Journal of Cardiovascular Medicine and Surgery

Drainage of pericardial effusion by pigtail catheter is one of the techniques. Breakage and retention of pigtail catheter is a rare complication. If the patient is sick and hemodynamically unstable, then the retrieval of the broken part is challenging. A 48 year old male patient with multiple co-morbidities presented with shortness of breath and episodes of syncope was diagnosed with retention of pigtail catheter and massive pericardial effusion. The retrieval of broken pigtail catheter and drainage of massive pericardial effusion by thoracotomy approach in a patient with multiple co-morbidities under the monitoring and guidance of transesophageal echocardiography may be a unique and novel useful technique.

We report a rare case of grape shaped coronary aneurysm of first diagonal branch of left anterior descending artery (LAD) which has been rarely reported in literature. Coronary atherosclerosis with negative vascular remodelling results in coronary stenosis and positive vascular remodelling result in coronary aneurysm.Local vascular pathobiology varies markedly even in a short segment of coronary artery where two focal stenoses sandwich one aneurysm resulting in grape shaped coronary aneurysm which is rare to see in clinical practice. We successfully revascularised the diagonal with Drug Eluting Stents (DES) followed by postdilatation with good angiographic result.

Myocarditis, a reported complication of COVID-19 infection, can also occur after administration of COVID-19 vaccination. If idetified early, and treated prperly, it will lead to full recovery. The occurrence and recurrence of myocarditis in a 36-year-old lady who was treated for severe COVID-19 pneumonia 4 months before she got her first COVID-19 Astra Zeneca vaccine is narrated. She developed myo-pericarditis a week after the first dose of the vaccine and a recurrence a month later after the first episode of the myo-pericarditis Conclusion: Severe myocarditis can occur after the first dose of the COVID-19 Astra Zeneca vaccine, with previous history of COVID-19. A high index of suspicion is required for its diagnosis post COVID-19 vaccination. Cardiac Magnetic Resonance (CMR) is key in the diagnosis of acute myocarditis.
 

Objective: Aortic stenos is with narrow aortic root is a rare presentation. Posterior aortic root enlargement and anterior aortic root enlargement individually have their own limitations. We present our experience combining both procedures in cases where single procedure of root enlargement is not sufficient. By both anterior and posterior root enlargement, we successfully could insert an adult size mechanical prosthesis with minimal morbidity and no mortality in paediatric patients.

Materials and Methods: we report our experience with three cases with small aortic root, allowing the implantation of only 15mm size aortic valve, initially. Posterior enlargement allowed implantation of 17mm valve, but, using a combined approach, a maximum size of 21mm aortic valve could be implanted.

Results: All the three cases had an uneventful postoperative period with relief of symptoms and significant reduction in postoperative gradients with minimal morbidity and no mortality.

Conclusion: Combined aortic root enlargement allows insertion of an adult size prosthesis and has been found to minimize the chance of Patient Prosthetic Mismatch and the morbidity associated with a redo surgery in paediatric cases and is demonstrated to be safe and feasible with improvement in quality of life in patients with small aortic root with minimal morbidity and no mortality.