Off-pump CABG is associated with significant reduction in intraoperative mediastinal blood loss and homologous transfusion requirements. Autologous transfusion of salvaged washed mediastinal blood reduced homologous transfusion significantly in the on-CPB group. Cell saver caused no significant adverse impact on coagulation parameters in on- or off-CPB CABG. Postoperative morbidity and blood loss were not affected by the use of CPB or autologous blood transfusion. We recommend the use of autologous blood transfusion in both on- and off-pump CABG surgery.
The results of this study suggest that trainees under supervision perform complex off-pump coronary artery surgery safely with low rate of mortality and complications. These findings are in agreement with previous literature reports. Trainees should be allowed to operate on sufficient number of patients undergoing off-pump surgery according to their skills and abilities. Patients should be reassured that safety is not compromised by the presence of a trainee as a primary surgeon.
We present a 30-year-old female patient with a myxoma of the right ventricle, which was attached to the free wall of the right ventricle and was moving in and out the pulmonary valve causing right ventricular outflow tract obstruction. Myxomas of the right ventricle are rare and their surgical excision can be challenging especially if they infiltrate into important structures of the myocardium. They can be part of a broader category of diseases known as Carney complex with a familial predisposition.
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