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Background: Sternal wound infections (SWIs) are a significant complication following sternotomy procedures, leading to morbidity, increased healthcare costs, and mortality. The rise of multidrug-resistant bacteria necessitates alternative treatment strategies. This study evaluates the efficacy of topical application of piperacillin and tazobactam in Preventing SWIs. Methods: A prospective study was conducted with 60 adult patients who have changed sternotomy for various cardiac procedures. The patients were divided into two groups: Group A received topical piperacillin and tazobactam, while Group B did not. Various parameters and post-operative outcomes were compared between the two groups. Results: Patient demographics and comorbidities did not differ significantly between the groups. However, significant differences were observed in post-operative variables. Group A, which received topical antibiotic therapy, had a shorter hospital stay, lower use of mechanical ventilation, and shorter total hospital stay compared to Group A. The mortality rate was higher in Group B. Conclusion: The study findings suggest that topical application of piperacillin and tazobactam holds promise in preventing SWIs. It may lead to improved clinical outcomes and reduced hospital stay. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the outcomes of sternotomy closure using conventional and hybrid techniques and investigate their associated complications in patients undergoing cardiac surgery. Methods: A retrospective observational study was conducted, analyzing data from medical records and surgical databases. The study included a cohort of patients who underwent sternotomy closure using conventional and hybrid techniques at a tertiary care hospital. Patient demographics, surgical details, intraoperative factors, postoperative outcomes, and follow-up information were collected. Descriptive statistics were used to summarize the data. Results: A total of 50 patients and 25 in each group. The majority of cases are off pump (42 patients) and on pump (8 patients) .Analysis of postoperative outcomes showed that 92% of patients achieved satisfactory sternal healing, and bone fusion was observed in 98% of cases. The rate of sternal dehiscence was 2%, with no statistically significant difference between the two closure techniques (p=0.62). Surgical site infections occurred in 9% of patients, with no significant difference between the closure groups (p=0.88) Conclusion: Both conventional and hybrid techniques demonstrated comparable efficacy in achieving successful sternal union after sternotomy closure. The rates of sternal dehiscence and surgical site infections were similar between the closure techniques. Further research is needed to identify risk factors and develop preventive strategies to reduce complications associated with sternotomy closure. [ABSTRACT FROM AUTHOR]

Aim and Objectives: Mitral valve disease is associated with severe mitral valve stenosis, and mitral valve regurgitation warrants a mitral valve repair or surgical replacement. Cardiothoracic surgeons use semi-continuous sutures or interrupted suture techniques in Mitral valve replacement. The study's primary aim was to compare the efficacy of the semi-continuous and interrupted suture techniques of prosthetic valve replacement in mitral valve replacement surgeries during the early postoperative period. Materials and Methods: a prospective randomised comparative study was conducted at the CTVS Department, GB Pant Hospital, New Delhi, India. The 100 patients with mitral valve disease (with any pathology) were included in the study from Jan 2020 to Dec 2021. They were divided randomly into two groups, group1 included patients who underwent semicontinuous technique for MVR (45 cases), and group2 included the patients who underwent interrupted technique (55cases). Data related to complete history, general examination including vital signs, investigations including complete blood count, chest X-ray (CXR), 12 lead Electrocardiography (ECG), echocardiography and coronary angiography were recorded preoperatively, and if the patient was more than 40 years old, operative data including total bypass time, aortic CCT of both groups were recorded and postoperative outcome including ICU stay and inotrope use, postoperative complications, pulmonary hypertension and echo findings as immediate postoperative and echo after 1 and 3 months postoperative was also recorded. Data were analysed with the help of SPSS 20 software Results: Both the groups were comparable in terms of age, gender and preoperative echocardiographic characteristics (p>0.05 each). Total bypass and cross-clamp times were significantly higher in patients who underwent interrupted technique. Conclusions: Semi-continuous technique was found to be a safe and reliable method of mitral valve replacement. It was found that the mean total bypass time and cross-clamp times were significantly higher among the interrupted group compared to the semi-continuous suturing group. [ABSTRACT FROM AUTHOR]

Background: Aortic diseases (AD) include Ascending Aorta aneurysm, Ascending Aorta aneurysm with Aortic arch aneurysm, and Aortic root aneurysm requiring surgical intervention and Aortic dissection DeBakey type I and type II are life-threatening disorders. There has been a shift of focus on AD treatment from open repair to endovascular treatment. The survival rate of patients with AD is also improving as there is an improvement in surgical treatment. Many studies have reported that discomfort is an essential determinant of people's lives, as patients with chronic pain might fall into disability or be unable to work. Methods: A retrospectively cross-sectional study was conducted among 117 participants from a single tertiary care G. B. PANT hospital in New Delhi. The data was compiled from the hospital's medical record database (MRD), and confidentiality of data was maintained. Amid the COVID-19 pandemic, a telephone follow-up and face-to-face interviews (29 patients) from September 2020 to Jan 2022 were conducted. Data related to Demographic variables and clinical profiles related to disease, diagnosis and treatment were collected using a questionnaire. The responses were recorded in the questionnaire. The primary outcomes were the incidence and discomfort symptoms. SPSS v22.0 software was used to analyse and describe the primary data of patients. Results: A total of 136 patients were included in the study; 117 patients comprised the survival group and 19 death group. 53 of 117 patients reported discomfort. The discomfort symptoms reported were diverse and mainly manifested as chest pain( 44%,52/117), back pain ( 44%,52/117), chest tightness (36%,42/117), dizziness (32 %,38/117) and weakness (29%,34/117). The multivariable analysis predicted that the discomfort increased significantly when the patient was positive for an alcohol drinking history. However, length of discharge was associated with a reduced incidence of discomfort. Conclusions: postoperative discomfort symptoms reported in the present study varied, and some subjects reported multiple symptoms. Therefore, attention to patients' physical condition after the operation and early targeted guidance can prevent serious aortic surgery-related consequences. Early diagnosis, sensible drinking, and long-term follow-up are required to monitor the patients’ recovery. [ABSTRACT FROM AUTHOR]

Background: Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on the recovery of patients after coronary artery bypass grafting (CABG). Methods: In this study, we selected patients who underwent CABG were identified. The postoperative outcomes were compared. We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 100 patients who underwent CABG. Results: The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (55%) than in euthyroid patients (32%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Conclusions: SCH or low total T3 might be associated with a poor prognosis after CABG, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients. [ABSTRACT FROM AUTHOR]

Objective: The rise in the number of elderly people worldwide has led to a dramatic increase in patients over the age of 50 who need surgery for heart disease. The purpose of the study is to assess the impact of age on postoperative outcomes in patients that undergo coronary heart bypass surgery. Methodology: We included patients in range of 50 – 70 years in our study. We divided these into two groups. Patients that are ≥50 years old who underwent CABG were selected as Group A . The patients who were 50–59 years old ( Group A ) were compared to patients aged 60 – 70 years old ( Group B ) to determine if the age difference of the patients had an impact on surgical outcomes. We included 50 patients in each group . Demographic information was collected for each patient. Pre-, intra-, and post-operative findings were identified. The rates of postoperative complications, mortality, hospital length of stay (LOS) and cost were compared Results: In our study, we found, Group A found 4% mortality rate while Group B found it was 6% . Hospital stay rate in group B was 17 %, while in Group A was 16 %. Postoperative complications were seen in 24% in group B, while 16% in group A. Postoperative hospital stay was 8.40 days in Group B while 6.90 in Group A. Conclusions: Patients aged 60 - 70 years had serious side effects after surgery. Finally, the findings of the study indicate that age affects the outcome of surgery after CABG. These older patients face greater risk of surgery and accumulate significant hospital costs. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of valvular heart diseases is growing rapidly in low- and middle-income countries. The purpose of this study was to determine correlation of duration of cardiopulmonary bypass and perioperative outcome of valvular heart surgery outcome. Methodology: We retrospectively reviewed data from adult patients undergoing valvular heart surgery during the past year. We performed a review of the medical, surgical, and intensive care records of consecutive elderly patients 18 years of age and older etc Results: There were 82 males and 18 female, and the mean age at the survey was 56.1 ± 12.1 years. Diabetes was the most common diseases reported in 37 of patients. During surgery, 16 patients died. Of these patients, cardiac-related deaths were reported in 7 patients, 3 with sepsis, 3 with lung-related death, and 1 with neurological death. In some patients, the cause of death involved a single organ transplant. The exact cause of death was not specified in 2 patients. 6 patients required repeated cardiac surgery, and half of these patients underwent further surgery within the same surgical intervention (early reconstruction). Among the patients who died, only 2.2 and 1.5% were cases of early and late rehabilitation. Valvular heart surgery was performed at the same surgical site in 6 patients. In these patients, the mortality rate was 23.0%. Conclusions: From present study, we strongly underline correlation of duration of cardiopulmonary bypass and perioperative outcome of valvular heart surgery outcome and we should take note of this relationship for better outcome. [ABSTRACT FROM AUTHOR]

Background: It is not yet clear how hemoglobin A1c (HbA1c) and preoperative glycemia can be used in clinical decision-making to prevent sternal wound complications following off-pump coronary bypass grafting (OPCAB). Methods: We conducted a retrospective study of 50 consecutive patients who underwent OPCAB surgery. The associations of HbA1c and preoperative glycemia with incidence and grade of SWC were analysed. Results: Preoperative HbA1c was <7% in 25 patients ( Group A) and ≥7.0% in 25 patients ( Group B ) Patients in the high HbA1c group were younger, with greater preoperative serum glucose levels 150 mg/dL vs 124 mg/Dl ( P < .001) and more frequent history of preoperative insulin use (18% vs 8%, P <.001) Hypertension and CCF was found more significant in Group B than A . Incidence of composite of postoperative morbidity and mortality endpoints was greater in patients with HbA1c ≥7.0% (22% vs 14%, P = .043). Perioperative time-weighted average glucose concentration was also greater in patients with HbA1c ≥7.0%, whereas the CV did not show any difference. Conclusions: Under certain conditions, HbA1c and glycemia are associated with SWC following OPCAB. These findings help to plan the process with minimal SWC risk. [ABSTRACT FROM AUTHOR]

Aims & Objectives: The objectives of this study was to discuss creating a hospital model in restarting cardiovascular surgery during Corona Virus disease-2019 (COVID 19) pandemic and to retrospectively analyze the early outcomes of patient operated during the study period under the modified policies of patient and hospital management. Methods: a modified model of hospital and patient management was created in the department of Cardiothoracic & Vascular Surgery, GB Pant Hospital during the national lockdown for COVID-19. Patients admitted and undergoing cardiovascular surgery in between 01-06-2020 and 30-11-2020 were retrospectively analyzed on various parameters to evaluate efficacy of this modified model. Results: Total 435 patients were admitted during study period, out of them 277 were operated. Valve replacement was the most common surgery performed in almost 60% of patients. There were total 30 mortalities in the admitted patients two being COVID positive mortality. None of the COVID negative patient who got operated, developed influenza like illness (ILI symptoms) till discharge. Total 20 health care workers including doctors, nursing staff, and auxiliary staff turned COVID positive during this study period. Aims & Objectives: The objectives of this study was to discuss creating a hospital model in restarting cardiovascular surgery during Corona Virus disease-2019 (COVID 19) pandemic and to retrospectively analyze the early outcomes of patient operated during the study period under the modified policies of patient and hospital management. Methods: a modified model of hospital and patient management was created in the department of Cardiothoracic & Vascular Surgery, GB Pant Hospital during the national lockdown for COVID-19. Patients admitted and undergoing cardiovascular surgery in between 01-06-2020 and 30-11-2020 were retrospectively analyzed on various parameters to evaluate efficacy of this modified model. Results: Total 435 patients were admitted during study period, out of them 277 were operated. Valve replacement was the most common surgery performed in almost 60% of patients. There were total 30 mortalities in the admitted patients two being COVID positive mortality. None of the COVID negative patient who got operated, developed influenza like illness (ILI symptoms) till discharge. Total 20 health care workers including doctors, nursing staff, and auxiliary staff turned COVID positive during this study period . [ABSTRACT FROM AUTHOR]

Situs inversus with dextrocardia and Lutembacher syndrome is a rare cardiac anomaly. It is associated with other complex cardiac anomalies and anatomical defects. A 30-year-old woman with this condition underwent mitral valve replacement and closure of a secundum atrial septal defect. We describe the surgical approach, position of the surgeon, and bicaval cannulation technique for this anatomical aberration. [ABSTRACT FROM AUTHOR]

A case of the right pulmonary artery-to- left atrial fistula with atrial septal defect (ASD) is presented. The fistula was detected after the patient developed desaturation following surgical closure of the ASD. It was managed with a transcatheter (trans-RPA route) closure of the fistula using a 12-mm Amplatzer ventricular septal defect closure device. [ABSTRACT FROM AUTHOR]