ABSTRACT
The term mycotic aneurysm refers to aneurysm associated with infection by microorganism. Sir William Osler first coined the term mycotic aneurysm in 1885 by disclosing the relation between abnormal cardiac valves and infection with micrococci not with fungi. An 11 years old female from Feni presented with asymptomatic vascular swelling in abdomen referred by a cardiologist. CT angiogram revealed fusiform aneurysm in distal part of abdominal aorta involving ostioproximal part of both common iliac arteries and saccular aneurysm of distal part of superior mesenteric arteries suggestive of mycotic aneurysm. Patient underwent vascular operation aorto biilliac bypass by PTFE graft with excision and ligation of aneurysm of superior mesenteric arteries .Mycotic aneurysm in bacterial endocarditis is rare. It is a challenging job for the cardiologists, infectious disease specialists and vascular surgeon. Time appropriate skilled prompt surgical management can bring smile for both patients and physicians.
ABSTRACT
Residual Ventricular septal defect after surgical repair for Tetralogy of fallot(TOF) can occasionally be heamodynamically important requiring re-intervention.Closed observation and followup make this defect heamodynamically insignificant, required no medication and no endocarditis.We describe one patient having residual defect after surgical repair of TOF.
ABSTRACT
Primarily double chamber of Right ventricle (DCRV) is an uncommon congenital anomaly consists of one or more anomalous muscle bundles(AMB) that divide Right ventricle into proximal high and distal low pressure chamber .Outcome of surgical treatment is excellent if diagnosed properly. A 5years old girl presented with breathlessness on exertion and repeated attack of cough, fever for last 4 years .patient ultimately diagnosed as DCRVand underwent intracardiac repair by open heart surgery. Her postoperative outcome was uneventful. Patient is discharged on 8th postoperative day after follow up postoperative chest X Ray and Echocardiography .
ABSTRACT
Background: Pulmonary function after coronary artery bypass graft surgery using harvested Internal mammary artery(IMA) were assessed in this prospective case control Clinical study comparing two groups of Patients with or without pleurotomy. Method: we conducted this Study at National Institute of Cardiovascular Diseases (NICVD), Dhaka, in the Department of Cardiovascular Surgery.A total of 60 consecutive patients undergoing CABG with use of IMA between july 2005 to June 2007 were reviewed. Study population were divided into Group A (n=30,undergone CABG with pleurotomy during IMA harvestion).Group B (n=30,undergone CABG with intactpleura during IMA harvestion). Results: in lung function spirometry revealed FEV1 significantly decreased in group A than B (56.81±17.76% Vs 79.85±7.7%; p=0.035)and when FEV1correalated with inspiratory vital capacity the advantage of intact pleura were confirmed at 6th postoperative day (78.02 ±12.17; B, 82.08 ±11.72 p=0.045). Vital capacity was significantly decreased in-group A than B at 3 months postoperatively (A 88.79 ± 14.38%;B 98.11±30.25%; p=0.009), but not on 6th Postoperative day. Pleuropulmonary complication like atelectasis, pleural effusion insignificantly higher in groupA than B(16.7 %VS6.7%) and (10% vs. 6.7%)at 6th postoperative day but not at 3months postoperatively. Conclusions: These results demonstrate that pleurotomy during Internal mammary artery harvesting significantly deteriorated pulmonary function variably than intact pleura group of patients.