RESUMEN
Coronary allograft vasculopathy, often known as cardiac allograft vasculopathy (CAV), is a substantial source of morbidity and mortality in people who have had heart transplants. Early detection and monitoring of CAV are crucial for improving outcomes in this population. Although cardiac computed tomography (CT) has emerged as a possible method for finding and evaluating CAV, invasive coronary angiography has long been thought of as the gold standard for recognizing CAV. This study focuses on the utility of cardiac CT for CAV diagnosis and treatment in the post-heart transplant population. It provides an overview of recent studies on the application of cardiac CT in CAV and highlights the advantages and disadvantages of this imaging modality. The potential application of cardiac CT for CAV risk assessment and care is also examined in the study. Overall, the data point to a potential role for cardiac CT in the detection and treatment of CAV in post-heart transplant patients. It enables evaluation of the whole coronary tree and low-radiation, high-resolution imaging of the coronary arteries. Hence, further study is required to determine how best to employ cardiac CT in treating CAV in this group.
RESUMEN
BACKGROUND: Airway management is the most essential skill in Anesthesiology and the inability to secure the airway is one of the most common reasons for anesthesia-related morbidity and mortality. This study aimed to evaluate and compare the insertion characteristics of laryngeal mask airway (LMA) ProSeal insertion using the standard introducer technique, 90-degree rotation technique, and 180-degree rotation technique in adult patients undergoing elective surgery. MATERIAL AND METHOD: This prospective, interventional, randomized, comparative study was carried out in the Department of Anesthesia and Intensive Care, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, after obtaining hospital ethical committee approval for 18 months of duration. Patients in the age group 18-65 years, of either gender, fulfilling American Society of Anesthesiologists grade I or II criteria, scheduled for elective surgery under general anesthesia with controlled ventilation using the LMA ProSeal were included in the study. The patients were randomized into three groups: Group I - Standard Introducer technique (n=40); Group NR - 90-degree rotation technique (n=40); Group RR - 180-degree rotation technique or back to front (airway) technique (n=40). RESULT: In this study, the majority (73.3%) of the patients were females with 31 patients in group I, 29 patients in group NR, and 28 patients in group RR. A total of 26.67% of male patients were included in the study. No significant difference in the gender distribution of the three groups was seen in the study. There was no incidence of failure in ProSeal laryngeal mask airway (PLMA) insertion in the NR group, while it was 2.50% in group I and 7.50% in group RR but the difference was not statistically significant. A statistically significant difference was seen in the incidence of LMA ProSeal blood staining (p=0.013). In the post-anesthesia care unit at 1 hour, the incidence of sore throat was 10% in patients with the NR group, 30% in the I group, and 35.44% in the RR group which was statistically significant. CONCLUSION: The study concluded that the 90-degree rotation technique was superior to both the 180-degree rotation and the introducer technique in adult patients in terms of insertion time, ease of insertion score, manipulation requirement, blood staining of PLMA, and post-op sore throat.
