Percutaneous balloon mitral valvuloplasty under neuroprotection: Too Early for Knighthood.

The case describes the successful percutaneous balloon mitral valvuloplasty under neuroprotection in a patient with severe symptomatic mitral stenosis and persistent left atrial appendage thrombus despite chronic warfarin therapy. Although the procedure was uneventful for any systemic embolism, the limitations of this approach are highlighted with authors still advocating that surgery remains the benchmark treatment for these patients. © 2014 Wiley Periodicals, Inc.

Isolated pericardial echinococcosis: Perioperative transesophageal echocardiographic evaluation.

Hydatid cyst (HC) is a human parasitic disease caused by the larval stage of Echinococcus granulosus. Cardiac involvement is rare and occurs in 0.5%-2% of patients with hydatid cyst, but isolated pericardial hydatid cyst is rarer still.

Longitudinal stent compression of everolimus-eluting stent: A report of 2 cases.

Second generation drug eluting stents (DES) have shown better safety and efficacy in comparison to first generation DES, because of thinner struts, nondurable polymers and coating with better anti-proliferative drugs. The newer DES with cobalt alloy base have demonstrated a greater trackability, deliverability, conformability, flexibility and radio-opacity. However, these thin strut stents have a downside of poor longitudinal axial strength, and therefore get easily deformed/compressed at their end with a slight trauma during exchange of various catheters.

Aberrant right vertebral artery from descending thoracic aorta.

We present a case of an abnormal origin of right subclavian artery and right vertebral artery distal to the origin of left subclavian artery in a 2-year-old patient who presented with cyanotic congenital heart disease with single ventricle physiology. The anomalous origin of a right vertebral artery from the proximal descending thoracic aorta is very rare. We have described the cine-angiographic identification of its origin and course, its embryologic development, and its clinical relevance.

Bispectral index as a possible early marker of cerebral hypoperfusion.

We report a case of unexplained transient ventricular fibrillation in a child with ventricular septal defect (VSD) scheduled for VSD closure. The bispectral index (BIS) values dropped within 15s of transient cardiac arrest and it showed recovery within 15 s of restoration of circulation. Monitoring BIS during surgery, especially cardiac surgeries may help identify periods of cerebral ischemia early.

Acquired supravalvular pulmonary stenosis due to extrinsic compression by a mediastinal dermoid cyst.

Acquired pulmonary stenosis is rare. When it occurs, it usually results from compression of the pulmonary artery or the heart by a mediastinal tumour. As these masses rarely cause compression that results in murmurs, it is hard to make a diagnosis.

Transvenous defibrillator implantation in a patient with persistent left superior vena cava.

Persistent left superior vena cava (LSVC) can be incidentally detected during pacemaker implantation through left pectoral side. There is technical difficulty of optimal site pacing and lead stability for right ventricle lead in such situation. We hereby report a case of successful single-chamber implantable cardioverter defibrillator (ICD) implantation in a 50 years-old male with LSVC.

Is endovascular therapy the right choice for treatment of functional compression of anomalous right coronary artery arising from left coronary sinus with interarterial course?

We report a case of successful percutaneous coronary intervention (PCI) for reversible ischaemia owing to an anomalous right coronary artery arising from the left coronary sinus with malignant interarterial course and not associated with obstructive coronary artery disease (CAD). PCI for treatment of functional compression of the ostioproximal intramural segment of the anomalous vessel, though described in the literature, is technically challenging, requiring appropriate hardware selection; the peculiar anatomical milieu, in the absence of atherosclerotic CAD, lends itself to an uncertain long-term outcome following endovascular therapy with stenting.

Post-myocardial infarction giant left ventricular pseudoaneurysm presenting with severe heart failure.

Left ventricle (LV) pseudoaneurysm is a late mechanical complication of myocardial infarction. A giant LV pseudoaneurysm is a rare presentation. We report a case of giant LV pseudoaneurysm in a post-MI patient who presented with gross congestive heart failure.

Giant left ventricular pseudoaneurysm presenting with hemoptysis.

Left ventricular (LV) pseudoaneurysm is a late mechanical complication of myocardial infarction (MI). A giant LV pseudoaneurysm is a rare presentation. We report a case of a giant LV pseudoaneurysm in a post MI patient, who presented with hemoptysis.

Modified nonlinear complex diffusion filter (MNCDF).

Background: Speckle noise removal is the most important step in the processing of echocardiographic images. A speckle-free image produces useful information to diagnose heart-related diseases. Images which contain low noise and sharp edges are more easily analyzed by the clinicians.

Percutaneous panvascular intervention in an unusual case of extensive atherosclerotic disease.

It is common to see patients with atherosclerotic coronary disease and peripheral arterial disease in routine clinical practice. One needs to have a comprehensive and integrated multi-speciality approach and panvascular revascularization in such patients. We report a 54-year-old diabetic hypertensive male with extensive atherosclerotic coronary and peripheral arterial disease, who presented with congestive heart failure, claudication of both lower limbs and mesenteric ischemia.

Spontaneous recovery of complete atrioventricular block complicating acute anterior wall ST elevation myocardial infarction.

Background: Complete atrioventricular block complicating acute anterior wall ST elevation myocardial infarction (MI) is classically considered one of the worst prognostic indicators.

Methods: We present the case of a gentleman who developed complete atrioventricular block during the course of acute anterior wall ST elevation MI, and had spontaneous resolution of the same. Mechanisms of spontaneous resolution of complete atrioventricular block in the setting of acute MI are discussed.

Percutaneous transcatheter device closure of an isolated congenital LV diverticulum: first case report.

A congenital left ventricular diverticulum is a rare cardiac malformation. It is a developmental anomaly that occurs during embryogenesis. Presentations vary from asymptomatic patients to sudden death.

Glucose-6-phosphate dehydrogenase deficiency and cardiac surgery.

Cardiac surgery involving cardiopulmonary bypass (CPB) in its conventional form involves many processes leading to free radical production, such as perioperative ischemia, reperfusion, circulation of whole body blood through the CPB circuit, hypothermia and acidosis. The red blood cells of a glucose-6-phosphate dehydrogenase (G6PD)-deficient person are unable to scavenge these free radicals, resulting in haemolysis. Here, we describe the successful anaesthetic management of two G6PD-deficient children who underwent cardiac surgery, on and off CPB, without any obvious haemolytic reaction, followed by a discussion of the disorder, with specific consideration of perioperative management of such cases.