Factors predicting the progress of mitral valve disease in surgically treated adults with ostium primum atrial septal defects.

Objective: This study was undertaken to analyze the clinical profile, associated features, and surgical treatments of adults operated on for ostium primum atrial septal defects, particularly factors influencing progression of mitral valve disease.

Methods: We retrospectively studied all patients aged 18 years and older operated on at our institution with reference to patient clinical features, investigation findings, surgical records, and outpatient follow-up data.

Results: Fifty-one patients, 29 female and 22 male, underwent operation at a mean age of 27.

Giant single left coronary artery with right ventricular fistula diagnosed in early childhood.

We present an unusual case of an 18-month-old boy, who presented with dyspnea and recurrent respiratory tract infections. Echocardiography and subsequent angiography were suggestive of a fistula from a coronary artery to the right ventricle. Finally, only on table could the actual diagnosis of a single left coronary artery with right ventricular fistula be made.

Clinical presentation and investigation findings in cardiac myxomas: new insights from the developing world.

Background: Cardiac myxomas are an uncommon condition and most of the available information on their clinical features comes from smaller series of patients from developed countries. Our aim was to quantify and correlate the clinical and investigation findings in cardiac myxomas in a developing country and compare them with existing data.

Methods: A retrospective study of case notes, electrocardiograms, and x-rays of 171 patients treated for cardiac myxoma from February 1992 to October 2006 at a large charitable institution in South India was conducted.

Aorta-right atrial tunnel: clinical presentation, diagnostic criteria, and surgical options.

Objective: Aorta-right atrial tunnel is a rare and distinct congenital anomaly. To the spectrum of aorta-right atrial communications, we want to add this separate entity of aorta-right atrial tunnel by presenting the clinical features, morphologic aspects, diagnostic criteria, surgical techniques, and outcome in various clinical settings for better understanding of this developmentally intriguing, clinically complex, and therapeutically challenging disorder.

Methods: From June 1994 through October 2004, 9 patients were treated for aorta-right atrial tunnel at our institution.

Late coronary bypass graft flow: quantitative assessment by roentgendensitometry.

Quantitative assessment of the flow in 45 saphenous vein aortocoronary bypass grafts in 30 patients was performed by a roentgendensitometric technique. Detalis of the technique are given. Mean graft flow for all grafts measured in the early postoperative period (two weeks) and again in the late postoperative period (six months to 3 years; average, 1.

Results of aortocoronary bypass grafting in patients with subendocardial infarction: late follow-up.

Twenty-eight patients with subendocardial infarction (Group A) were compared with 28 patients with unstable angina (Group B) and 28 with stable angina (Group C) matched for age and sex. The three groups did not differ in prevalence of diabetes, hypertension, old infarction or duration of disease. There were no significant differences in number of diseased vessels, coronary score, abnormal left ventricular wall motion or left ventricular end-diastolic pressure.

Survival after coronary surgery.

A 4.4 year follow-up study has been done on a previously reported group of 200 consecutive patients who underwnet coronary bypass. The yearly mortality rate has been 1% (8/200 in 4 years).

Significance of new Q waves after bypass grafting: correlations between graft patency, ventriculogram, and surgical venting technique.

New postoperative electrocardiographic Q waves have been described in eight of 40 per cent of patients undergoing bypass grafting for coronary artery disease. Various theories have been proposed to explain these new Q waves. Correlations of new Q waves to vein bypass occlusion, prolonged pump time or aortic cross-clamping time are controversial.

Should the pericardium be closed after an open-heart operation?

A controlled clinical study was carried out to decide whether the pericardium should be left open or closed after open-heart operations. One hundred patients had the pericardium closed with interrupted silk, another 100 had the pericardium left open. Complications were alike except for the more frequent occurrence of a pericardial rub in the closed group (14 vs 3 patients), though the incidence of post-pericardiotomy syndrome was equal.