Browsing by Author "Manikandan, Sethuraman"
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Item Absent right superior vena cava and persistent left superior vena cava: The perioperative implications(ANESTHESIA AND ANALGESIA, 2007)Item Airway implications of post-ductal coarctation of the aorta and an aberrant right subclavian artery(CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2008)Item An innovative simple technique of blood conservation in adult patients with tetralogy of Fallot and severely raised hemoglobin.(The Journal of extra-corporeal technology, 2007)The adult patients of tetralogy of Fallot often present with high hemoglobin levels. High hemoglobin and hematocrit on cardiopulmonary bypass (CPB) are associated with increased hemolysis, plasma free hemoglobin, renal dysfunction or failure, postoperative bleeding, exploration for bleeding, and increased requirement of allogeneic blood and blood products. Despite the presence of high hemoglobin and its association with adverse outcome, blood conservation is rarely practiced in these patients because of the fear of possible hemodynamic instability, and hypoxemic spell. We describe an innovative, simple technique of blood conservation for adult patients of tetralogy of Fallot with severely raised hemoglobin. With this technique, hemoglobin can be normalized on CPB; moreover, there is no fear of hypoxemic spell or hemodynamic instability. Furthermore, the blood conserved is readily available for transfusion in the perioperative period, if needed.Item CASE 2-2007 - Systemic air embolization after termination of cardiopulmonary bypass(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2007)Item Case 4-2008 - Difficult weaning from cardiopulmonary bypass in the lateral position caused by lung collapse(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008)Item CASE 5-2011 Acute Respiratory Distress Syndrome in an Infant After Repair of Tetralogy of Fallot(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2011)Item CASE 6-2011 Aortic Valve Replacement in a Patient With Aortic Stenosis, Dilated Cardiomyopathy, and Renal Dysfunction(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2011)Item Double color flow during transesophageal echocardiography in a child with tetralogy of fallot: Is this real or an artifact?(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008)Item Endotracheal tube fixation in neurosurgical procedures operated in prone position.(Journal of anaesthesiology, clinical pharmacology, 2011)Item Perioperative implications of retrograde flow in both the subclavian arteries in an adult undergoing surgical repair of coarctation of aorta.(Interactive cardiovascular and thoracic surgery, 2011)During surgical repair of coarctation of aorta (CoA), management of spinal cord ischemia and prevention of paraplegia is an important issue. The risk factors for paraplegia include level and duration of aortic-clamping, clamping of left subclavian artery (SCA), intraoperative temperature, variability of collateral circulation to the spinal cord, cerebrospinal fluid pressure, upper body arterial pressure, and aortic pressure beyond the aortic clamp. A short clamp time (<30 min), and distal aortic pressure>60 mmHg, minimizes the risks of spinal cord injury. In an adult patient during surgical repair of CoA, the arterial pressure in the femoral artery remained around 45 mmHg and repair took 83 min of aortic-clamping. Neurological assessment on regaining consciousness showed no deficit of lower limbs. Aortic root angiogram had shown retrograde filling of both SCAs. A unique situation in which clamping of SCAs would increase flow to the spinal cord as their clamping would stop stealing of blood and aortic-clamping proximal to CoA will further increase collateral flow; because of these reasons, the patient tolerated prolonged aortic-clamping despite low distal aortic pressure without neurological deficit. However, aortic-clamping increased left ventricular after-load and the patient developed worsening of mitral regurgitation and pulmonary hypertension during aortic clamping.Item Perioperative issues due to long-standing lung collapse during repair of a large ascending aortic aneurysm.(Annals of cardiac anaesthesia, 2008)Acute lung collapse during open-heart surgery may potentially lead to problems such as inadequate gas exchange, increased pulmonary vascular resistance, increased afterload to the right ventricle, and difficulty in weaning from cardiopulmonary bypass (CPB). Therefore, expansion of the lungs is ensured prior to separation from CPB. We report the inability to manually expand a chronically collapsed lung during the repair of ascending aortic aneurysm. The collapsed lung did not pose difficulty in separation from CPB and in blood gas management during the perioperative period. We discuss perioperative management issues in such situations.Item Resolution of Airway Compression Induced by Transesophageal Echocardiography Probe Insertion in a Pediatric Patient After Repair of an Atrial Septal Defect and Partial Anomalous Pulmonary Venous Connection(JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2008)