Valve Replacement for Massive Hemoptysis in Mitral Stenosis: An Uncommon Course in Modern Practice.

Massive hemoptysis is uncommon in mitral stenosis in contemporary practice. We report a patient without any previous illness presenting with life-threatening pulmonary hemorrhage, who was initially managed as cryptogenic hemoptysis. Once mitral stenosis was confirmed, the patient underwent mitral valve replacement with total and complete cessation of bleeding.

Intraoperative 2D and 3D transesophageal echocardiographic assessment of cor triatriatum with ostium secundum atrial septal defect in an adult patient.

Cor triatriatum is a rare congenital cardiac anomaly. Majority of the cases present in the childhood with an incidence of 0.4%.

Perioperative management of transcatheter, aortic and mitral, double valve-in-valve implantation during pregnancy through left ventricular apical approach.

Pregnant women with stenotic degeneration of bioprosthetic cardiac valves may require another valve replacement procedure when their symptoms deteriorate with progression of pregnancy, but fetal mortality is higher with cardiac surgery done on cardiopulmonary bypass. Transcatheter valve-in-valve implantation may help to improve the fetal and maternal outcomes in these situations. Double valve-in-valve implantation is rare and has not been reported in a pregnant patient.

Left ventricular global systolic function assessment by echocardiography.

The left ventricle, with its thickened myocardial walls, unlike the right ventricle has no measurable geometric shape. It has a conical apex and its function quantification, needs intensive, 2D, 3D and M mode transesophageal echocardiography, which is described in this review.

Coronary artery bypass grafting in a patient with protein S deficiency: perioperative implications.

Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).

Off-pump coronary artery bypass grafting through left antero-lateral thoracotomy (thora-cab) - case report and review of literature.

We report the first case of off-pump complete myocardial revascularization through antero-lateral thoracotomy (Thora-CAB) in Middle-East. 69 year old gentleman having angina pectoris for last three years with severe double vessel disease involving the left anterior descending artery (95% proximal lesion) and the circumflex system (80% mid circumflex lesion with significant osteal disease in obtuse marginal) and insignificant disease in right coronary artery with moderate left ventricular impairment underwent Thora-CAB. Post-operatively, he had minimal pain, quick symptomatic improvement and no complications.

Determinants of early outcome after neonatal cardiac surgery in a developing country.

Objective: Significant technologic advances have improved outcomes in neonatal cardiac surgery over the past 3 decades. However, outcomes might be different in developing countries with resource limitations. We sought to identify the determinants of early outcome after neonatal cardiac surgery in a tertiary referral center in South India.

Management of infants with large, unrepaired ventricular septal defects and respiratory infection requiring mechanical ventilation.

Objectives: We sought to describe the hospital management and early outcome of critically ill infants presenting with large ventricular septal defects and pneumonia requiring mechanical ventilation at a referral center in a developing country. Infants with large ventricular septal defects who have pneumonia might present with respiratory failure requiring mechanical ventilation. In the developing world this presentation is relatively common, but few data exist describing patient management strategies.