Background and Aims: Improvement in quality of life is one of the principal goals of valve surgery. The purpose of this study was to assess the quality of life in patients living with mechanical heart valves. Methods: We conducted a cross-sectional descriptive study among 131 (42 Males, and 89 Female) patients, who had undergone valve procedures at different times in clinic visit of department of cardiac surgery, unit I of Shahid Gangalal National Heart Centre from August 1 till August 29, 2019. Quality of life index was measured using Ferrans and Power quality of life index, cardiac version IV via written questionnaire or verbal interview. Results: Mean age was 40.57±1.4 (16-75) years. Mean duration of follow up was 4.68±4.03 years (3 months to 18 years). Subjects reported the lowest quality of life scores in the health and functioning domain prior to surgery (15.61±1.30), which improved 47.15% after surgery (22.95±0.45), psychological/spiritual domain improved 16.68%, social and economic domain 26.24%, family domain 11.49%, with overall improvement 28.62%. Women had significantly lower mean overall quality of life index (22.99±03.58) (95% confidence interval 22.24-23.75) compared to male counterparts (24.21±4.11) (95% confidence interval 22.92-25.49) (p<0.05). Family domain had the highest score at the latest follow up (28.84±1.63). There was a statistically significant correlation between the duration of operation and overall quality of life index (Pearson's rho 0.217, p<0.01). There was no significant difference with the patients’ age. Conclusion: This study confers significant improvement of quality of life after valve surgery with time. Age does not appear to limit the quality of life. Family support seems to be the biggest strength in our population.

Double outlet right ventricle (DORV) with or without pulmonary atresia is a common indication for Rastelli operation. We very infrequently perform this surgery in our center. Here, we report a case of a ten-year-old girl who recently underwent Rastelli operation and patent ductus arteriosus (PDA) ligation for DORV, pulmonary atresia with ductal dependent pulmonary circulation by using custom-made valved conduit

The occurrence of acute aortic rupture after aortic valve replacement is unusual; but catastrophic. We report a case of a 71-year-old gentleman with a bicuspid aortic valve who developed acute aortic rupture after an elective bioprosthetic aortic valve replacement surgery in which successful repair was carried out with the preservation of the prosthetic valve.

Abstract:Ebstein's anomaly is a rare congenital cardiac malformation that affects the tricuspid valve commonly, but its association with pericardial disease is even rarer. We report a case of 25 year old man presented with dyspnoea on exertion and fatigability. A diagnosis of Ebstein's anomaly with atrial septal defect (ASD) with constrictive pericarditis was confirmed using transthoracic echocardiography. Peroperatively pericardiotomy was done after meticulous dissection of pericardium. Under cardiopulmonary bypass tricuspid valve was replaced with 29 mm Edward life science porcine tissue heart valve with direct closure of ASD. Patient showed excellent symptomatic improvement and was discharged on 7 th POD with advice and after 3 months of follow up patient was doing well post operartive day.

Background and Aims: Factors responsible for complications and outcomes of surgical closure of ventricular septal defect differ between different cardiac centers globally. In this study, we tried to evaluate outcomes and predictors of morbidity and mortality of surgical closure of VSD in a single center. Methods: The retrospective cohort study was conducted in Shahid Gangalal National Heart Centre from 14th April 2018 to 13th April 2020. It included consecutive series of patients undergoing ventricular septal defect closure as a primary surgery   Results: Out of a total 166 patients, males were 100 (60%). Adverse complications occurred on 36 (21%) with mortality of 6 (3.6%). The age ranged from 4 months to 35 years. The weight <10 kgs at the time of operation had significant post-operative prolong ventilation duration (more than 6 hours) with a p value of 0.012; significant prolong ICU stays (>2 days) with a p value of <0.001; significant prolong hospital stay (> 7 days) with a p value of <0.001. The longer CPB time was associated with significantly prolonged ventilation duration (p value 0.001); significant longer ICU stay (p value 0.02). The age <1 year at the time of operation had significant prolonged ICU stay; significantly prolonged hospital stays (p value of 0.033). Severe pulmonary artery hypertension (PAH) and weight up to 10 kgs at the time of operation demonstrated a trend towards association with mortality. Conclusion: Surgical VSD closure can be done with acceptable level of mortality and morbidity in our context.