Rheumatic valvular heart disease is quite common in Bangladesh. It affects most commonly mitral and aortic valve. As a result of annular fibrosis, aortic root become smaller in some patients. So, if smaller prosthesis is implanted, there is gross patient prosthesis mismatch (PPM), poor LV regression, increase overload, and ultimately low survival rate. Its' to report our experience in aortic root enlargement in case of double valve replacement where a patient of severe mitral stenosis and aortic regurgitation with small aortic annulus requiring aortic root enlargement (ARE).Weaning from Cardiopulmonary bypass (CPB) was uneventful, perioperative and post operative period was satisfactory. Post-operative echocardiography revealed normally functioning prosthesis. In case of small aortic root, aortic root enlargement (ARE) can be safely done by double valve replacement to overcome the prosthetic patient mismatch (PPM). KYAMC Journal Vol. 11, No.-2, July 2020, Page 108-110

Single atrium is a rare congenital heart disease in which there is developmental absence of both septum primum and secondum part of atrial septum. this report of rare case is to share our experience in surgery for Single atrium. Patient with single atrium with persistant left superior venacava (PLSVC) and left sided Inferior venacava (IVC) underwent gluteryldehye treated autologous pericardial patch closure, separating the two atria and leaving the coronary sinus, both PLSVC and Left IVC in the right atrial side and drainage of all four pulmonary vein into Left atrium. Post operatively there was no conduction defects in electrocardiogram and echocardiogram showed no residual shunt across the neoatrial septum. The long-term survival of surgical correction of single atrium is good. To avoid injury to the conduction system one has to be utmost careful by keeping the sutures remote and superficial from the bundle. KYAMC Journal Vol. 10, No.-1, April 2019, Page 54-56

Background: Coronary artery bypass surgery (CABG) with cardioplegia has been considered the gold standard operation for coronary revascularization. Activation of compliments system after CABG surgery involves C-reactive protein (CRP). Patients with preoperative increased CRP levels have significantly higher CRP levels on postoperative days and are at increased risk of developing postoperative complications. High sensitivity CRP ( hs-CRP ) is lower concentration of CRP measured by the hs-CRP test. It is more sensitive and more useful in predicting the potential risk level for cardiovascular disease, heart attacks and strokes. Objective: To assess the association of preoperative hs-CRP level with the incidence of postoperative arrhythmia, low output syndrome and sternal wound infection following on pump CABG surgery. Materials & Methods: The study was cross sectional analytical study. A total of 70 patients were selected. For the purpose of analysis the study subjects were divided into two group; Group A patients with preoperative hs-CRP level <3mg/l (n=35) and Group B patients with preoperative hs-CRP level >3mg/l (n=35). The incidence of early outcome- arrhythmia, low output syndrome and sternal wound infection were observed within 30 days of surgical procedure. Results: The incidence of arrhythmia, low output syndrome and sternal wound infection were significantly less in group A than those in group B. Logistic regression analysis showing significant correlation of hs-CRP with arrhythmia, p value is 0.005; with low output syndrome, p value is 0.003 and with sternal wound infection, p value is 0.004. Conclusion: Preoperative hs- CRP is an important determinant of post operative outcome after CABG surgery and might be useful as predictive marker in risk stratification for postoperative complications in patients scheduled for on pump CABG surgery. KYAMC Journal Vol. 9, No.-4, January 2019, Page 153-158

Background: Ever Since its inception , minimally invasive cardiac surgery is growing rapidly for better convenience and superb post operative outcome. As newer instruments, surgical technique and operative exposure are increasing more and more patients are demanding minimally invasive cardiac surgery. Objective: The study was conducted to evaluate the various pre operative and peroperative factors in minimally invasive cardiac surgery. Materials and Methods: A retrospective observational study on the patients who underwent minimally invasive cardiac surgery in the department of cardiovascular and thoracic surgery, Khwaja Yunus Ali Medical College, Sirajganj, Bangladesh from January 2016 to December 2020. Results: A total of 40 cases were operated through minimally invasive cardiac surgery in our department. Maximum number of cases was Atrial septal defect(ASD), and minimally invasive direct coronary artery bypass (MIDCAB). About 62.50% were female, majority of patients were in the range of 11-15 years. Right anterolateral thoracotomy was done in 27 cases and left anterolateral thoracotomy in 10 cases. The maximum number of cannulation done in femoral artery and femoral vein, followed by direct superior vena caval cannulation and only a single percutaneous superior venacaval cannulation through internal jugular vein. In 14 cases the length of incision was in the range of 3-4 cm and 12 cases in 4-5cm. Conclusion: Minimally invasive cardiac surgery is now becoming more demanding. As more and more centers are opening the door to newer technology, common people are also becoming conscious about its excellent post operative outcome. KYAMC Journal.2021;12(02): 71-74

Sinus of Valsalva Aneurysms are extremely rare cardiac anomalies.The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its may be either acquired or congenital. The right coronary sinus is most frequently affected. The most common complication being rupture.We present the case of a 12-year old girl with ruptured non-coronary sinus of valsalva aneurysm associated with ventricular septal defect , mitral regurgitation grade II and severe pulmonary hypertension. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion,rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short-and long-term.