Padmanabhan Chandrasekar

Idiopathic Pulmonary Artery Aneurysm With Pulmonary Regurgitation

Idiopathic pulmonary artery aneurysms are rare and need a multidisciplinary approach to diagnosis and treatment. Surgery is the treatment of choice, especially when the aneurysms are large and when they are associated with pulmonary regurgitation. This report highlights a case in which successful surgical repair preserved the native pulmonary valve after pulmonary artery reconstruction.

Giant solitary fibrous tumor of the pleura

Solitary fibrous tumors are rare mesenchymal tumors accounting for <5% of all neoplasms in the pleura and other sites. A 45-year-old man reported to us with cough and dyspnea. Radiological investigations revealed a giant mass displacing the mediastinum to the left. The tumor weighing 3.0 kg was successfully resected via a right thoracotomy. Histology and immunohistochemistry confirmed a benign tumor. Recurrence and malignant transformation of these benign tumors have been reported. Our patient has been followed up for 4 years with no recurrence.

Unusual case of chondroblastic osteosarcoma of the rib in an adult

Primary osteosarcoma arising from the ribs is very rare. An unusual case of a primary chondroblastic osteosarcoma of the rib in a 30-year-old woman is described here. The patient underwent wide excision of the tumor along with the involved rib, followed by chemotherapy. Although clinically unsuspected in this unusual site, pathology confirmed a completely resected chondroblastic osteosarcoma.

Open surgical repair of abdominal aortic aneurysm: Proximal aortic control by endoaortic balloon - A novel approach

Patients with infrarenal abdominal aortic aneurysm with unfavorable anatomy for endovascular aneurysm repair have to undergo open surgical repair. Open surgery has its own morbidity in terms of proximal clamping and declamping, bleeding and prolonged hospital stay and mortality. We present two such patients with juxtarenal abdominal aortic aneurysm who underwent open surgical repair. The proximal aortic control during open surgical repair of the aneurysm was achieved by endoaortic balloon occlusion technique.

Radial Artery Flows: Comparative Study:

Between December 1997 and February 1999, 150 patients who had the left radial artery as one of the conduits for coronary artery bypass graft surgery were randomly divided into 3 groups of 50 each. Group A received a left supraclavicular block with 20 mL of 1.5% lidocaine with adrenaline (1 in 200,000), and 10 mL of 0.25% bupivacaine. Group B received intravenous diltiazem at 0.5 to 1 μg·kg−1·min−1 after induction and during radial artery harvest. Group C received neither the block nor diltiazem. Radial artery blood flow was measured for 20 seconds and compared between the 3 groups. All patients received diltiazem by infusion in the postoperative period for 24 hours. Radial artery take-down was abandoned in one patient in group B. There was one in-hospital death. No ischemic complication of the hand was noted. There was a statistically significant difference in mean blood flow between group B (39.20 mL/20 sec) and group C (28.84 mL/20 sec). Group A flow (34.08 mL/20 sec) was also higher than group C, but this was not statistically significant. The results advocate the use of either supraclavicular block or intravenous diltiazem during radial artery harvest.

Surgical Management of Ruptured Iliac Artery Aneurysm by Inlay Grafting

SURGICAL MANAGEMENT OF RUPTURED ILIAC ARTERY ANEURYSM BY INLAY GRAFTING We recently treated a case of ruptured isolated iliac artery aneurysm and would like to focus attention on the surgical repair of this uncommon and life-threatening lesion. The patient was an obese diabetic 64-year-old male who presented with hypertension and increasing pain in the right iliac fossa and dysuria. A 6.6-cm aneurysm of the right common iliac artery was demonstrated by abdominal ultrasound scan. No pulsatile mass could be detected. Shortly after admission he collapsed and was resuscitated with volume infusion. It was evident that the aneurysm was leaking and the patient underwent emergency exploration without further vascular studies.