Dual ruptured sinus of Valsalva aneurysms.

Ruptured sinus of Valsalva (RSOV) aneurysm is a rare anomaly accounting for around 0.14-3.5% in patients undergoing open cardiac surgeries. We report a rare case of an 18-year-old male with dual RSOV aneurysms who was managed successfully by patch closure via the transaortic approach and which to our knowledge has never been reported ("PubMed" and "Google Scholar" as the search engine with dual, ruptured, sinus of Valsalva aneurysm as the MeSH words). Dual RSOV aneurysm in a single patient is an extremely rare condition which can lead to early cardiogenic shock and should be managed surgically at the earliest.

Is Deep Hypothermic Cardiac Arrest Mandatory in Aortic Arch Surgeries?

Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated.

Is Deep Hypothermic Cardiac Arrest Mandatory in Aortic Arch Surgeries?

ABSTRACT Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated.

Left handedness in cardiac surgery-boon or bane?

Left-handed individuals consist of around 11% of the population and true ambidextrous consists of only 2-3% of the total population. Almost a similar ratio is seen in medical profession also. Difficulties are obvious for left-handed cardiac surgeons in the operating room due to regular right-handed instruments, laterality, and positioning of the patients. In this article, we discuss about the problems and the potential solutions for left-handed cardiac surgeons.

Iatrogenic dissection in paediatric cardiac surgery.

Iatrogenic dissection due to aortic cannulation is extremely rare. We are reporting here a case of 11-month-old child who developed an iatrogenic aortic dissection during repair of supracardiac total anomalous pulmonary venous connection (TAPVC).

Vacuum phenomenon: Clinical relevance.

Vacuum phenomenon (VP) is an anatomical entity of potential confusion in the diagnosis and evaluation of joint pathology. Observation of this phenomenon has been demonstrated on basic radiographs, computed tomography, and magnetic resonance imaging. Although VP is most often associated with degenerative joint disease, it is observed with other pathologies. Two problematic scenarios can occur: a false-positive diagnosis of serious pathology instead of benign VP and a false-negative diagnosis of benign VP with a more serious underlying process Despite this potential for confusion, criteria for distinguishing VP from other causes of joint pain and for evaluating a suspected case of VP have not been fully established. We reviewed the literature to determine underlying mechanism, symptomology, associated pathologies, and clinical importance of VP. The formation of VP can be explained by gas solubility, pressure-volume relationships, and human physiology. CT, GRE-MRI, and multipositional views are the best imaging studies to view VP. Although most cases of VP are benign, it can be associated with clinical signs and symptoms. VP outside the spine is an underreported finding on imaging studies. VP should be on the differential diagnosis for joint pain, especially in the elderly. We have proposed criteria for diagnosing VP and generated a basic algorithm for its workup. Underreporting of this phenomenon shows a lack of awareness of VP on the part of physicians. By identifying true anatomic VP, we can prevent harm from suboptimal treatment of patients.