Suture fixation of migrated septal occluder device to prevent further migration: a simple surgical technique.

As the use of percutaneous intervention is increasing for the closure of the atrial septal defect, the procedure related complications are also on rise, migration of the device being most common. The migrated devices with failed percutaneous retrieval must be removed surgically under cardiopulmonary bypass. During establishment of cardiopulmonary bypass, the handling of heart may cause further migration of the device into other chambers of heart which leads to difficulty in finding and retrieval of the device.

Thymectomy through lateralized partial sternotomy.

A young woman with nonthymomic myasthenia gravis with failure of medical treatment was offered thymectomy through partial sternotomy. Shifting of vertical arm of "L" incision laterally avoids fracture of opposite sternal flange and provides better sternal stability postoperatively.

Repair of postinfarct ventricular septal defect and total myocardial revascularization in a case of dextrocardia with situs inversus.

We report a case of an elderly man who suffered an acute myocardial infarction (MI) with the complication of a post-MI ventricular septal defect (VSD). Situs inversus with dextrocardia was diagnosed during the course of hospitalization. Total myocardial revascularization was achieved using saphenous vein conduits.

Use of pericardial strip for reinforcement of proximal anastomosis in Bentall's procedure.

Bleeding from a proximal suture line is not uncommon following composite graft anastomosis in Bentall's procedure. Passage of valve sutures through the pericardial strip, which is used to encircle the sewing ring of the composite graft, strengthens the repair. The strip can also be sutured to the left ventricular outflow tract in case of bleeding from proximal anastomosis in that particular region.

Surgical removal of duct occluder device under mild hypothermia without cardiopulmonary bypass.

Because the use of percutaneous intervention is increasing for the closure of the patent ductus arteriosus, the procedure-related complications are also on rise, with migration of the device being most common. The routine practice is to remove the migrated duct occluder device under cardiopulmonary bypass. Amplatzer duct occluder used in a 4-month-old infant dislodged into the descending thoracic aorta.

Simple and inexpensive technique for internal mammary artery harvest.

A simple, inexpensive, and easy-to-use method for exposure of the left internal mammary artery is described. Two blades of the conventional four-blade sternal spreader hooking the Adson forceps, which passes through the loops of sternal wires, provides excellent exposure of the IMA. The same retractor is used for the rest of the procedure.