Strict selection criteria governing an 'adequate' aortic rim, the size of the device, and the choice of the device may help reduce the incidence of complications like the rare, but potentially fatal embolization of the device into the pulmonary artery following percutaneous device closure of an ASD.
Delayed development of left ventricular pseudoaneurysm is a rare late complication of mitral valve prosthesis and requires early surgical intervention. Here we describe the occurrence of such a complication diagnosed 6-months after the valve surgery in a 60-year-old lady. The anatomic delineation of subannular left ventricular pseudoaneurysm using multiple imaging modalities including CT angiography is also being discussed.
Gastrointestinal bleeding due to angiodysplasia of the large intestine associated with calcific aortic stenosis is a well-known entity. Angiodysplasias are artero-venous malformations and they form one of the common causes of occult gastro-intestinal bleeding in the elderly. A 59-year-old man underwent aortic valve replacement for severe aortic regurgitation, developed severe gastro intestinal bleeding. Selective angiography was inconclusive. Exploratory laparotomy revealed angiodysplasia of the terminal ileum, which was resected. We report this case to draw attention to this rare cause of gastro intestinal bleeding and the difficulty in arriving at a diagnosis by the usual investigations.
Scimitar syndrome is a rare variant of partial anomalous pulmonary venous connection. The combination of scimitar syndrome with anomalous connection of the left superior pulmonary vein to the left innominate vein is extremely rare, and is yet to be documented in literature. We report the successful single-stage correction of such a rare type of anomalous pulmonary venous connection.
Objective:Homologous blood transfusion after open heart surgery puts a tremendous load on the blood banks. This prospective randomized study evaluates the efficacy of infusing back residual cardiopulmonary bypass (CPB) circuit i.e., pump blood as a means to reduce homologous transfusion after coronary artery bypass surgery (CABG) and whether its use increases postoperative drainage.Materials and Methods:Sixty-seven consecutive patients who underwent elective CABGs under CPB were randomized into 2 groups: (1) cases where residual pump blood was used and (2) controls where residual pump blood was not used. Patients were monitored for hourly drainage on the day of surgery and the 1st postoperative day and the requirements of homologous blood and its products. Data were matched regarding change in Hemoglobin, Packed Cell Volume and coagulation parameters till 1st postoperative day. All cases were followed up for three years.Results:There was a marginal reduction in bleeding pattern in the early postoperative period in the cases compared to controls. The requirement of homologous blood and its products were also reduced in the cases.Conclusions:The use of CPB circuit blood is safe in the immediate postoperative period. The requirement of homologous blood transfusion can come down if strict transfusion criteria are maintained.
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