Background. Long-term graft patency is the major factor impacting survival after coronary artery bypass grafting. Arteries are superior in this regard. Radial artery is considered the second best conduit after internal mammary artery. Several studies have shown excellent radial artery patency. We evaluated the morphologic characteristics of radial artery by three modalities, (i) preoperative Doppler ultrasound, (ii) intraoperative manual morphometry, and (iii) postoperative histology-based morphometry, and compared these with the aim of validating Doppler as a noninvasive test of choice for preoperative assessment of radial artery. Methods. This was a prospective study involving 100 patients undergoing coronary artery bypass grafting in which radial artery was used. The radial artery was assessed using preoperative Doppler ultrasound studies, intraoperative morphometry, and postoperative histopathology and morphometry. The morphometric measurements included (i) luminal diameter, (ii) intimal and medial thickness, and (iii) intima-media thickness ratio. Results. Using Bland-Altman plots, there was a 95% limit of agreement between the preoperative Doppler measurements and the postoperative histopathology and morphometry. Conclusion. Doppler ultrasound is an accurate screening test for evaluation of radial artery, in terms of intimal/medial thickness and luminal diameter as a conduit in coronary artery bypass grafting and has been validated by both morphometric and histopathology based studies.
Constrictive pericarditis following Coronary Artery Bypass Surgery is an uncommon disorder. We report a patient who developed constrictive pericarditis after Coronary Artery Bypass Grafting. After an unsuccessful trial of medical management and pericardial tapping, he underwent pericardiectomy via a left posterolateral thoracotomy.
There is an ongoing debate regarding the choice of ideal induction agent between propofol and etomidate for cardiac surgical patients. Etomidate appears to be better than propofol as the induction agent due to the superior hemodynamic stability. However, the adrenal suppression due to etomidate can pose challenges to the anesthesiologist in certain clinical situations.
The Internet of Things (IoT) is inter communication of embedded devices using networking technologies. The IoT will be one of the important trends in future, can affect the networking, business and communication. In this paper, proposing a remote sensing parameter of the human body which consists of pulse and temperature. The parameters that are used for sensing and monitoring will send the data through wireless sensors. Adding a web based observing helps to keep track of the regular health status of a patient. The sensing data will be continuously collected in a database and will be used to inform patient to any unseen problems to undergo possible diagnosis. Experimental results prove the proposed system is user friendly, reliable, economical.
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