Successful management of penetrating cardiac injury in a limited resource setting without cardiac surgical instruments and heart-lung machine.

Penetrating cardiac injuries (PCI) are often fatal and do not present enough time for effective referrals to higher centers. Most deaths occur in transit from a remote healthcare setting with limited resources. I present the first reported case of PCI in the medical literature to be managed successfully in the absence of heart-lung machine as well as dedicated cardiac surgical instruments and equipment, and which was further complicated by mediastinitis.

2nd postoperative day discharge after full sternotomy off pump coronary artery bypass grafting surgery - A report of 2 consecutive rapid discharges.

Introduction And Importance: Very early discharge after coronary artery bypass grafting (CABG), defined as discharge in ≤4 days after surgery, is considered safe and comes with a host of benefits including lower costs and earlier return to work.

Case Presentation: I present two consecutive cases of off pump coronary artery bypass grafting (OPCAB) performed through conventional full sternotomy that were discharged on the second post-operative day (at 36 and 42 h after surgery), the former being the earliest described in medical literature till date.

Clinical Discussion: From my early experience, I list out all the factors that facilitated such ultra fast-track recovery and present a checklist to enable rapid (<2 days) discharge after CABG.