RESUMO
BACKGROUND: The interest in beating heart surgery is growing since better results can be obtained with this procedure compared to conventional myocardial protection techniques using cardioplegic solutions. This led us to consider mitral valve replacement with beating heart. OBJECTIVES: This study aimed to determine the safety and efficacy of beating heart mitral valve replacement without cross clamp. METHODS: This prospective study was conducted on the patients with isolated mitral valve disease requiring mitral valve replacement according to ACC / AHA guidelines. In this study, 15 patients underwent mitral valve replacement using beating heart technique (Group A) and 15 ones underwent mitral valve replacement using arrested heart technique (Group B). The patients were randomized using block randomization. The data were analyzed using the SPSS statistical software. RESULTS: Preoperative parameters were comparable in the two groups. Most of the patients in both study groups were in NYHA class III or IV. Postoperatively, however, most of the patients in the two groups were either in NYHA class I or II. No mortality occurred in the beating heart group, while one mortality occurred in the arrested heart group. The results showed a significant difference between the two groups regarding the mean bypass time, mean operating time, mean ICU stay, and mean length of hospital stay. CONCLUSIONS: Beating heart mitral valve replacement is equally safe as the arrested heart technique. Thus, it is recommended as an appropriate alternative to the arrested heart technique for mitral valve replacement.
RESUMO
Cardiac injury presents a great challenge to the emergency resident because these injuries require urgent intervention to prevent death. Sometimes serious cardiac injury may manifest only subtle or occult symptoms or signs. As there is an epidemic of cardiac injuries in Kashmir valley due to problems of law and order, we herein present a review on management of such injuries.
RESUMO
BACKGROUND: The association between gallstones and abnormal lipids and later increase in risk of coronary artery disease and stroke has been shown in many studies. The aim of study is to elucidate the association of dyslipidaemia with Cholilithiasis and effect of Cholecystectomy on the same. METHODS: 73 patients with symptomatic gallstones were studied prospectively. Plasma concentration of cholesterol, triglycerides, LDL, HDL was analysed preoperatively and postoperatively on day 3 and after 6 months of Cholecystectomy. None of the patients received any lipid lowering drug or dietary restriction. Results were analysed and compared. RESULTS: 36 (80%) of the female patients and 20 (71.42%) of male patients had one or other abnormality in their lipid profile preoperatively Plasma concentration of total cholesterol, triglycerides, and LDL cholesterol were significantly reduced in patients on day 3 of surgery and 6 months thereafter. There was no significant increase/decrease in HDL cholesterol in 6 months after Cholecystectomy. CONCLUSION: There was a significant decrease in plasma concentration of lipids in Cholecystectomy patients postoperatively. These changes in plasma lipids are likely to have significant effect in the development of coronary artery diseases in patients with Cholecystectomy.
