Introduction
Creation of arteriovenous fistulas (AVF) for providing vascular access in patients dependent on hemodialysis is a very frequent type of surgery. One of the common complications of such a fistula is the formation of an aneurysm or a pseudoaneurysm and the risk of impending rupture. These are a few of the reasons why such surgically created AVF have to be taken down surgically. Some of these may be taken down for cosmetic reasons electively while some present in an emergency due to rupture of the aneurysm itself.
Aim
This is a retrospective study of 26 patients who underwent AVF takedown at our center over a period of 4 years.
Material and methods
We intended to study the patient profile, the surgery that they underwent and the post-operative course of these patients.
Results
We found that aneurysm formation was the most common reason for a takedown, although we did see a good percentage of patients who presented to us with a ruptured AVF aneurysm. Our procedure was a ligation of the aneurysm with resection of the aneurysmal segment and maintaining arterial continuity. No attempt to preserve the fistula was made in any of these cases.
Conclusions
This article gives a brief overview of our experience in AVF takedown.
Cor triatriatum sinister is a rare congenital cardiac anomaly in which a fibromuscular membrane divides the left atria into 2 chambers. It is even rarer when present at an adult age. Symptoms and presentation of the patient depend on the size of the opening into the membrane through which 2 chambers of left atrium communicate with each other. Cor triatriatum sinister rarely remains asymptomatic till adulthood. In adults symptoms of Cor triatriatum sinister mimic the symptoms of mitral stenosis. Corrective surgery is the choice of treatment, but when it present as an emergency case especially at an early age, balloon dilatation of the membrane opening is done. Elective balloon dilatation of membrane opening at an early age diagnosed with Cor triatriatum sinister followed by corrective surgery at an adult age can be a safer option compared to direct corrective surgery at an early age. We present a case of a 25-year-old female who was diagnosed first time at this age as cor triatriatum sinister and treated successfully with corrective surgery.
Introduction
Aneurysms of sinuses of Valsalva are rare aortic anomalies having an incidence of 1.4–4.94% in the Asian population. Spontaneous rupture is the most common complication and ruptured aneurysms usually present with congestive cardiac failure.
Aim
Our study was aimed at evaluating the clinical profile of patients with ruptured sinus of Valsalva aneurysms (RSOVA) and their distribution, the surgical management and post-operative course.
Material and methods
We retrospectively identified 21 patients who presented to us with RSOVA over a period of 7 years and underwent surgery for the same.
Results
RSOVA was more common in young males. Most cases involved the right coronary sinus (RCS) followed by the non-coronary sinus (NCS). The site of rupture was mostly the right ventricular outflow tract or the right atrium. All patients had a relatively asymptomatic post-operative course in the ward. On follow-up, most of the patients were symptom free.
Conclusions
Surgery on cardiopulmonary bypass with moderate hypothermia with excision of windsock deformity and patching of the rupture site is a safe method of treating ruptured sinus of Valsalva aneurysms. Patients need to be followed up regularly to monitor for the development of aortic regurgitation.
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