.

Ionomic profiling of pericardial fluid in ischemic heart disease.

Metals are essential cofactors that play a crucial role in heart function at the cell and tissue level. Information regarding the role of metals in the pericardial fluid and its ionome in ischemic heart disease (IHD) is limited. We aimed to determine the association of elements in pericardial fluid and serum samples of IHD patients and their correlation with systolic and diastolic function.

Understanding of metals dysregulation in patients with systolic and diastolic dysfunction in ischemic heart disease.

Ischemic heart disease (IHD) is the leading cause of death and chronic disability in the world. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e'), were correlated with differential regulation of various metals in patients sera samples (n = 62) using inductive coupled plasma-mass spectrometry (ICP-MS).

Direct true lumen versus conventional cannulation for acute type-A aortic dissection.

Acute type-A aortic dissection is a surgical emergency and has a high rate of short-term mortality. Aortic dissection is highly under-reported in Pakistan. With the technological developments in its management, arterial cannulation technique of direct true lumen cannulation has emerged with improved outcomes.

Iatrogenic trauma following percutaneous and minimally invasive surgical interventions.

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery.

Rare aneurysm of anterior mitral valve leaflet-a case report.

Background: Mitral valve aneurysm (MVA) is a saccular outpouching of the mitral leaflet which expands on systole and collapses during diastole. The case of MVA was first described in 1729 by Morand. It is one of the rare entities with a reported incidence of only 0.

Untargeted metabolomic analysis of coronary artery disease patients with diastolic dysfunction show disturbed oxidative pathway.

Introduction: Left ventricular diastolic dysfunction (LVDD) is common in patients with coronary artery disease (CAD) with prevalence estimates of 34% and constitutes a predictor of all-cause mortality. Although diastolic dysfunction is induced by myocardial ischemia and has been shown to alter the clinical course, the role of coronary artery disease in the diastolic dysfunction and its progression into heart failure has not been completely elucidated.

Objective: The present study was conducted to identify possible metabolites in coronary artery disease patients that are differentially regulated in patients with diastolic dysfunction.

Is Grown Up Congenital Heart (GUCH) disease different in a developing country?

In the current era grown up congenital heart disease (GUCH) patients undergoing surgical interventions are increasing. Most of the interventions in the developed countries are either complex or redo-operations in patients who had previously undergone repair, palliation or correction. However, in the developing countries most of the interventions are primary and corrective.

Coronary artery bypass grafting in South Asian patients: Impact of gender.

Background: Outcomes following Coronary artery bypass grafting (GABG) vary between genders, with females having a higher postoperative mortality than males. Most of the studies are on Caucasian or mixed population and it is postulated that Asian population and in particular women have higher morbidity and mortality. In this study we have compared outcomes of elective CABG in men and women of South Asian origin in terms of morbidity and mortality.

Anemia in a middle aged female with aortitis: a case report.

Background: Idiopathic aortitis is among the most common causes of non-infectious aortitis, which rarely presents with anemia.

Case Presentation: Here we report a case of a 49-year-old muhajir female who presented with shortness of breath and easy fatigability for the past 6 months. Physical examination revealed pallor and a diastolic murmur in the aortic region.

Intraoperative air embolism originating from a pulmonary vein.

Air embolism entering the systemic arterial system originating from the pulmonary circuit itself is an extremely rare occurrence. We report the case of an 18-year-old female undergoing correction of an atrial septal defect, who had an air embolism that is believed to have originated from the right superior pulmonary vein. Although the exact mechanism of air entry remains a matter of speculation, several plausible hypotheses are proposed and discussed.

Body mass index--predictor of outcome after coronary artery bypass grafting.

Objective: Increased body mass index has been associated with increased postoperative morbidity. We studied the effect of body mass index in our population, using a modified scale suggested by the World Health Organization.

Methods: From January 2006 to December 2008, 1019 patients undergoing first-time isolated elective coronary artery bypass grafting were selected from our cardiac surgery database.

Pericardial fluid and serum biomarkers equally predict ventricular dysfunction.

Background: serum level of amino-terminal pro-B-type natriuretic peptide, a cardiac hormone produced by the heart, is elevated in patients with left ventricular dysfunction. The purpose of this study was to compare the abilities of serum and pericardial fluid levels of amino-terminal pro-B-type natriuretic peptide to detect the left ventricular systolic dysfunction determined by echocardiography.

Methods: 50 patients undergoing coronary artery bypass grafting were included in this study.

Tuberculous ascending aortic pseudoaneurysm.

Pseudoaneurysms of the ascending aorta due to infective organisms are a rare but challenging entity with a risk of high morbidity and mortality. Previous cardiac surgery is an attributing factor, but they can present without previous surgical interventions. Various micro-organisms are responsible for this pathology.

Redo coronary artery surgery; early and intermediate outcomes from a tertiary care hospital in a developing country.

Objective: To evaluate outcomes of re-operative coronary artery surgery in a tertiary care hospital in a developing country.

Method: Preoperative, intra-operative and postoperative variables were analyzed in 82 consecutive patients who underwent re-operative coronary surgery on cardiopulmonary bypass.

Results: The mean age was 63.

The frequency of heparin induced thrombocytopenia in patients undergoing elective cardiac bypass surgeries.

Objective: To determine the frequency of Heparin Induced Thrombocytopenia (HIT) in patients undergoing elective cardiac bypass surgeries and to observe the platelets evolution post surgically in these patients.

Method: A prospective study was designed and 100 unselected consecutive patients undergoing elective cardiac bypass surgery were enrolled and evaluated. The clinical and laboratory details were noted before and after surgery.

Is urgent coronary artery bypass grafting a safe option in octogenarians? A developing country perspective.

Life expectancy has increased during recent decades leading to a growing number of older population. The objective of this study was to evaluate the outcomes of coronary artery bypass grafting (CABG) in octogenarians and to compare the outcomes of the emergent CABG with elective surgery. Prospectively collected data from 31 consecutive octogenarian patients who underwent CABG between 1 January 2006 and 31 December 2008 were analyzed.