Cervical Cannulation for Surgical Repair of Congenital Cardiac Defects in Infants and Small Children.

Introduction:: The biggest challenge faced in minimally invasive pediatric cardiac surgery is cannulation for cardiopulmonary bypass. Our technique and experience of cervical cannulation in infants and small children for repair of congenital cardiac defects is reported in this study.

Methods:: From January 2013 to June 2015, 37 children (22 males) with mean age of 17.

A rare malformation of bilateral superior vena cava with bilateral partial anomalous pulmonary venous connection in the presence of ostium secundum atrial septal defect: management strategies and pitfalls.

Bilateral superior vena cava (SVC) with bilateral partial anomalous pulmonary venous connection is a very rare congenital cardiac malformation. Here, we are reporting a case of 18-year-old male who had bilateral SVC with bilateral anomalous pulmonary venous connection associated with ostium secundum atrial septal defect. The patient underwent successful surgical correction for the same.

Elective nasal continuous positive airway pressure to support respiration after prolonged ventilation in infants after congenital cardiac surgery.

Background: We sought to compare the effectiveness of oxygen (O) treatment administered by an O mask and nasal continuous positive airway pressure (NCPAP) in infants after congenital cardiac surgery.

Methods: In this retrospective observational study, 54 infants undergoing corrective cardiac surgery were enrolled. According to the anesthesiologist's preference, the patients ventilated for more than 48 h were either put on NCPAP or O mask immediately after extubation.

Invasive pericardial hydatid cyst: Excision of multiple huge cysts.

Cardiac hydatid cyst is rare even in endemic countries, and poses a therapeutic challenge due to varying presentation and unpredictable pre-, peri-, and postoperative complications. We herein present a case of multiple, multifocal, huge pericardial hydatid cyst, with invasion into the left ventricle and main pulmonary artery in a young male patient, presented with atypical chest pain.

Dialyzer-based cell salvage system: a superior alternative to conventional cell salvage in off-pump coronary artery bypass grafting.

Objectives: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters.

Methods: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) ( n  = 75), (2) conventional cell salvage (CCS) ( n  = 73) and (3) without cell salvage (WCS) ( n  = 74). Salvaged blood was transfused at the end of the operation.

Hemodiafiltration-A Technique for Physiological Correction of Priming Solution in Pediatric Cardiac Surgery: An In Vitro Study.

Pediatric cardiopulmonary bypass (CPB) circuit invariably requires priming with packed red blood cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological and becomes worse with increasing duration of storage. It is recommended to correct these abnormalities before initiation of CPB.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular a rrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion.

Recurrent Left Atrial Myxoma in a Young Patient: A Rare Entity.

Recurrence of atrial myxoma arising from the site other than inter-atrial septum is quite rare, which is more common in familial than sporadic cases. We here in present a case of 15-year-old young female who presented with recurrence of left atrial (LA) myxoma from unusual site - posterior LA wall after 3 years without any constitutional symptoms, which is the hallmark of recurrence. Complete removal of underlying atrial septum with atrial wall for recurrence prevention is the dictum in primary operation for tumour removal.

Intramural Anomalous Right Coronary Artery From the Main Pulmonary Artery.

Anomalous origin of the right coronary artery from the main pulmonary artery (anomalous right coronary artery from pulmonary artery; ARCAPA) is a rare congenital anomaly. Here, we present an unusual case of anomalous right coronary artery from the main pulmonary artery with proximal intramural course.

Comparison of Albumin, Hydroxyethyl Starch and Ringer Lactate Solution as Priming Fluid for Cardiopulmonary Bypass in Paediatric Cardiac Surgery.

Introduction: In paediatric cardiac surgery, there is still not any information with regard to the best choice of priming fluids for Cardiopulmonary Bypass (CPB). Albumin, Hydroxyethyl Starch (HES) & ringer lactate are equally used, but each has its advantages & disadvantages. Albumin & HES had better fluid balance which affect outcome in paediatric cardiac surgery significantly.

Surgical repair of multiple congenital left ventricular aneurysms with rupture into left atrium.

Congenital left ventricular aneurysm (CLVA) associated with multiple aneurysms with rupture into the left atrium (LA) is rare. We report a 17-year-old male with two CLVAs, one of which ruptured into the LA, and discuss the surgical management and review the literature of this rare disease.

Surgical Removal of Embolized Ventricular Septal Occluder Device.

Ventricular septal defect (VSD) with valvar pulmonary stenosis (PS) is a combination of cardiac defects for which treatment by means of percutaneous catheter-directed intervention is sometimes considered. Septal occluder device embolization is a rare but potentially dreadful complication. Adequate precautions are of great importance, as operator-related and anatomical factors can contribute to the risk of device embolization.

Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique.

Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands.

Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients.

Background: The modification in technique is useful for successful right-sided internal jugular vein (IJV) cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients.

Materials And Methods: This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95) and female (n = 65) who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French) using Seldinger technique.

Results: Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred.

Procalcitonin level for prediction of postoperative infection in cardiac surgery.

Background: Diagnosing infection after cardiac surgery remains difficult due to the systemic inflammatory response induced by cardiopulmonary bypass. We compared procalcitonin levels with white blood cell counts as predictors of infection after cardiac surgery.

Methods: We prospectively enrolled 100 consecutive adult cardiac patients.

Totally Anomalous Pulmonary Venous Connection With Obliterated Vertical Vein.

A rare variant of totally anomalous pulmonary venous connection with obliterated infradiaphragmatic vertical vein is described. A 20-day-old male child weighing 2.2 kg was admitted with cyanosis and tachypnea.

Double-Chambered Right Ventricle with Ventricular Septal Defect and Subaortic Membrane- Three-Dimensional Echocardiographic Evaluation.

Double-chambered right ventricle (DCRV) is a rare congenital anomaly in which the right ventricle is divided into two compartments with varying pressures due to an anomalous muscle bundle. Here, we describe a case of an adolescent male with DCRV with associated ventricular septal defect and subaortic membrane. Two-dimensional and three-dimensional transthoracic echocardiography with color flow clearly outlined all the three cardiac anomalies as well as their relationship with each other.

Prevalence and Predictors of Metabolic Syndrome in Young Asymptomatic Gujarati Population.

Background. Metabolic syndrome is a cluster of risk factors leading to the development of atherosclerotic cardiovascular diseases. We aimed to evaluate the prevalence of metabolic syndrome (MS) and its predictors in young and apparently healthy Gujarati individuals.

Pretransfusion Comparison of Dialyser-Based Hemoconcentrator With Cell Saver System for Perioperative Cell Salvage.

Objective: Cell Saver system is the method of choice for red blood cell salvage from the surgical field; however, cost is a limiting factor. We at our institute have devised a cost-effective version of dialyser-based autotransfusion system. We performed pretransfusion comparison of our autotransfusion system with conventional cell saver system.

Horseshoe lung with cor triatriatum and partial atrioventricular canal defect.

Cor triatriatum with partial atrioventricular canal defect is a rare congenital cardiac anomaly. We report a case of cor triatriatum and partial atrioventricular canal defect in association with horseshoe lung.

Fluorescein dye-guided intraoperative identification and closure of muscular ventricular septal defect.

Objective: Various techniques for intraoperative identification of muscular ventricular septal defects (VSDs) are cumbersome, difficult to use in infants, and inefficient in confirming the completeness of closure. We used simple technique of intraoperative fluorescein saline injection into the left ventricle to locate the muscular VSDs and to confirm their closure.

Methods: This is a prospective observational study conducted between April 2013 to December 2013, involving 22 patients with multiple VSDs either in isolated form or in association with other congenital cardiac anomalies.