Mitral prosthetic replacement via a right thoracotomy on beating heart under normothermic bypass offers a safe alternative to redo median sternotomy in this high-risk group. Operative access is facilitated and procedural time reduced. Complication rates are low and perioperative mortality is lower than that generally reported with conventional surgery.
Primary spindle cell sarcoma of the left atrium is an extremely rare tumour. Surgical excision is the mainstay of treatment since it responds poorly to chemotherapy or radiotherapy. In spite of all the treatment, the prognosis remains poor due to inadvertent delay in diagnosis, few therapeutic options and propensity to metastasize. We present a 47-year-old male who underwent a surgical excision of a left atrial mass in February 2010. It was proved to be a high-grade spindle cell sarcoma on histopathology. He presented again in October 2010 with recurrence of the tumour for which he was re-operated. However, the tumour recurred again within one month, to which the patient succumbed.
An asymptomatic 14-year-old boy presented with minor chest trauma. Chest X-ray showed opacity in the upper zone of the left lung. Further investigations with magnetic resonance imaging showed it to be a posterior mediastinal mass with a fistula to the lung, along with cystic changes in the left upper lobe of lung. Left upper lobectomy with excision of the mass was performed. Histological examination later showed an oesophageal duplication cyst with a fistula to the left upper lobe of the lung. We present this unusual complication of an oesophageal cyst infiltrating the lung in an asymptomatic child.
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether off-pump coronary artery surgery reduces the incidence of postoperative atrial fibrillation. Altogether 107 papers were found using the reported search, of which 18 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that off-pump coronary artery surgery significantly reduces the incidence of postoperative atrial fibrillation with a number needed to treat of 20 to prevent one case of AF.
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether skeletonised internal mammary artery (IMA) is better than pedicle IMA in coronary artery bypass grafting? Altogether 106 papers were found using the reported search, of which 12 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that skeletonisation increases the length of conduit by around 3 cm and may also increase flow and conduit diameter. Skeletonisation should be the technique of choice for diabetics in whom BIMA harvest is desired, but at the expense of an extra 15-20 min per operation, no convincing outcome benefits have been shown for single IMA harvest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.