Cardiac Surgery

Pulmonary valve replacement for pulmonary regurgitation is a common practise. Pulmonary stenosis relief or after release of right ventricular outflow tract obstruction, progressive pulmonary regurgitation leading to biventricular failure is a big problem. If early pulmonary valve replacement done by homograft or tissue valve then we can overcome this problem. In our case report we have done pulmonary valve replacement by Edward life science Tissue valve for calcified pulmonary valve. And our patient showed a good response after valve replacement. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19514 University Heart Journal Vol. 9, No. 1, January 2013; 54-55

Isolated infundibular pulmonary stenosis (IIPS) in adult is an uncommon cardiac abnormality. Infundibular pulmonary stenosis leading to right ventricular hypertrophy is a big problem. Early excision of hypertrophied muscular band can overcome this problem. In our case report we have done excision of pulmonary infundibular muscle band of a late case of isolated pulmonary infundibular stenosis. And our patient showed a good response after excision of infundibular muscle band. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22711 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 140-142

<p>Emergency department of vascular surgery of National Institute of Cardiovascular Diseases (NICVD) is rendering service for the patients suffering from vascular trauma since 2001. Data regarding this practice of emergency services is rarely published. This paper aims to provide the epidemiological characteristics of patients presenting the vascular emergency department of NICVD between 01/9/14 to 30/09/14. This study is intended to benefit the policy makers, healthcare providers in Bangladesh to promote and define the specialty of emergency vascular department and to allocate resources more effectively to address country’s acute care needs. In total sixty four (64) patients was attended in this 1 month. The male to female ratio was 60:4 with age range from nine to sixty four years (mean age 30.8years). Among them thirty nine percent patients belong to low socioeconomic class, thirty one percent from middle class and others from affluent family. Forty patients (62.5%) were referred from various institute of Dhaka city and rest from outside Dhaka. Seventy five percent patients came by ambulance, eight percent by private vehicles and rest by other means. Fifty eight patients (90.62%) came with referral papers from other health institutes, where there is no vascular surgery department. Most common cause of referral was vascular trauma (78.12%), other causes of referral were complicate vascular aneurysm (7.8%) and vascular thrombosis (14.06%). The time since injury and seeking treatment for vascular surgery ranged two hours to six days. Mean time was 10.3 hours. Forty cases (62.5%) sustained vascular trauma by accident with sharp cutting objects during occupational and house hold activities, assault (stab injury, blunt injury and gunshot) ten cases (15.62%), road traffic accident seven cases (10.93%), intravenous drug abusers three cases (4.68%), accidentally fall from height three cases (4.68%) and post operative complication one cases (1.56%). This study demonstrates that eighty eight percent study populations presented with arterial injuries and only twelve percent with venous injuries. Associated injuries (tendon, nerve, muscle, fracture of bones and joints dislocation) were present in fifty six patients (87.5%). Most common artery that was injured was radial artery. Vascular Injuries were treated with end to end anastomosis in twenty five patients (36.6%), ligation of vessels in twenty three patients (35.9%), fasciotomy was done in eight patients (12.5%) , embolectomy (fogerty) was done in four patients (6.25%) ,. aneurysmectomy was needed in two patients (3.1%) and interposition venous graft was used in two cases (3%). The emergency department of vascular surgery of National Institute of Cardiovascular Diseases (NICVD) is taking the entire burden with their small resources to ensure the best quality care for the management of the patients with vascular injuries. The data can inform and guide the allocation of national resources towards emergency care, injury prevention campaigns, emergency service evaluation and clinical guideline…

Background: Bronchodilator {P2selective adrenergic drug-salbutamol) causes bronchodilation and increases the vital capacity, tidal volume and total lung capacity and reduces gas trapping. Use of bronchodilator in patients undergoing Off-pump coronary artery bypass graft (OPCABG) may lead to better preservation of pulmonary function. Objective: To evaluate the role of bronchodilator on preservation of post-operative pulmonary function in patients who underwent OPCABG. Methods: This study was conducted on 50 patients randomized into two groups to assess the pulmonary function after off-pump CABG. Among them, 25 patients (group-I) were treated by preoperatively bronchodilator and compared them with other 25 patients (group-II) who were not treated by preoperative bronchodilator. We compared arterial blood gas analysis, duration of total mechanical ventilation, days spent in the surgical ICU and spirometric indices. Results: Mean±SE value of mechanical ventilation time after operation i...

Ectopic parathyroid are most frequently found in the anterior mediastinum, in association with the thymus or the thyroid gland. Ectopic parathyroid glands are a major cause of persistent and recurrent Hyperparathyroidism. We report a case of 65-year-old female was referred from Surgical Endocrine department to the department of Cardiac Surgery on 20 September, 2017 in Bangabandhu Sheikh Mujib Medical University with parathyroid crisis due to an ectopic mediastinal parathyroid adenoma with her serum calcium and PTH markedly increased in short time. Computed tomography of the chest and lower neck showed an ovoid soft tissue density area measuring about 25×20×15mm in the anterior mediastinum. Technetium-99m-sestamibi (MIBI) scintigraphy scan showed positive and detected localized parathyroid adenoma/hyperplasia in superior mediastinum. Ectopic parathyroid adenoma resection was performed via median sternotomy approach. But after 4 hours patient developed the color change of the left arm...

Here, we report a case of a right atrial myxoma attached to the lateral wall, which is seen in only 10% cases, impinging upon the tricuspid valve. A 57 year old male normotensive, non-diabetic, nonsmoker patient was presented to us on 5th of August 2018 with the complaints of cough, dyspnea and orthopnea for the last two years. This type of presentation is very rare. After excision of myxoma, there was a significant improvement in the signs and symptoms of the patient. In this report, we emphasize the rarity of myxoma in the Right Atrium, and its difficulty in diagnosis because of its uncommon location and atypical presentation, surgical management has shown to quickly alleviate the majority of symptom and expectant sequeale.

Stuck up and fracture of coronary angioplasty hardware are unwonted complications of percutaneous coronary interventions (PCI) for which surgical retrieval and management is once in a while required. We present one case of a 59-year-old diabetic, a hypertensive gentleman who attended the emergency room (ER) with central chest pain for 2 hours. After evaluation of the patient by physical and noninvasive diagnostic tests, he was diagnosed as a case of acute myocardial infarction (AMI) with stable hemodynamic. For the aforementioned findings, the patient was treated first with a thrombolytic agent in ER and then shifted to Cardiology Department for monitoring and further coronary evaluation by coronary angiography (CAG). CAG revealed essentially single vessel disease (SVD) with complex left anterior descending (LAD) artery lesion, so PCI was attempted but failed with an unfortunate incidence of the broken delivery shaft and left in vivo. Immediate decision making and surgical management for retrieval of lost angioplasty device and correction coronary lesion with revascularization save the patient from grave complication. All the series of events and management approaches of this very complex coronary artery lesion are discussed in this article.