Journal of Cardiovascular Medicine and Surgery

Background: Stellate ganglion block (SGB) is a minimally invasive, simple bedside procedure. Although it is easy to perform, caution should be implemented because it lies near large vessels, multiple nerves, and the airway. Occasionally ventricular arrhythmias like ventricular tachycardia (VT) and ventricular fibrillation (VF) can be refractory to usual drug therapy and electrical defibrillations. Stellate ganglion blockade (SGB) has been described as an effective intervention in patients with refractory ventricular arrhythmia. Method: Anaesthesiologists in cardiac critical care units performed Stellate ganglion block on six patients at the bedside. Outcomes of left SGB for VT and VF burden and defibrillations at 24 hours of SGB were studied. Result: Six patients underwent left SGB, hemodynamic stability and rate control was observed in all patients (100%) after successful blockade but conversion to normal sinus rhythm was seen in only three (50%) of the patients. Defibrillation after blockade was not required for 24 hours in 50% of the patients, 18 hours in 1(17%) of the patients and rest 2 (33%) required after 12 hours. None of the patients had any side-effects’ except hoarseness of voice in one patient which was resolved spontaneously after 6 hours.. Conclusion: The perioperative management of non-cardiac tumors with cardiovascular extension is unique and challenging. The facilities of cardiovascular team with CPB, one lung ventilation, DHCA, rapid transfusion and TEE were useful for a perfect outcome.

Introduction: Congenital Vascular Malformation (CVM) is a benign vascular tumour that results from arrest in the embryogenesis of vessel formation. Multimodal therapy is advocated in the management of CVM, from radiological embolization to surgical excision. It has been proposed that ‘surgically accessible’ lesions managed with complete excision may provide optimum results with least recurrence. We present our surgical experience in such patients at a single centre in North India. Methods: Patients presenting with clinical CVM were evaluated with duplex ultrasound/ Magnetic Resonance Imaging scan to confirm diagnosis and assess extent. They were counselled about natural history of disease and treatment options. Localised lesions suitable for R0 resection with minimum residual disability/cosmetic disfigurement were counselled for excision. Records of patients undergoing surgery from March 2022 to October 2024 were accessed and analysed for demographic details, clinical presentation, any complications, histological diagnosis and recurrence. Results: Eleven patients underwent excision biopsy of CVM at a new semi-urban setup over two years, out of total of 45 patients who presented in study period. A female preponderance was noted (8/11). The mean age of presentation was 29 years (SD 13.0, range 10-53). Suprapatellar bursa was breached inadvertently during excision of a vastus medialis CVM. One patient developed superficial surgical site infection. There were no recurrences over a median follow-up of 12 months (range 1-24 months). Conclusion: Individualized decision for CVM is advocated. In the modern era of minimally invasive surgical procedure preference, complete surgical resection of CVM in selected patients can provide recurrence free treatment.

Background: Athletes hearts are generally larger and stronger than those of non-athletes due to their physical demand Cardiomyopathy of their sports. This is due to physiological adaptation to regular intense exercise. Hypertrophic cardiomyopathy (HCM) is a cardiac disorder characterized by thickening of the heart muscle, which can lead to heart failure, arrhythmias, and sudden cardiac death. Athletes with HCM may be at increased risk of adverse cardiac events due to the combination of exercise-induced changes in heart function and the underlying cardiac abnormalities. Bradycardia typically is a heart rate of less than 60 beats per minute. Athletes may develop bradycardia as a result of their training, adaptation of the heart in response to regular physical activity" commonly known as athlete's heart."Athletes with HCM develop an enlarged heart, which can be mistaken for" athlete's heart. Objectives: To provide an overview of the prevalence, diagnosis, and management of HCM in athletes. Method: A case study of 25-year-old who presented with shortness of breath, chest pains, and palpitations on exertion. He had an electrocardiogram and echocardiogram with features of HCM; however, the LV diastolic function was normal and cardiopulmonary exercise testing revealed high peak oxygen consumption in keeping it with a physiological left ventricular hypertrophy. Lifestyle modifications, by reducing the intensity of exercise to help manage symptoms and minimize the risk of complications were implemented. Medications to improve heart function. With these, there was a complete change on his ECG and Echocardiography, thereafter indicating a physiological LVH rather than HCM. Conclusion: HCM is the most common cause of sudden cardiac death (SCD) in young athletes, accounting for up to 36% of cases. Prevalence of HCM in athletes is estimated to be around 0.2%, which is higher than that in the general population. Not all athletes with HCM are at equal risk of SCD, and risk stratification is an essential part of management.

Cardiac rhabdomyoma in an adult without tuberous sclerosis complex is extremely rare entity.8 Isolated tricuspid stenosis accounts for about 2.4% of all cases of organic tricuspid valve disease. A young woman presented to us with breathlessness and features of heart failure with a history of rheumatic fever. Eventually she was diagnosed with an atrial mass and an isolated tricuspid stenosis. Mass was excised and valve stenosis was corrected surgically under cardiopulmonary bypass. Histology proved the mass to be a rhabdomyoma. The patient is doing well till date.

Primary tricuspid valve disease related to its congenital malformation is rare. Ebstein’s anamoly is a rare congenital condition affecting the septal and posterior leaflets of the tricuspid valve. Ebstein’s anamoly has a wide spectrum of pathological features. We describe the case of 33 year old female with Ebsteinoid tricuspid valve orifice, severely hypoplastic right ventricle and thrombus in a giant right atrium, with intact interatrial and interventricular septa. The patient was managed surgically with Kays tricuspid annuloplasty and right Bidirectional Glenn anastomosis constituting one and a half ventricular repair with satisfactory outcome.

LeRiche Syndrome, characterized by a combination of intermittent claudication, erectile dysfunction, and absent femoral pulses due to atherosclerotic occlusion of the aortoiliac and femoral arteries, presents significant diagnostic and therapeutic challenges. This report explores the case of a patient with LeRiche Syndrome with superficial femoral artery (SFA) occlusion, treated by combination of aortoiliac revascularization and SFA angioplasty. Preoperative imaging, including angiography, revealed aortoiliac occlusion with complete occlusion of the SFA. The patient underwent successful revascularization of the aortoiliac arteries with stenting, followed by angioplasty of the occluded SFA. Postoperative recovery was uneventful, with significant improvement in symptoms, including resolution of claudication and restoration of femoral pulses. This case underscores the importance of comprehensive vascular evaluation and individualized treatment strategies for managing LeRiche Syndrome, highlighting the role of combined aortoiliac revascularization and SFA angioplasty in achieving favourable outcomes.