Abstract:Background: The antifibrinolytic drug tranexamic acid (TA) decreases blood loss in Pediatric
Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium.
Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity and clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients. Keywords: Myxoma; Left Atrium DOI: http://dx.doi.org/10.3329/cardio.v4i1.9399 Cardiovasc. J. 2011; 4(1): 99-101
Introduction:Coronary artery bypass surgery has been performed for more than 30 years using cardiopulmonary bypass(CPB) and full median sternotomy. CPB and median sternotomy has been considered to be causes of major morbities in cardiac surgery. Use of CPB has been associated with total body inflammatory response, microemboli, neurologic complications, excessive use of blood and blood products. 1 Median sternotomy can be complicated by sternal dehiscence, mediastinities, prolonged pain, tinnitus on activities, prolonged recovery and delay in return to normal life style.The first offpump CABG was performed in 1958. 1 Recently Calafiore and associates, Westaby and Benetti and others have reported relatively a large series with excellent results. Most of these operations were performed using a full median sternotomy. Thoracotomy has been selectively used. 3 Numerous study have reported the advantages of lesser invasive approaches, which includes decreased use of blood, 1-3 decreased pain, decreased length of hospitalization, 4 faster recovery and over all decrease in cost, 1,2,4 decreased stroke; decreased mortality. [2][3][4] Coronary artery bypass grafting without CPB using left lateral thoracotomy approach is of renewed interest. 5 We evaluated 83 patients who underwent minimally invasive direct coronary artery bypass grafting a left lateral thoracotomy(Thora CAB). Patients and methods:
Background: coronary artery bypass surgery (CABG) is expensive, uses disposable appliances and patients require more perioperative intensive care, long stay in hospital and often have a lengthy recovery time. These complications, together with the growing trend towards less invasive techniques in other areas of surgery, have encouraged cardiac surgeons to see if minimally invasive cardiac surgery can become a reality with improved outcomes and costs. Methods: This is a prospective nonrandomized comparative clinical study done at the Department of Cardiac Surgery in National Institute of Cardiovascular Diseases (NICVD) Sher-E- Bangla Nagar, Dhaka from July 2006 to June 2008 among routine CABG patients. Purposive sampling was done with 26 patients in group A selected for MIDCAB and 24 patients in Group B selected for conventional CABG surgery. Patients were followed up for three months. Postoperative outcomes were assessed to evaluate the safety and efficacy of MIDCAB in relation to conventional CABG. Results: Mean age were 54.19 vs 53.87 in group A and Group B. 92.3% vs 87.5% were male respectively. Mean duration of operation, per operative blood loss transfusion and arrythmia were lower in MIDCAB group (p<0.05) number of grafts were also statistically significant (p< 0.001). Regarding post-operative outcome ventilation time in hours ICU stay post-operative hospital stay in days, postoperative MI and stroke rate were lower in favor of group A MIDCAB patients (p<0.001). Three months postoperatively six-meter walking distance is also statistically significant in favor of Group A MIDCAB (p<0.01) patients. However, pain score in early post-operative period was higher in group A significantly but it decreased significantly in late post-operative period which is also highly statistically different (p<0.001). However, mortality and quality of life at three months were similar in both groups. Conclusion: No difference in mortality rates detected between MIDCAB and CCABG group. But there was evidence that MIDCAB is associated with less perioperative and early postoperative morbidity and improved quality of life. The MIDCAB surgery is an effective procedure of complete revascularization in ischemic heart diseases like CCABG. The procedure is associated with shorter operating time, shorter ICU stay time, shorter hospital stays and better quality of life than for CCABG. Cardiovasc. j. 2021; 13(2): 135-143
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