Pub Date : 2021-01-01DOI: 10.4236/wjcs.2021.1110012
Vinod Bhan, Sri Satyavathi, K. S. Rao, V. Vanajakshamma
Background: Cardiac myxoma is a very rare heart tumor which presents as life threatening mass in cardiac chamber. The tumor may present with vague symptoms which can lead to delay in diagnosis. Methods: 22 patients underwent complete excision of intracardiac myxoma between January 2011 and December 2020. Majority of the patients were females (60%) with mean age of 48.9 years who presented with symptoms of dyspnea on exertion. 3 patients had significant complications due to myxoma. 2 presenting with tumor embolism and limb ischemia while 1 patient presented with pulmonary edema. All patients were diagnosed by echocardiography which helped in evaluation of size and extent of tumor. Majority of patients underwent trans-septal biatrial approach for tumor excision. Results: 95% of patients survived the operation. The mean tumor size excised was 5.0 ± 1.6 cm in the largest diameter. 11 patients had sessile tumor while 1 patient had dumb bell tumor occupying both atria. 15 patients were surviving the operation while 2 deaths happened after 6 years of surgery. Conclusion: Cardiac myxomas are rare tumors which can cause severe systemic and cardiac symptoms in patients. Early diagnosis and immediate surgical management give excellent early and long-term results.
{"title":"Cardiac Myxoma: 10 Years Study of Presentations, Resection and Outcome","authors":"Vinod Bhan, Sri Satyavathi, K. S. Rao, V. Vanajakshamma","doi":"10.4236/wjcs.2021.1110012","DOIUrl":"https://doi.org/10.4236/wjcs.2021.1110012","url":null,"abstract":"Background: Cardiac myxoma is a very rare heart tumor which presents as life threatening mass in cardiac chamber. The tumor may present with vague symptoms which can lead to delay in diagnosis. Methods: 22 patients underwent complete excision of intracardiac myxoma between January 2011 and December 2020. Majority of the patients were females (60%) with mean age of 48.9 years who presented with symptoms of dyspnea on exertion. 3 patients had significant complications due to myxoma. 2 presenting with tumor embolism and limb ischemia while 1 patient presented with pulmonary edema. All patients were diagnosed by echocardiography which helped in evaluation of size and extent of tumor. Majority of patients underwent trans-septal biatrial approach for tumor excision. Results: 95% of patients survived the operation. The mean tumor size excised was 5.0 ± 1.6 cm in the largest diameter. 11 patients had sessile tumor while 1 patient had dumb bell tumor occupying both atria. 15 patients were surviving the operation while 2 deaths happened after 6 years of surgery. Conclusion: Cardiac myxomas are rare tumors which can cause severe systemic and cardiac symptoms in patients. Early diagnosis and immediate surgical management give excellent early and long-term results.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84793861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4236/wjcs.2021.1112016
A. Hoque, R. Rahman, A. Khan, Md Abdullah Yusuf, Muhammad Asif Ahsan Chowdhury, I. Ahmed, W. Salam, M. Hossain, T. Hossain
The use of bilateral internal thoracic arteries to treat coronary artery disease is very less despite of improved long-term survival. In this case report, a patient presented with TVD has been managed with anaortic off-pump complete arterial revascularization (OPCABG) by using composite LIMA RIMA Y Sequential 5 grafts to achieve complete arterial revascularization success-fully. This type of operative procedure is technically difficult in a resource poor country like Bangladesh. However, this has been done by a group of young cardiac surgeon. During follow up, the patient is in a good condition.
使用双侧胸廓内动脉治疗冠状动脉疾病的病例很少，尽管可以提高长期生存率。在本病例报告中，一名TVD患者通过使用复合LIMA RIMA Y序贯5移植物进行无氧非泵完全动脉血运重建术(OPCABG)，成功实现了完全动脉血运重建术。在孟加拉国这样一个资源贫乏的国家，这种手术在技术上是困难的。然而，一群年轻的心脏外科医生已经做到了这一点。随访期间，患者情况良好。
{"title":"Anaortic Off-Pump Complete Arterial Revascularization Using Composite LIMA RIMA Y Sequential 5 Grafts in a Patient with Triple Vessel Disease Performed in a Low Resource Country: A Case Report","authors":"A. Hoque, R. Rahman, A. Khan, Md Abdullah Yusuf, Muhammad Asif Ahsan Chowdhury, I. Ahmed, W. Salam, M. Hossain, T. Hossain","doi":"10.4236/wjcs.2021.1112016","DOIUrl":"https://doi.org/10.4236/wjcs.2021.1112016","url":null,"abstract":"The use of bilateral internal thoracic arteries to treat coronary artery disease is very less despite of improved long-term survival. In this case report, a patient presented with TVD has been managed with anaortic off-pump complete arterial revascularization (OPCABG) by using composite LIMA RIMA Y Sequential 5 grafts to achieve complete arterial revascularization success-fully. This type of operative procedure is technically difficult in a resource poor country like Bangladesh. However, this has been done by a group of young cardiac surgeon. During follow up, the patient is in a good condition.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82442573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4236/wjcs.2021.116008
K. Karabacak, E. Kubat, G. Erol, M. Kadan, Furkan Burak Akyol, Elgin Hacızade, S. Doganci, M. Ince, U. Yuksel, M. Çelik, C. Bolcal
Background: Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. The aim of this study was to present initial experience of the AVNeo procedure of a single center. Methods: The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. Results: The mean age of patients was aged 58.21 ± 13.14 years and 16 (66.7%) of them were men. 16 patients were operated on for aortic ste-nosis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bicuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed in 13 (54.17%) patients. No patients needed reoperation for bleeding, pacemaker implantations, conversion to classical prosthetic aortic valve replacement, or infective endocarditis. Two patients died due to non-cardiac rea-sons. Preoperative peak and mean aortic valve pressures improved signifi-cantly at 1 st and 6 th months (Preop: 89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmHg 1 st month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6 th month: 18.13 ± 3.02 mmHg and 6.93 ± 1.83 mmHg). Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. Although this procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.
{"title":"Aortic Neocuspidization with Autologous Pericardium: Initial Experience of Single Center","authors":"K. Karabacak, E. Kubat, G. Erol, M. Kadan, Furkan Burak Akyol, Elgin Hacızade, S. Doganci, M. Ince, U. Yuksel, M. Çelik, C. Bolcal","doi":"10.4236/wjcs.2021.116008","DOIUrl":"https://doi.org/10.4236/wjcs.2021.116008","url":null,"abstract":"Background: Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. The aim of this study was to present initial experience of the AVNeo procedure of a single center. Methods: The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. Results: The mean age of patients was aged 58.21 ± 13.14 years and 16 (66.7%) of them were men. 16 patients were operated on for aortic ste-nosis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bicuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed in 13 (54.17%) patients. No patients needed reoperation for bleeding, pacemaker implantations, conversion to classical prosthetic aortic valve replacement, or infective endocarditis. Two patients died due to non-cardiac rea-sons. Preoperative peak and mean aortic valve pressures improved signifi-cantly at 1 st and 6 th months (Preop: 89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmHg 1 st month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6 th month: 18.13 ± 3.02 mmHg and 6.93 ± 1.83 mmHg). Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. Although this procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86476949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Coronary heart disease (CHD) remains the major cause of mor-tality and morbidity in the entire world population despite therapeutic ad-vances that control many risk factors. Lipid profile is regarded as an important factor in the development of coronary heart disease. There have been numerous studies confirming the association of hyperlipidemias with coronary heart disease in most of the Western as well as Asian countries of the world. But we have very little data on the relation between CHD and lipid profile. Aim of the Study: The aim of this study was to assess abnormal lipid levels and their association with coronary heart disease. Methods: This comparative observational study was conducted at the Department of Cardiology in M. Abdur Rahim Medical College, Dinajpur, Bangladesh from January 2019 to December 2019. Properly written consent was taken from all the participants before starting the main part of the investigation. Obeying inclusion and exclusion criteria of the study, a total of 131 participants were finalized as the study population. Among them, the Case Group was formed with 90 patients who had CHD, and with 41 healthy people, the Control Group was formed. the P-value of 0.242. Serum cholesterol concentration and HDL concentration were significant between the Case and Control groups in all age groups and the P-value was <0.0001 in every age group. Triglyceride concentration was significant between the Case and Control groups in 41 - 50 and 51 - 60 years age groups with a P-value of <0.0001. But in the >60 years age group, we did not find any significant correlation and there the P-value was 0.478. LDL concentration between the groups showed significant correlations between the Case and Control groups in 41 - 50 and 51 - 60-years’ age groups where the P values were found, <0.0001 and 0.0002 respectively. But in the >60 years’ age group, we did not find any significant correlation and there the P-value was 0.515. Conclusion: In this study, it was found that the total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol concentrations were significantly higher in coronary heart disease (CHD) patients.
{"title":"Lipid Profile of Coronary Heart Disease Patients: A Prospective Observational Study","authors":"Md. Rezaul Alam, Md. Bashir Uddin, Md. Mojib Uddin, Mahbubur Rahman, S. Mitra","doi":"10.4236/wjcs.2021.1111015","DOIUrl":"https://doi.org/10.4236/wjcs.2021.1111015","url":null,"abstract":"Background: Coronary heart disease (CHD) remains the major cause of mor-tality and morbidity in the entire world population despite therapeutic ad-vances that control many risk factors. Lipid profile is regarded as an important factor in the development of coronary heart disease. There have been numerous studies confirming the association of hyperlipidemias with coronary heart disease in most of the Western as well as Asian countries of the world. But we have very little data on the relation between CHD and lipid profile. Aim of the Study: The aim of this study was to assess abnormal lipid levels and their association with coronary heart disease. Methods: This comparative observational study was conducted at the Department of Cardiology in M. Abdur Rahim Medical College, Dinajpur, Bangladesh from January 2019 to December 2019. Properly written consent was taken from all the participants before starting the main part of the investigation. Obeying inclusion and exclusion criteria of the study, a total of 131 participants were finalized as the study population. Among them, the Case Group was formed with 90 patients who had CHD, and with 41 healthy people, the Control Group was formed. the P-value of 0.242. Serum cholesterol concentration and HDL concentration were significant between the Case and Control groups in all age groups and the P-value was <0.0001 in every age group. Triglyceride concentration was significant between the Case and Control groups in 41 - 50 and 51 - 60 years age groups with a P-value of <0.0001. But in the >60 years age group, we did not find any significant correlation and there the P-value was 0.478. LDL concentration between the groups showed significant correlations between the Case and Control groups in 41 - 50 and 51 - 60-years’ age groups where the P values were found, <0.0001 and 0.0002 respectively. But in the >60 years’ age group, we did not find any significant correlation and there the P-value was 0.515. Conclusion: In this study, it was found that the total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol concentrations were significantly higher in coronary heart disease (CHD) patients.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88202836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4236/wjcs.2021.1111013
K. Souaga, Gnamien Randolph Niava, E. Katché, K. A. Amani, Yoboua Aimé Kirioua-Kamenan, Jean Calaire Degré, A. Ekou, A. N’guetta, J. Kouame, L. Kohou-koné, Y. P. Yapo, K. Kendja, K. Kangah
{"title":"Surgical Myocardial Revascularization in a Sub-Saharan African Country: Indications and Results","authors":"K. Souaga, Gnamien Randolph Niava, E. Katché, K. A. Amani, Yoboua Aimé Kirioua-Kamenan, Jean Calaire Degré, A. Ekou, A. N’guetta, J. Kouame, L. Kohou-koné, Y. P. Yapo, K. Kendja, K. Kangah","doi":"10.4236/wjcs.2021.1111013","DOIUrl":"https://doi.org/10.4236/wjcs.2021.1111013","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76781945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4236/wjcs.2021.1111014
Md. Abir Tazim Chowdhury, Md. Zulfiqur Haider, Sohail Ahmed, S. Z. Nine, Md. Kamrul Hasan, A. Khan, Md. Junayed Imam Bhuiyan, Mohammad Zishan Uddin, N. Ahmed
{"title":"Surgical Management for a Broken Delivery Shaft in Vivo during PCI Following Acute Myocardial Infarction in a Complex LAD Artery Lesion: A Case Report and Literature Review","authors":"Md. Abir Tazim Chowdhury, Md. Zulfiqur Haider, Sohail Ahmed, S. Z. Nine, Md. Kamrul Hasan, A. Khan, Md. Junayed Imam Bhuiyan, Mohammad Zishan Uddin, N. Ahmed","doi":"10.4236/wjcs.2021.1111014","DOIUrl":"https://doi.org/10.4236/wjcs.2021.1111014","url":null,"abstract":"","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88628444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-09DOI: 10.4236/wjcs.2020.1012026
N. Harshavardhan, A. Satsangi
Left ventricular assist device (LVAD) is being used increasingly in recent years for end stage heart failure as a bridge to transplant (BTT) and also as a destination therapy (DT). Patients with end stage heart failure have some degree of elevated pulmonary capillary wedge pressure, causing right ventricular hypertrophy which in due course leads to decreased dilatation of the RV and fall in cardiac output & severe tricuspid regurgitation (TR) presenting with features of RV failure (RVF). Implantation of LVAD improves left heart function at the cost of right ventricular output with an incidence of 25%-30%. RVF may lead to impaired LVAD flow, difficulty in weaning from cardio-pulmonary bypass (CPB), decreased tissue perfusion and multi-organ failure. In this article we comprehended the pathophysiology leading to RVF post LVAD implantation and its preoperative predictors and the various treatment modalities for managing RVF post LVAD implantation.
{"title":"Right Ventricular Failure Following Left Ventricular Assist Device Implantation","authors":"N. Harshavardhan, A. Satsangi","doi":"10.4236/wjcs.2020.1012026","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1012026","url":null,"abstract":"Left ventricular assist device (LVAD) is \u0000being used increasingly in recent years for end stage heart failure as a bridge \u0000to transplant (BTT) and also as a destination therapy (DT). Patients with end \u0000stage heart failure have some degree of elevated pulmonary capillary wedge \u0000pressure, causing right ventricular hypertrophy which in due course leads to \u0000decreased dilatation of the RV and fall in cardiac output & severe \u0000tricuspid regurgitation (TR) presenting with features of RV failure (RVF). \u0000Implantation of LVAD improves left heart function at the cost of right ventricular \u0000output with an incidence of 25%-30%. RVF may lead to impaired LVAD flow, \u0000difficulty in weaning from cardio-pulmonary bypass (CPB), decreased tissue \u0000perfusion and multi-organ failure. In this article we comprehended the \u0000pathophysiology leading to RVF post LVAD implantation and its preoperative \u0000predictors and the various treatment modalities for managing RVF post LVAD \u0000implantation.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"130 1","pages":"243-253"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77206100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-09DOI: 10.4236/wjcs.2020.1012029
I. Okyere, Sanjeev Singh, P. Okyere, P. K. S. Fiifi-Yankson, B. Farhat, S. G. Brenu
Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network. They are mostly found intracranially but extracranially, the scalp AVM cases are also well reported. However, arteriovenous malformation (AVM) of the scalp is a rare lesion whose natural history is not clearly understood. The clinical manifestation of AVM includes asymptomatic state, local discomfort, headaches and occasional scalp necrosis leading to massive haemorrhage. CT or MR angiography remains the cornerstone for investigation. The options of treatment include complete surgical excision, embolization or a combination of the two modalities. We present the successful management of a young man who presented with a torrential bleeding from a ruptured scalp arteriovenous malformation and had to undergo emergency complete excision followed with a rotational flap for the scalp reconstruction.
{"title":"Management of Ruptured Scalp Arteriovenous Malformation: A Rare Case and Literature Review","authors":"I. Okyere, Sanjeev Singh, P. Okyere, P. K. S. Fiifi-Yankson, B. Farhat, S. G. Brenu","doi":"10.4236/wjcs.2020.1012029","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1012029","url":null,"abstract":"Arteriovenous malformation (AVM) are \u0000vascular anomalies that arise due to abnormal connection with shunting of blood \u0000from arteries to veins without an intervening capillary network. They are \u0000mostly found intracranially but extracranially, the scalp AVM cases are also \u0000well reported. However, arteriovenous malformation (AVM) of the scalp is a \u0000rare lesion whose natural history is not clearly understood. The clinical \u0000manifestation of AVM includes asymptomatic state, local discomfort, headaches \u0000and occasional scalp necrosis leading to massive haemorrhage. CT or MR \u0000angiography remains the cornerstone for investigation. The options of \u0000treatment include complete surgical excision, embolization or a combination of \u0000the two modalities. We present the successful management of a young man who \u0000presented with a torrential bleeding from a ruptured scalp arteriovenous \u0000malformation and had to undergo emergency complete excision followed with a \u0000rotational flap for the scalp reconstruction.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"23 1","pages":"271-278"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90080285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-09DOI: 10.4236/wjcs.2020.1012027
Sandeep K. Singh, S. Ralhan, A. Sanyal, Frankleena Parage, V. Sisodia, S. Lohchab
Purpose: We harvested bilateral Internal Mammary Arteries and made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective of the presence or absence of various risk factors for sternal dehiscence. The purpose of this study was to find an effective way of sternal closure in patients undergoing OPCAB with both the Internal Mammary Arteries harvested for grafting. Method: The patients who did not have any risk factors were placed in group I and all of them had a standard six wire closure of sternotomy. The patients having any risk factors were placed in group II. The patients in group II were randomized by including every alternate patient from group II to subgroup II A and every other alternate patient from group II to subgroup II B. Patients in subgroup II A again had a standard closure of sternotomy while in patients of subgroup II B bilateral Robiscek repair and four-five interlocking figure of eight wires were used for closure of sternotomy. Results: The patients who had risk factors for sternal dehiscence had higher risk for sternal dehiscence as compared to patients without any risk factors if bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure then the rate of sternal complications in the patients with risk factors for sternal dehiscence was not more than the patients without risk factors. Conclusion: We can harvest bilateral Internal Mammary Arteries for OPCAB without fear of sternal complications even in patients with high risk for sternal dehiscence if we use bilateral Robiscek repair with four to five interlocking figure of eight wires for sternal closure.
{"title":"Prevention of Sternal Dehiscence Following Use of Bilateral Internal Mammary Arteries in OPCAB","authors":"Sandeep K. Singh, S. Ralhan, A. Sanyal, Frankleena Parage, V. Sisodia, S. Lohchab","doi":"10.4236/wjcs.2020.1012027","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1012027","url":null,"abstract":"Purpose: We harvested bilateral Internal Mammary Arteries and \u0000made LIMA-RIMA Y in all the patients undergoing OPCAB at our center irrespective \u0000of the presence or absence of various risk factors for sternal dehiscence. The \u0000purpose of this study was to find an effective way of sternal closure in \u0000patients undergoing OPCAB with both the Internal Mammary Arteries harvested for \u0000grafting. Method: The patients who did not have any risk factors were \u0000placed in group I and all of them had a standard six wire closure of \u0000sternotomy. The patients having any risk factors were placed in group II. The \u0000patients in group II were randomized by including every alternate patient from group \u0000II to subgroup II A and every other alternate patient from group II to subgroup \u0000II B. Patients in subgroup II A again had a standard closure of sternotomy \u0000while in patients of subgroup II B bilateral Robiscek repair and four-five \u0000interlocking figure of eight wires were used for closure of sternotomy. Results: The patients who had risk factors for sternal dehiscence had higher risk \u0000for sternal dehiscence as compared to patients without any risk factors if \u0000bilateral Internal Mammary Arteries were harvested for OPCAB. But if we used \u0000bilateral Robiscek repair with four to five interlocking figure of eight wires \u0000for sternal closure then the rate of sternal complications in the patients with \u0000risk factors for sternal dehiscence was not more than the patients without risk \u0000factors. Conclusion: We can harvest bilateral Internal Mammary Arteries \u0000for OPCAB without fear of sternal complications even in patients with high risk \u0000for sternal dehiscence if we use bilateral Robiscek repair with four to five \u0000interlocking figure of eight wires for sternal closure.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"47 1","pages":"254-263"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75068720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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