Suvitesh Luthra

Early changes in pulmonary functions after mitral valve replacement.

BACKGROUND This study evaluates changes in pulmonary functions before and after mitral valve replacement (MVR). MATERIALS AND METHODS Twenty-five patients with rheumatic mitral lesions who had undergone MVR were divided into three groups, based on New York Heart Association (NYHA) class. They were evaluated for changes in pulmonary functions, preoperatively and postoperatively at 1 week, 1 month and 3 months to find any improvements after MVR. RESULTS Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow rates were universally found to be decreased preoperatively. Total lung capacity (TLC) and diffusion capacity (DLCO) were significantly reduced preoperatively in NYHA Class III and IV. The pulmonary functions further declined at 1 week after surgery. Except for FVC in NYHA Class IV (32.3% improvement, P < 0.05), the changes were statistically insignificant. CONCLUSIONS Pulmonary functions deteriorate immediately after surgery and then recover gradually over a period of 3 months. However, they remain below the predicted values.

Traumatic sternocostal lung hernia

We report the case of a 6‐year‐old child who fell from a height of almost 10 metres. He had a large wound in the anterior chest wall with herniation of the lung through a defect produced by dysjunction of costo‐chondral/sterno‐chondral cartilages of the second to the fifth right ribs. Successful reduction and surgical repair was performed through a right anterolateral thoracotomy.

Cutaneous Microangiopathic Thrombosis Complicated by Pyoderma Gangrenosum in Post-Cardiac Surgery Heparin-Induced Thrombocytopaenia

Thrombotic cutaneous gangrene is a rare complication of heparin-induced thrombocytopaenia after cardiac surgery. We report a case and discuss management issues with cardiopulmonary bypass for cardiac surgery in this condition.

Acute Presentation in Adult in Bland‐White‐Garland Syndrome: Double‐Conduit, Two‐Coronary Repair

Abstract  Adult presentation with myocardial infarction in anomalous origin of the left main coronary artery from the pulmonary artery is rare. We describe the different coronary flow physiology in the adult form. A double‐conduit repair with a separate feeder vessel to each limb of the left coronary circulation may be necessary to balance the myocardial demand and supply in large systemic collateral coronary beds. The report describes the use of the left internal mammary and radial artery for repair.

Emergency closed mitral valvotomy with transesophageal echocardiographic guidance.

For reprint information contact: Harkant Singh, MCh Tel: 91 981 507 5294 Email: baryah@gmail.com Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Sciences and Research, Sector 12, Chandigarh 160012, India. A 25-year-old patient with mitral stenosis presented in acute pulmonary odema after a failed balloon mitral valvotomy. She underwent a successful emergency closed mitral valvotomy (CMV) through a quick limited anterolateral thoracotomy with cardiopulmonary bypass on standby.