Comparison of topical use of protamine and tranexamic acid in surgical patients requiring cardio-pulmonary bypass

To determine the effectiveness of local protamine in reducing post-operative blood loss compared to loca1 tranexamic acid. Randomized controlled trial. Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi from January 2011 to September 2011. One hundred and twenty cardiac surgrcal patients were randomly divided into two equal groups, one receiving local protamine while the other group receiving local tranexamic acid before chest closure. The efficiency was measured as post-operative blood loss and requirement of blood and blood products in the post-surgical ICU. RAverage blood loss in protamine group was significantly less [252.97 ml] compared to tranexamic acie group [680.67 ml]. hTumber of patients requiring no post-operative blood transfusion was sigruficantly higher in protamine group [76.7%] compared to tranexamic acid group [53.3%]. Local protamine is more effective in reducing post-operative blood loss than local tranexamic acid

Anomalous origin of left coronary artery from pulmonary artery [ALCAPA]

Anomalous origin of the left coronary artery from the pulmonary artery also recognized as Bland White Garland syndrome is a very rare congenital condition. A two-months old baby boy presented with dyspnoea for two weeks and a pansystolic murmur on auscultation. The base line investigations showed cardiomegaly and bilateral basal haze on X-ray chest. ECG showed ST elevation in leads I and AVI and echocardiography showed situs solitus, levocardia, hypokinetic intra-ventricular septum, ejection fraction of 30%, mitral regurgitation of grade-I and an anomalous origin of the left coronary artery from pulmonary artery was diagnosed. Patient was in left heart failure. It was rectified surgically by creating a trans-pulmonary tunnel [Takeuchi repair]. Postoperative course was uneventful and he was finally discharged in stable condition