Gilldowns6601

th pre- as well as post-bypass period.

We looked for a correlation between the surgically measured mitral valve size and the cardiac dimensions (left ventricle internal diameter, left atrial size, aorta size, and body surface area) measured by preoperative and intraoperative echocardiography. We also assessed to see if we could predict the mitral prosthesis size based on the correlation data obtained.

The hospital records of 180 patients who underwent mitral valve replacement (MVR) with TTK Chitra valve between January 2008 and December 2012 at our hospital, were studied. The correlation between surgically measured mitral annulus size to left ventricular internal diameter systolic (LVIDS) and diastolic (LVIDD), left atrial size (linear measurement), and aorta size on echocardiography and body surface area was calculated using Pearson correlation coefficient. Mean LVIDS was calculated for each valve prosthesis size separately and the correlation was studied.

The correlation between mitral valve prosthesis size and left ventricular internal diradual increase in the mean LVIDS with increase in the prosthetic valve size. Box plot and scatter plot showed linear correlation between valve size and mean LVIDS.

Obstructive sleep apnea (OSA) is reported in a high proportion of cardiac surgical patients, up to 73%. STOP-BANG is a validated questionnaire for screening of outpatients for OSA with high sensitivity. There is sparse literature from India regarding the prevalence of OSA in preoperative cardiovascular patients and the utility of screening tools.

We sought to study the utility of the STOP-BANG questionnaire as a screening tool for OSA in cardiovascular patients validating it with ambulatory level 3 polysomnography.

It was a prospective study where consecutive patients getting admitted for coronary artery bypass surgery (CABG) from August 2017-February 2019 were recruited. All the patients were screened with the STOP-BANG questionnaire. 53 patients underwent overnight level 3 polysomnography using Apnea-Link. Correlations were made between clinical symptoms, STOP-BANG score, and OSA severity, measured using Apnea hypopnea index (AHI).

We had 120 patients(103 males) with a mean age 60 years. Snoring wasnical parameters, airway narrowing and neck circumference can predict OSA.

Transcatheter paravalvular leak (PVL) closure in recent times has emerged as a safe and effective alternate to redo-surgical repair. We sought to examine the clinical efficacy and safety of percutaneous PVL closure at our center.

A retrospective study from August 2012 to December 2019 of 19 patients who underwent 21 procedures for PVL closure. The mean age was 49.25 ± 14.72 years. The target valve was mitral in 11 (57%) and aortic in 7 (36%) cases. One (5%) patient had prosthetic valve in left atrioventricular valve with congenitally corrected transposition of great arteries. Majority of the cohort presented with heart failure without hemolysis (89%), with most of them being in NYHA functional class III (57%) or class IV (21%). A procedural success of 85% was achieved. Post procedure severity of regurgitation reduced from severe in thirteen patients and moderate in six patients to moderate in two patients and mild in fourteen patients. Symptomatic improvement was observed in all cases who had successful closure with NYHA function class improving from 3 ± 0.64 to 1.6 ± 0.94. The mean follow-up duration was 21 ± 13 months (median 24 months). There was one (4.7%) mortality with cumulative survival from all-cause mortality of 95%.

The results of percutaneous PVL closure appear encouraging in our series with modest number of patients and offers a promising alternative to redo-surgery in this high-risk cohort.

The results of percutaneous PVL closure appear encouraging in our series with modest number of patients and offers a promising alternative to redo-surgery in this high-risk cohort.

Postoperative delirium (POD) is a common complication in cardiac surgery especially in elderly population which can lead to a delay of weaning from ventilator and extubation. Cardiopulmonary bypass (CPB)-induced inflammation is related to POD. Anti-inflammatory effect of anesthetic agent might attenuate POD.

The present study was primarily aimed to compare within-24-h POD between ketamine-based anesthesia and propofol-based anesthesia during CPB. The secondary objective was to identify risk factors associated with within-24-h POD.

Our study was a randomized controlled trial in patients undergoing cardiac surgery with CPB. Enrolling patients were aged >65 years, and able to comprehensive communication. Exclusion criteria were aortic surgery, cognitive disorders, cerebrovascular and carotid disease, and positive result of preoperative CAM-ICU.

Patients were randomly assigned to group Ketamine infusion of 1 mg/kg/h and group Propofol infusion of 1.5-6 mg/kg/h during CPB. POD was evaluated by validatederative inflammation was a significant prediction of 24-h POD.

Cardiopulmonary bypass (CPB) induced acute lung injury is accounted for most of the post-operative pulmonary dysfunction which leads to decreased compliance and hypoxemia. Airway Pressure Release Ventilation (APRV) as compared to other modes of ventilation has shown to improve gas exchange in Acute lung injury (ALI)/Acute respiratory distress syndrome (ARDS) lungs.

We hypothesized APRV as a better primary mode of postoperative ventilation in adult post-cardiac surgery patients.

The study included 90 postoperative surgical patients, which were randomized into three groups SIMV-PC(P), APRV(A), and SIMV-VC(V) with 30 patients in each group.

Lung compliance and serial arterial blood gas were assessed at regular intervals. PaO

/FiO

ratio (a measure of oxygenation) and lung compliance were used as an indirect indicator for improvement in lung function. Hemodynamic parameters were closely observed for all the patients.

Statistical analysis was done using 'R' software.

There was a statistically significant improvement in PaO2/FiO2 ratio in the APRV group as compared to other groups. There was also an improvement in lung compliance after 6 h of ventilation and lesser duration of ventilation in the APRV group. However, it was not statistically significant.

Our study suggests that APRV can be a useful alternative primary mode of ventilation to improve lung compliance and oxygenation in adult post-cardiac surgical patients.

Our study suggests that APRV can be a useful alternative primary mode of ventilation to improve lung compliance and oxygenation in adult post-cardiac surgical patients.

In this study we compared noninvasive arterial pressure measurement using ClearSight™ vascular-unloading-technique (Edwards Lifesciences Corp, Irvine, CA) with invasive arterial pressure measurement during induction of anesthesia undergoing mayor cardiac surgery.

Prospective, monocentric.

University hospital.

54 patients undergoing mayor cardiac surgery.

During induction all patients were simultaneously monitored with invasive (reference method) and noninvasive arterial pressure measurement (test-method) over a mean time period of 27 minutes.

We observed slightly lower systolic and mean arterial pressures noninvasive than invasive. For systolic arterial pressure the mean of the differences was -18,05 mmHg (p < 0,05, SD ±16,78 mmHg), the mean arterial pressure MAP -5,47 mmHg (p < 0,05, SD ±11,08 mmHg) and for diastolic pressure -1,09 mmHg (p < 0,05, SD±11,15 mmHg),. The mean of the differences in heartrate was 1,15 (p < 0,05, SD±6,9 mmHg). When considering all measured values of the invrement offers sufficient security to safely initiate anesthesia, especially when MAP is of particular interest. The use of non-invasive arterial blood pressure measurement with ClearSight ™ during induction of anesthesia in patients scheduled for major cardiac surgery is reliable and easy to use.Cemento-osseous dysplasia is non-neoplastic, reactive fibro-osseous lesions that affect the tooth-bearing areas of the jaws. Osseous dysplasia is further divided into three subtypes Periapical osseous dysplasia, focal osseous dysplasia, and florid osseous dysplasia. We hereby, present a case of florid cemento-osseous dysplasia occurring in a 40-year old dentulous Indian woman. The patient presented with lesions involving the mandibular right and left quadrant.Hemangioma is a relatively common benign proliferation of blood vessel that primarily develops during childhood. Sodium Bicarbonate cell line It is a most common benign tumor of vascular origin is the region of head and neck. The common sites are lips, tongue, buccal mucosa, and palate in oral cavity. Due to aesthetic concern and appearance problems of the hemangioma of lower lip and face it requires appropriate management. This is a case report of a rare hemangioma of lower lip and face bilaterally with involvement of mandible, floor of mouth, oropharynx, anterior 2/3rd of tongue parotid/submandibular glands in a 46-years-old female along the course of facial artery bilaterally with arterial feeders from the facial artery bilaterally, and draining into the jugular veins. This type of case is being reported first time in English literature.Gingival enlargement (GE) is a well-known clinical phenomena with the primary aetiology being plaque and poor oral hygiene. Many reasons for GE have been known. Most of the time good oral hygiene is sufficient to achieve normal healthy gingiva. GE is a heterogeneous group of disorder characterized by progressive enlargement of the gingiva with an increase in submucosal connective tissue elements. Some of them are inherited and iatrogenic while others are idiopathic. In this case, we report a case with massive idiopathic GE in a 9-year-old female child; treatment received, histopathological description and follow-up are discussed.A young female sought treatment for a painful swelling in the right mandibular posterior region for the past 1 month with severe halitosis and paresthesia of right lower lip. Past history revealed that #46 was impacted due to an odontogenic tumor and an unsuccessful attempt was made to remove the impacted teeth and the tumor. A warm, tender, mild extra-oral diffuse swelling with right side cervical lymphadenopathy present. Intra-orally, there was a missing crown of 46 with a diffuse, tender buccal cortical expansion with a draining sinus. Imaging studies revealed a radiopaque lesion with a well-defined and rounded radiolucent halo. A provisional diagnosis of acute suppurative osteomyelitis was made and the remaining roots along with the radio-opaque material removed in toto via an open approach method and the entire area reconstructed with autograft harvested from rib. Histopathologically lesion was diagnosed to be a complex composite odontome. The challenges of diagnosis and the implication are discussed.Accidental detection of asymptomatic clinically suspicious lesions is a common occurrence in routine clinical examination of the oral cavity. In certain cases, these lesions may mimic benign lesions further adding to confusion. In this case report, we have discussed the case of a 51-year-old male patient with an asymptomatic palatal mass which was detected during a routine dental check-up and subsequently confirmed to be an adenoid cystic carcinoma (ACC) arising from the minor salivary glands. The patient underwent right partial maxillectomy followed by radiation therapy and has been disease-free for 6 years and is on follow-up. ACC is a malignant tumour of the salivary glands commonly occurring in the palate, characterized by a slow indolent growth phase, with a high predilection for late recurrences which can be local or systemic. This article describes the importance of recognizing this clinical entity as a differential diagnosis in the evaluation of asymptomatic palatal lesions to enable early diagnosis and institution of appropriate treatment to successfully treat the disease.