Browsing by Author "Sarma, AK"

Now showing 1 - 4 of 4
  • Item
    Atypical presentation of bilateral phrenic nerve palsy and its unusual recovery after coronary artery bypass grafting.
    (THORACIC AND CARDIOVASCULAR SURGEON, 2006) Duara, R; Sarma, AK; Sinha, PK; Ashalatha, R; Misra, M
    Bilateral phrenic nerve paralysis after coronary artery bypass surgery in a 47-year-old female patient is reported. This became evident on the 5th post-extubation day and mimicked acute coronary syndrome and led to difficulty in diagnosis. The patient required re-intubation and mechanical ventilation for only 6 days. The diagnosis of clinical and radiological abnormalities suggestive of bilateral phrenic nerve dysfunction was assisted by fluoroscopy, measurement of needle electromyography, and phrenic nerve motor conduction studies. The patient was followed up postoperatively for 14 weeks with complete regression of the neuropathy one month after surgery. An awareness of this complication should lead to improved care and successful postoperative management of patients.
  • Item
    Is there any change in free flow of pedicled left internal thoracic artery conduit at varying degrees of clockwise twist up to 360 degrees?
    (JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2005)
    Twisting of the aorta-coronary venous conduits is an extremely uncommon occurrence and has been reported by Roberts and colleagues' with fatal outcome. There is a reported case of a twisted pedicled left internal thoracic artery (LITA) graft as well in which the patient survived, and the follow-up coronary angiogram revealed a patent LITA with good distal runoff.(2) However, there are no published data in the English-language literature (PubMed, MEDLINE) regarding measurement of free flow from a pedicled LITA conduit in different degrees of twist. Therefore, to determine its significance on free flow, we studied the effect of varying degrees of clockwise twist of the LITA up to 360°.
  • Item
    Severe hypothyroidism after coronary artery bypass grafting
    (ANNALS OF THORACIC SURGERY, 2005)
    A 56-year-old man with unstable angina underwent urgent coronary artery bypass grafting. The patient required reintubation and prolonged ventilation because of persistent drowsiness and hypotension. The patient was weaned off the ventilator and extubated; however, he remained drowsy and lethargic. Neurologic examination, electroencephalogram, and computed tomography scan of the brain did not show any organic cause of his depressed neurologic status. His metabolic profile revealed severe hypothyroidism. The patient responded well to oral thyroxine. We report the unusual manner in which hypothyroidism presented in the patient. A high index of suspicion is required to diagnose and treat this complication.
  • Item