Karthik Vaidyanathan

Endoscopic vs conventional vein harvesting: a prospective analysis.

Minimally invasive vein harvesting is associated with better leg wound healing and a lower incidence of wound infections. We analyzed our experience in 2 prospectively enrolled groups of non-randomized patients undergoing elective coronary artery bypass grafting. Group 1 was 81 patients who had endoscopic vein harvesting; group 2 was 80 who had conventional open vein harvesting. The time taken for endoscopic harvest (skin incision to skin closure) was significantly less than that for open harvest (51.07 vs 75.94 min). The number of cases to reach a plateau on the learning curve for endoscopic vein harvest was 20 for 2 lengths of vein and 35 for 3 lengths of vein. Significantly more suture repairs per vein were required in group 1 (1.32) than group 2 (0.38). The incidence of wound infection was 1.2% in group 1 vs 8.8% in group 2. Endoscopic vein harvesting is not difficult to learn and it should be preferred over open vein harvest, given its benefits in wound healing.

Late Dissection of Pulmonary Autograft Treated by Valve‐Sparing Aortic Root Replacement

Abstract  Dissection of the pulmonary autograft is an extremely rare complication requiring emergent treatment as there is a chance of rupture and proximal aortic involvement. The autograft dissection can involve the aortic annulus, causing separation of leaflets from the annulus in addition to causing annular dilatation, thereby precluding resuspension of leaflets. The usual treatment in such cases is to perform the Bentall procedure, which involves placing a valved conduit (usually mechanical valve) and thereby necessitating anticoagulation. This report describes a case of successful valve‐sparing aortic root replacement following the Ross procedure with dissection of autograft.

Isolated Congenital Pulmonary Regurgitation with Right Ventricular Outflow Tract Aneurysm—A Rare Variant of Uhl's Anomaly

Abstract:  Isolated absent pulmonary valve syndrome is a very rare entity. We report the case of a four‐year‐old boy who had congenital absent pulmonary valve with a thin and aneurysmal right ventricular infundibulum. The histological picture was suggestive of Uhls anomaly. This association of partial right ventricular Uhls anomaly with absent pulmonary valve syndrome has not been described before. We discuss the embryological and clinical significance of this association. (J Card Surg 2010;25:415‐417)

Tricuspid valve replacement with a fresh antibiotic preserved tricuspid homograft.

Prosthetic replacement of valves in children is limited by size constraints of the prosthesis and lack of growth potential. In specific situations like infective endocarditis, valve preservation is near impossible and in such instances alternatives are hard to get. Furthermore, in the tricuspid position the long-term results of both mechanical and bioprosthesis are not optimal. We used an innovative method in a small boy with tricuspid valve endocarditis by using a tricuspid homograft in the tricuspid position.

Endomyocardial Fibrosis in an Adult Mimicking Left Ventricular Mass

Endomyocardial fibrosis is a rare condition that occurs primarily in tropical countries. It can often mimick a variety of other common cardiac conditions such as apical hypertrophic cardiomyopathy and Ebstein anomaly. We report a case of a left ventricular mass that at histologic examination was found to be endomyocardial fibrosis.

Double Barrel Reconstructon of the Right Ventricular Outflow Tract

(J Card Surg 2010;25:235‐235)

Left Ventricular Epicardial Hydatid Cyst Compressing the Left Circumflex Artery

Abstract  Cardiac hydatid is a rare disease with varied presentation. We report a unique case of left ventricular epicardial hydatid cyst causing left circumflex artery compression. Cardiac hydatids have to be surgically treated on diagnosis because of the high risk of catastrophic rupture. We discuss the surgical principles and the other adjuncts to avoid recurrence.

Ascending aortic pseudoaneurysm following open heart surgery

Received 18 November 2007; received in revised form 9 January 2008; accepted 11 January 2008 rom ht