Off-pump coronary artery bypass grafting (OPCABG) is fast becoming widely adopted technique for surgical revascularization of the heart. However, OPCABG presents with unique technical and hemodynamic challenges which require additions to conventional monitoring techniques. Transesophageal echocardiography (TEE) provides reliable and real-time information to monitor these challenges during OPCABG. TEE is an invaluable diagnostic tool for real-time imaging during OPCABG. It is beneficial not only in the intraoperative period but also in the postoperative care units for better patient outcomes.
Spindle cell sarcoma of heart are the least reported primary cardiac tumours. We present a case of a 60-year-old man reported to us following successful resuscitation after cardiac arrest. This patient presented with symptoms of dyspnoea on exertion. The echocardiography showed features of cardiac tamponade. CT scan chest+ Abdomen + Pelvis confirmed echocardiography findings, and showed significant pericardial effusion with early cardiac tamponade. Patient continued to suffer dyspnoea even after pericardiocentesis and was unstable in the intensive care unit, hence he was shifted to operating room for re-exploration. The mass was excised in a piecemeal without instituting cardiopulmonary bypass. The total weight of the mass was approximately 500gms. The macroscopic examination of the specimen revealed a cystic mass with solid grey brown tissue. Following surgical debulking, chest X -ray in Intensive Care Unit showed improvement. The patient visited the outpatient clinic after 15 days of surgery. 2-D echocardiography revealed minimal pericardial effusion and patient was comfortable.
Cardiac surgery is one of the largest consumer of blood and blood products in medicine. The transfusion rate in cardiac surgery accounts to almost 40-90%. Although lifesaving, it still increases the risk of allergic reactions, risk of transmission of infection, increased morbidity and mortality. The aim of this study was to find out causes of anaemia and requirement of blood or blood products in cardiac surgical patients.
Perioperative Hyperglycaemia can lead to sepsis, mediastinitis, prolonged mechanical ventilation, cardiac arrhythmias, increased ICU and hospital stay. The different centres follow different protocols to treat hyperglycaemia and still there is a controversy regarding the tight sugar control protocol. This survey was carried out to find the appropriate protocol regarding glycaemic control in various centres in UK.
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