Negative pressure wound therapy with instillation on sternal wound: is it really worrisome?

“Double-ring” combined aortic and mitral valve repair

Multivalvular rheumatic heart disease in a case of dextrocardia with situs inversus: an arduous surgical access Abstract Dextrocardia is a rare congenital cardiac anomaly where the base-apex axis of the heart is directed to right side. Incidence of dextrocardia is 1 in 10,000 live births, and it may be associated with other congenital cardiac diseases. In cases of dextrocardia, the atrial situs can be situs solitus, situs inversus, or situs ambiguous of which dextrocardia with situs inversus (mirror image dextrocardia) is more common (40%). If all the visceral organs also get mirrored, then it is called dextrocardia with situs inversus totalis. Though dextrocardia can be associated with other congenital cardiac anomalies, its association with rheumatic heart disease is extremely rare. We report a case of dextrocardia with rheumatic heart disease involving the mitral and tricuspid valves.

Homograft neo pulmonary artery following banding of hemitruncus

Aortic valve replacement in porcelain aorta—a novel technique for endoaortic occlusion Abstract Aortic valve surgery invariably becomes a high-risk, challenging procedure when there is extensive calcification of the ascending aorta which precludes safe cross-clamping. Very few case reports of performing aortic valve surgery in this condition with a non-cross-clamping technique of using endoaortic occlusion have been reported. We describe and recommend a non-cross-clamping technique of using a semi-compliant polyurethane balloon catheter (CODA balloon, Cook Incorporated, Bloomington, IN) and report its successful outcome in a patient, with porcelain aorta, who underwent aortic valve replacement.

Coexistence of inclusion lung with hydatid invasion: a rare case report

Deferring sternal closure after complex congenital heart surgery—to do or not to do is the question!

Transcatheter aortic valve replacement in low-risk patients: superiority or shifting goalposts and statistical crystal-gazing? Abstract Transcatheter aortic valve replacement (TAVR) has been compared to surgical aortic valve replacement (SAVR) in two different industry-sponsored trials (Edwards Lifesciences—the SAPIEN 3 system; Medtronic—the CoreValve, EvolutR, and EvolutPRO) in patients with low risk for surgical aortic valve replacement. In the balloon-expandable SAPIEN 3 system, requirements for both non-inferiority (P < 0.001) and superiority (P < 0.001) were met for the primary outcome which was a composite of death from any cause, stroke, or re-hospitalization. In the self-expanding EVOLUT valve study, the requirement for the non-inferiority of TAVR was met for a composite of death and stroke. In both studies, the mean age of patients was 74, and extrapolation of these results to a younger low-risk population cannot be recommended. Moreover, unblinded adjudication of end points, the large numbers of concomitant procedures in the SAVR group, using a composite end point as the primary outcome and the use of estimated rather than actual figures remain some of the important concerns of these studies.

The role of multiple arterial grafts during CABG: at the heart of ART

Lonely planet is OK, but why lonely physician?