Multidisciplinary Cardiovascular Annals
Volume:3 Issue: 3, Sep 2011

Cardiac function may change following complete surgical correction of Tetralogy of Fallot (TOF) and measures that can assess these changes are either invasive or very expensive. This study aim was to investigate the use of Doppler echocardiography as a simple, inexpensive and reproducible method for assessment of cardiac function. In a case-control study 30 children who underwent surgical correction of TOF and visited the children’s clinic in Ali Asghar Hospital in Zahedan between September 2005 and March 2007 were compared with 30 healthy age and sex matched children. All participants underwent physical examination, chest radiography and electrocardiography (ECG) before echocardiography. Cases who did not have any clear cardiac signs and whose surgical repair had been performed at least 6 months ago entered the study. Echocardiography was performed for both groups. Data were analyzed using the SPSS software and suitable statistical tests. Right ventricular myocardial performance index (MPI), mean right ventricular isovolumic relaxation time (IRT) and isovolumic contraction time (ICT) and mean RV PEP/ET were higher in cases than controls (p<0.001, 0.014, <0.001 and 0.0001, respectively). There were no significant differences between mean RV E/A between cases and controls (p=0.999). Mean left ventricular MPI and ICT were higher in cases than controls (p<0.001). Mean left ventricular IRT was not different between the twogroups (p=0.501). The findings of this study showed that LV and RV dysfunction ensue complete surgical correction of TOF. Therefore, right and left ventricular performanceindexes can serve as valuable parameters in assessing cardiac performance in suchpatients.

The main goal of this study was to assess the results of the pulmonary Artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary Hypertension (PH). We analyzed data from 305 patients who had operation between April 2005 and April 2010 in Rajaee Heart Center, Tehran, Iran. All patients were approached through a Left thoracotomy and 20% of patients underwent PA banding based on Trusler's rule (Group1), 55% of them underwent PA banding based on PA pressure measurement (Group 2), and the rest of them (25%) based on surgeon experience (group 3). The follow-up period was 39±20 month and 75 % of patients (230 cases) had definitive repair of mean interval 23±10 month. The rate of anatomically and functionally effectiveness of PA banding in all groups were high (97% and 92% respectively).There were no significant differences in anatomically and functionally efficacy rate between all groups (p= 0.77, p=0.728 respectively). There was PA bifurcation stenosis in 6 cases (2%), and pulmonary valve injury in 1 case (0.3%). There were 11 patients (3.6%) intubated two days or more in intensive care unit (ICU). The mortality rate in PA banding was 2% and in definitive repair was 3%. With low mortality (2%) and morbidity and high efficacy rate of PA banding in our series, we believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. We believe that PA banding can be done safely with low morbidity and mortality.

The benefits of using arterial grafts in coronary artery bypass grafting (CABG) have been elucidated in previous investigations. Alternative arterial grafts such as radial artery (RA) and right gastroepiploic artery (RGEA) have been used widely for CABG with increasing importance. Med-Line (1986-2010) was searched using the subsequent keyword arterial graft, CABG, RA and GEA. Overall, a total of 82 observational and comparison studies were considered relevant to this review and were summarized. This review provides a summary of the outcomes of RA and/or GEA arterial grafts regarding morbidity, mortality, patency rates, technical features and certain characteristics of the considered arterial conduits. This review article further supports the utility of the RA when used as either a composite or aortocoronary graft which results in improved results. Although some investigations showed acceptable results justify its use in clinical settings, there is still much concern about using the GEA in CABG. Right GEA, as an arterial graft, can be used as an in situ graft or a free graft.

Hemangiomas are rare primary cardiac neoplasms with a reported incidence of 2.8% of all neoplastic lesions of the heart and pericardium. So far, fewer than a hundred documented cases have been reported. We present two cases treated and diagnosed as having cardiac hemangiomas. Both of the patients had uneventful postoperative courses.

Aminoglycoside treatment has been associated with nephrotoxic effects. However, the effect of perioperative aminoglycoside treatment on the risk of acute kidney injury requiring dialysis among patients undergoing cardiac surgery remains uncertain. We performed a register study based on prospectively collected data from population-based health care databases of 3625 consecutive patients undergoing cardiac surgery at the Aarhus University Hospital, Skejby, Denmark. Patients requiring preoperative dialysis were excluded, leaving a total of 3587 patients (99% of original patient cohort), of whom 89 received perioperative aminoglycosides. The cumulative risk of in-hospital dialysis-dependent acute kidney injury was 3.2% (n = 115). Perioperative use of aminoglycosides was associated with an increased risk of postoperative dialysis (adjusted odds ratio [OR], 4.41; 95% confidence interval [CI], 1.83–10.59). Other predictors included reoperation because of bleeding (adjusted OR, 2.80; 95% CI, 1.63–4.80), use of inotropic support during anesthesia (adjusted OR, 2.10; 95% confidence interval, 1.49–2.95), and cardiopulmonary bypass lasting longer than 120 minutes (adjusted OR, 1.95; 95% CI, 1.19–3.20) along with EuroSCORE variables. Postoperative dialysis was associated with higher 30-day mortality (10.9% vs 2.5%, P <. 0001, 2 test), but use of aminoglycosides was not independently associated with mortality. Perioperative use of aminoglycosides in adults undergoing cardiac surgery was associated with increased risk of postoperative dialysis

The absence of the right superior vena cava (SVC) is usually associated with the presence of a left SVC. Here we’ll present a case with the absence of the right SVC and a persistent left SVC found in association with an ostium secundum atrial septal defect and unroofed coronary sinus.

A 70-year-old woman underwent coronary artery bypass grafting (CABG) due to coronary heart disease in our center. Intraoperatively, the thymic gland seemed bulky and appeared to contain blood clots, giving the impression of a hemorrhagic cyst of the gland. The lesion consisted of variously-sized blood-filled channels with flat lining and extensive fresh and old hemorrhage as well as organized thrombus formations. The remnants of the thymus gland in the periphery could also be seen.There being no evidence of malignancy in this vascular tumor, a diagnosis of thymic cavernous hemangioma was made. The operation was uneventful, and the patient was soon discharged from the hospital in good clinical condition.