Double orifice mitral valve: A rare cause of isolated severe congenital mitral regurgitation.

Double orifice mitral valve (DOMV) is a rare congenital anomaly of the mitral valve apparatus consisting of an accessory bridge of fibrous tissue, which partially or completely divides the mitral valve into two orifices. It usually occurs as an associated lesion. Encountering a DOMV as an isolated finding meriting intervention is indeed rare. We, here, report a case of "complete bridging type DOMV" occurring as an isolated entity and presenting as severe congenital MR requiring surgery.

Double-outlet left atrium: Successful repair of an extremely rare anomaly.

The clinical detail, echocardiographic features, angiographic evaluation, and surgical repair of double-outlet left atrium (LA) in a 2-year-old boy are discussed. In a solitus position and normally connected systemic and pulmonary venous drainage setting, the only outlet of the right atrium was a secundum atrial septal defect. The LA thus received the entire venous return and then drained into both ventricles through a common atrioventricular valve.

Skeletonization of the Recurrent Laryngeal Nerve During Norwood Procedure and Aortic Arch Repair.

Recurrent laryngeal nerve injury is a frequent adverse event of aortic arch repair. We hereby present a technique of skeletonization of the recurrent nerve to preserve its function during the Norwood procedure and aortic arch repair.

Glycemic control in cardiac surgery: rationale and current evidence.

Studies in cardiac surgical patients have shown an association of hyperglycemia with increased incidences of sepsis, mediastinitis, prolonged mechanical ventilation, cardiac arrhythmias and longer intensive care and hospital stay. There is considerable controversy regarding appropriate glycemic management in these patients and in the definition of hyperglycemia and hypoglycemia or the blood sugar levels at which therapy should be initiated. There is also dilemma regarding the usage of "tight glycemic control" with studies showing conflicting evidences. Part of the controversy can be explained by the differing designs of these studies and the variable definitions of hyperglycemia and hypoglycemia.

Delayed presentation of iatrogenic left ventricular pseudoaneurysm.

Occurrence of left ventricular aneurysm outside the realm of ischemic heart disease is uncommon and one following an iatrogenic trauma is very rare. We describe one such case of left ventricular pseudoaneurysm developing following pericardiocentesis and presenting one year after the procedure, and its successful surgical management.

Congenital aneurysm of left atrial appendage: a case report.

Aneurysm of the left atrial appendage (LAA) is a very infrequent condition. We report a case of a two-year-old child with congenital aneurysm of the LAA with a large thrombus in it. He presented with an episode of seizures with left-sided hemiparesis. Diagnosis was based on transthoracic echocardiography and magnetic resonance imaging. The patient was successfully treated by surgical resection of the aneurysm and removal of the thrombus.

Left atrial thrombus formation immediately after mitral valve replacement: a case report.

Mechanical dysfunction from valve thrombosis is a dreaded complication of valve replacement surgery, usually presenting months to years after the procedure. Here we report acute deterioration of prosthetic valve function due to intraoperative obstruction by a thrombus.

Surgical treatment of pulmonary aspergilloma: a series of 72 cases.

BACKGROUND: The objective of this study was to evaluate the immediate and long-term result of resectional surgery in pulmonary aspergilloma. METHODS: Seventy-two patients who underwent pulmonary resectional surgery for symptomatic aspergilloma between 1990 to 2002 were studied. Seventy-nine definitive operations were carried out, including one bilateral lobectomy for recurrent lesions and six thoracoplasties to deal with post-operative complications, besides 21 pneumonectomies and 51 lobectomies. There were 10 bilobectomies as well, included in the lobectomy group. RESULTS: At a mean follow-up of 3.5 years, there were two post-operative deaths and a few complications occurred in 20 cases translating into a morbidity of 28.57% and a mortality of 2.77 percent. Major complications included were persistent air leak, persistent pleural space, empyema, bronchopleural fistula and massive haemorrhage. All events were seen in cases of complex aspergilloma; cases of simple aspergillomas had an uneventful course. CONCLUSIONS: Surgery offers definitive and long-term symptom-free survival in cases of pulmonary aspergilloma at a negligible risk; though almost one-third of those undergoing surgery develop some complications, these are largely manageable.