Journal of Cardiovascular Medicine and Surgery

Single coronary artery (SCA) is a rare congenital anomaly which occurs in a structurally normal heart. We came across a patient presenting with typical angina radiating to left shoulder. Past history was unremarkable. Electrocardiogram (ECG) showed features of lateral wall myocardial infarction. Conventional angiogram (CAG) revealed a SCA (resembling Type R-III)1 supplying the entire myocardium with insignificant lesion in the distal half of right coronary artery (RCA). Cardiac computed tomography (CT) was done which confirmed the presence of SCA originating high above the right sinus of Valsalva. Conservative management was planned.

Submitral aneurysm is an extremely rare cardiac anomaly which was initially described among the African population and is considered rare in other parts of the world. In majority of the reported cases aetiology is congenital. We report a unique case of 54-year-old immunocompetent female with submitral aneurysm and tuberculous endocarditis of the mitral valve. She underwent successful submitral aneurysmoraphy with mitral valve replacement. Postoperative recovery has been uneventful without relapse for 12 months.

Senning procedure involves creating a network of baffles from the flaps raised from right atrium and native atrial septum so that inferior vena cava and superior vena cava flow is redirected to the mitral valve and pulmonary venous blood flow is redirected to the tricuspid valve. We describe a case of leak across the Senning baffle and the associated characterization on intraoperative transesophageal echocardiography.

Background: Type B aortic dissections have historically been treated with best medical therapy. Surgical repair is associated with significant morbidity and mortality. In East Africa there are a limited number of surgeons who are able to successfully operate on Type B aortic dissections. Method: We present four cases that were managed by Thoracic Endovascular Aortic Repair (TEVAR). The outcomes were acceptable with no mortalities and in-hospital stay of less than one week. Conclusion: TEVAR is now considered the standard of treatment for type B aortic dissections and should be considered in patients with suitable anatomy.

Left ventricular rupture is a dreaded complication usually associated with myocardial infarction due to loss of myocardial integrity. Very few are linked with valve surgery. These are inherently unstable and unpredictable, therefore require early detection, prompt assessment and rapid management. Intraoperative transesophageal echocardiography plays a vital role not only for early detection but also for decision making regarding conservative management or surgical repair. The authors enumerate the clinical experience of 3 patients of left ventricular rupture following MVR and their prompt management. Here, we describe the review of left ventricular (LV) rupture after mitral valve replacement (MVR).

Introduction: Cardiomyopathies are a heterogeneous group of heart diseases. The present study aimed to assess the clinical profile of patients diagnosed with cardiomyopathy and factors affecting their clinical outcomes. Methodology: Diagnosed patients of cardiomyopathyadmitted in general medical ward in our department were included. Diagnosis of cardiomyopathy was made based on the history, clinical examination and echocardiography findings and classified as dilated or hypertrophic cardiomyopathy. Results: Dilated cardiomyopathy was seen in 92.5% of the patients. Ischemic etiology was observed in approximately half of all patients (47%). Other less common etiology of cardiomyopathy was peripartum, thyroid abnormality, HIV infection, alcoholism, infectious disease, tachycardia and drug induced. Breathlessness and fatigue were the two most common presenting complaints. Discharge from the medical ward was ordered 66% of the patients, 17% had to be transferred to ICU and 17% expired during the follow up period. Serum creatinine higher than 1.3 mg/dl and total bilirubin more than 1.2 mg/ dl were found to be significantly associated with patient being either transferred to ICU or die during the follow up period. Conclusions: Non-ischemic etiology was more prevalent and higher serum creatinine and total bilirubin were associated with poor clinical outcomes. Future research is suggested from the clinical standpoint as well as those involving molecular techniques.

Background: Coronary artery ectasia (CAE) is a well recognized angiographic finding, characterized by abnormal dilatation of the coronary arteries. Abnormal epicardial dilatation of the coronary arteries has been recognized for decades. The most widely used term for this condition now is “coronary artery ectasia”. However, the incidence of CAE is may be due to several factors. The present study is done to study the clinical as well as angiographic characteristics of the patients who underwent coronary angiography. Methods: A total of 600 CAG’s (coronary angiography) done were randomly selected from our institute and were reviewed. Calculation of vessel lumen diameter and clinical variables such as age, sex, and occupation and serum lipid levels were noted. Results and Observation: Among the 600 CAG’s reviewed 20 cases were (3.3%) were found to have Coronary artery ectasia (CAE) among 16 were male (80%) and 4 (20%) were female. Parameters like both diabetic and hypertensive, obesity conditions were also evaluated. The present study also evaluated that the atherosclerotic coronary artery disease as the major cause of ectasia. Markis Type IV was found to be high when compare with other types. Conclusion: Coronary artery ectasia represent not an uncommon form of atherosclerotic coronary artery disease seen in approximately 5% cases undergoing coronary angiography. In view of the slow progression and complex manifestations of atherosclerosis, CAD at a certain stage might result in aneurysmal dilatation. This transition is unpredictable based on our current knowledge. The present study is a small step in understanding them.