The World Health Organization Collaborating Center for Emergency and Trauma (WHO-CCET) in South East Asia, The World Academic Council of Emergency Medicine (WACEM), and The American College of Academic International Medicine (ACAIM) 2021 Framework for using Telemedicine Technology at Healthcare Institutions.

The coronavirus disease 2019 crisis has forced the world to integrate telemedicine into health delivery systems in an unprecedented way. To deliver essential care, lawmakers, physicians, patients, payers, and health systems have all adopted telemedicine and redesigned delivery processes with accelerated speed and coordination in a fragmented way without a long-term vision or uniformed standards. There is an opportunity to learn from the experiences gained by this pandemic to help shape a better health-care system that standardizes telemedicine to optimize the overall efficiency of remote health-care delivery.

Mitral valve repair in patients with low left ventricular ejection fractions: early and late results.

Study Objectives: This retrospective study was performed to examine the outcome of mitral valve repair (ie, mitral valvuloplasty [MVP]) in relation to preoperative low left ventricular ejection fraction (LVEF).

Design And Settings: From our series of 338 consecutive patients who underwent MVP between 1983 and 2001, we compared the course of 302 patients with preoperative LVEF of > 35% (group I) to that of 36 patients with LVEF of
Results: Preoperatively, group II patients were more likely to be associated with ischemic heart disease (IHD) [p < 0.

Hypomagnesaemia.

In the management of electrolyte abnormalities along with hypokalaemia and hypocalcaemia, etc, presence of hypomsgenesaemia should be thought of even when serum magnesium is within normal limit as magneium is a predominantly intracellulr ion. Two cases of hypomagnesaemia as one of the factors of electrolyte distrubances are communicated in this write-up.

Mobilization of the anterior mitral leaflet for excision of a left ventricular myxoma.

Left ventricular myxomas are extremely rare. We report use of a left atrial approach with mobilization of the anterior mitral valve leaflet to enhance exposure of the subvalvar region and facilitate excision of a left ventricular myxoma entangled within the chordal apparatus, lying between the anterolateral papillary muscle and the left ventricular wall. The detached mitral leaflet was reattached to the annulus with a continuous suture.

Minimally Invasive Coronary Artery Bypass Grafting: A Review.

Minimally invasive coronary artery bypass grafting (CABG) without cardiopulmonary bypass is a useful option for selected patients with isolated, proximal stenoses of the left anterior descending (LAD) or right coronary artery (RCA), or with recurrent stenosis after conventional CABG (with cardiopulmonary bypass), angioplasty, or stenting, particularly in elderly patients and those with major comorbidities making cardiopulmonary bypass too risky. Benefits of minimally invasive CABG include a smaller skin incision, shorter operating time, fewer arrhythmias, less blood loss, a shorter hospital stay, and lower cost. Multivessel disease can be treated with a staged, hybrid approach integrating minimally invasive CABG and transcatheter interventions.

Can retrograde cardioplegia alone provide adequate protection for cardiac valve surgery?

Background: When aortic insufficiency is present, antegrade delivery of cardioplegia requires coronary cannulation. Use of retrograde cardioplegia simplifies administration. The efficacy of the retrograde route alone in ensuring adequate myocardial protection may be assessed by the clinical outcome.

Limited-access coronary artery bypass grafting. The Texas Heart Institute experience.

Limited-access coronary artery bypass grafting, without the aid of cardiopulmonary bypass, is being performed with increased frequency, but its indications are not well defined. To determine the outcome of, and indications for, this procedure, we analyzed our experience with limited-access coronary artery bypass grafting. Between February 1996 and June 1998, 84 patients underwent limited-access coronary artery bypass grafting at our institution.

Aortic root replacement: results using the St. Jude Medical/Hemashield composite graft.

Background: Aortic root replacement remains a formidable operation. Although perioperative mortality has declined steadily, there is no consensus regarding the preferred method of reconstruction or type of composite to be used. We present our last 2 years' experience with aortic root replacement using the St.

Outcome of isolated coronary artery bypass surgery in octogenarians.

Background: Between 1989 and 1992 100 consecutive patients aged 80 or older underwent isolated coronary artery bypass grafting (CABG) in our institution. Eighty-six percent had angina grade III or IV symptoms.

Methods: Emergency surgery was required in 31, urgent surgery in 30, and elective surgery in 39 patients.

Single-stage repair of thoracic ectopia cordis.

Thoracic ectopia cordis is a rare congenital defect most often seen in association with sternal and congenital heart defects. Surgical correction of these defects is complex and generally requires a staged closure including (1) coverage of the "naked heart," (2) placement of the heart into the thoracic cavity, and (3) sternal or thoracic reconstruction. Survival past the perioperative period is rare, with only 2 reported cases in the English-language literature.

Acute appendicitis mistaken as acute rejection in renal transplant recipients.

Case histories of 2 renal transplant recipients are reported who had presenting features of fever, leukocytosis and pain/tenderness over right iliac fossa and were diagnosed to be due to acute appendicitis rather than more commonly suspected acute rejection episode which has very similar features. Diagnosis of acute appendicitis was suspected on the basis of rectal examination and later confirmed by laparotomy. The purpose of this communication is to emphasize the need for proper diagnosis in patient with such presentation; otherwise wrong treatment may be received.

Pattern of renal amyloidosis in western India. A study of 104 cases.

A total of 31,266 autopsies and 1556 renal biopsies were scrutinised over a period of 19 years (1968-1986) retrospectively and prospectively, with an aim to study the incidence and pattern of renal amyloidosis in western India. A total of 104 cases with amyloidosis were detected, 41 from the autopsy series (0.1%) and 63 from biopsies (4%).

Aortic arch rupture in a child following minor blunt trauma.

We report the case of a seven-year-old boy who sustained near-total transection of the aortic arch following apparently minor blunt injury. The radiological and operative findings and the successful outcome of urgent surgical repair support an aggressive approach to the diagnosis and management of suspected aortic injuries in children.