RESUMO
The development of left atrial myxoma after coronary artery bypass graft surgery is a rare entity. A 60-year-old man with previous off-pump coronary artery bypass grafting four years ago with patent coronary grafts was diagnosed with left atrial mass. The patient underwent successful resection of the same through minimally invasive right anterolateral thoracotomy. Histopathology of the atrial mass confirmed the diagnosis of atrial myxoma.
Assuntos
Ponte de Artéria Coronária/efeitos adversos , Neoplasias Cardíacas/etiologia , Neoplasias Cardíacas/patologia , Mixoma/etiologia , Mixoma/patologia , Ponte Cardiopulmonar/métodos , Átrios do Coração/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Mixoma/cirurgia , Reoperação , Esternotomia/métodos , Fatores de Tempo , Tomógrafos Computadorizados , Resultado do TratamentoRESUMO
Abstract The development of left atrial myxoma after coronary artery bypass graft surgery is a rare entity. A 60-year-old man with previous off-pump coronary artery bypass grafting four years ago with patent coronary grafts was diagnosed with left atrial mass. The patient underwent successful resection of the same through minimally invasive right anterolateral thoracotomy. Histopathology of the atrial mass confirmed the diagnosis of atrial myxoma.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ponte de Artéria Coronária/efeitos adversos , Neoplasias Cardíacas/etiologia , Neoplasias Cardíacas/patologia , Mixoma/etiologia , Mixoma/patologia , Reoperação , Fatores de Tempo , Ponte Cardiopulmonar/métodos , Tomógrafos Computadorizados , Resultado do Tratamento , Esternotomia/métodos , Átrios do Coração/patologia , Neoplasias Cardíacas/cirurgia , Mixoma/cirurgiaRESUMO
OBJECTIVE:: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS:: A total of 110 patients who underwent single (aortic or mitral) valve replacement surgery were enrolled. Patients were divided in two groups based on the cardioplegia solution used. In group 1 (56 patients), long-acting lignocaine based-blood cardioplegia solution was administered as a single dose while in group 2 (54 patients), standard St Thomas IB (short-acting blood-based cardioplegia solution) was administered and repeated every 20 minutes. All the patients were compared for preoperative baseline parameters, intraoperative and all the postoperative parameters. RESULTS:: We did not find any statistically significant difference in preoperative baseline parameters. Cardiopulmonary bypass time were 73.8±16.5 and 76.4±16.9 minutes (P=0.43) and cross clamp time were 58.9±10.3 and 66.3±11.2 minutes (P=0.23) in group 1 and group 2, respectively. Mean of maximum inotrope score was 6.3±2.52 and 6.1±2.13 (P=0.65) in group 1 and group 2, respectively. We also did not find any statistically significant difference in creatine-phosphokinase-MB (CPK-MB), Troponin-I levels, lactate level and cardiac functions postoperatively. CONCLUSION:: This study proves the safety and efficacy of long-acting lignocaine-based single-dose blood cardioplegia compared to the standard short-acting multi-dose blood cardioplegia in patients requiring the single valve replacement. Further studies need to be undertaken to establish this non-inferiority in situations of complex cardiac procedures especially in compromised patients.
Assuntos
Soluções Cardioplégicas/administração & dosagem , Parada Cardíaca Induzida/métodos , Implante de Prótese de Valva Cardíaca/métodos , Lidocaína/administração & dosagem , Adolescente , Adulto , Valva Aórtica/cirurgia , Bicarbonatos/administração & dosagem , Cloreto de Cálcio/administração & dosagem , Creatina Quinase/sangue , Feminino , Humanos , Ácido Láctico/sangue , Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Valva Mitral/cirurgia , Período Pós-Operatório , Cloreto de Potássio/administração & dosagem , Estudos Prospectivos , Cloreto de Sódio/administração & dosagem , Resultado do Tratamento , Troponina I/sangue , Adulto JovemRESUMO
Abstract OBJECTIVE: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS: A total of 110 patients who underwent single (aortic or mitral) valve replacement surgery were enrolled. Patients were divided in two groups based on the cardioplegia solution used. In group 1 (56 patients), long-acting lignocaine based-blood cardioplegia solution was administered as a single dose while in group 2 (54 patients), standard St Thomas IB (short-acting blood-based cardioplegia solution) was administered and repeated every 20 minutes. All the patients were compared for preoperative baseline parameters, intraoperative and all the postoperative parameters. RESULTS: We did not find any statistically significant difference in preoperative baseline parameters. Cardiopulmonary bypass time were 73.8±16.5 and 76.4±16.9 minutes (P=0.43) and cross clamp time were 58.9±10.3 and 66.3±11.2 minutes (P=0.23) in group 1 and group 2, respectively. Mean of maximum inotrope score was 6.3±2.52 and 6.1±2.13 (P=0.65) in group 1 and group 2, respectively. We also did not find any statistically significant difference in creatine-phosphokinase-MB (CPK-MB), Troponin-I levels, lactate level and cardiac functions postoperatively. CONCLUSION: This study proves the safety and efficacy of long-acting lignocaine-based single-dose blood cardioplegia compared to the standard short-acting multi-dose blood cardioplegia in patients requiring the single valve replacement. Further studies need to be undertaken to establish this non-inferiority in situations of complex cardiac procedures especially in compromised patients.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Soluções Cardioplégicas/administração & dosagem , Implante de Prótese de Valva Cardíaca/métodos , Parada Cardíaca Induzida/métodos , Lidocaína/administração & dosagem , Valva Aórtica/cirurgia , Período Pós-Operatório , Cloreto de Potássio/administração & dosagem , Bicarbonatos/administração & dosagem , Cloreto de Cálcio/administração & dosagem , Cloreto de Sódio/administração & dosagem , Estudos Prospectivos , Resultado do Tratamento , Ácido Láctico/sangue , Troponina I/sangue , Creatina Quinase/sangue , Magnésio/administração & dosagem , Valva Mitral/cirurgiaRESUMO
Bilateral superior vena cava (SVC) with bilateral partial anomalous pulmonary venous connection is a very rare congenital cardiac malformation. Here, we are reporting a case of 18-year-old male who had bilateral SVC with bilateral anomalous pulmonary venous connection associated with ostium secundum atrial septal defect. The patient underwent successful surgical correction for the same.