Backaround: Surgical myocardial revascularization in certain subset of patients carries significantly higher morbidity and mortality. Off pump myocardial revascularization versus revascularization using cardiopulmonary bypass and cardioplegic arrest in these patients remains a matter of debate. We evaluated our results of off pump myocardial revascularization in these palients by comparing them with similar group of patients who underwent off pump myocardial revascularization at another prime institute of the country, Methods: From October 2004 to September 2005, 181 patients were operated for off pump CABG at our institute. Out of these, data for 132 patients having one or more adverse prognostic factors were retrospectively entered into a database. These factors included: • Unstable angina. • Recent acute myocardial infarction. • Severe left ventricular dysfunction • Critical left main coronary artery stenosis. • Diffusely diseased or small or intramyocardial target arteries, • Patients' operated as emergency. Results: Hospital mortality was nil. Mean duration of mechanical ventilatory support was 10.75 hours (Standard deviation of 5.76 hours) Mean duration of ICU stay was 4.22 days. (Standard deviation of 0.89 days) Mean duration of postoperative hospital stay was 8.06 days (Standard deviation 1.18 days) Complications: • Post operative atrial fibrillation in 8 patients (6.06%) • Ventricular tachycardia in 1 patient (0.76%) • Respiratory insufficiency requiring ventilatory support in 2 patients (1.52%) • Pulmonary oedema in 1 patient (0.76%) • Pre-renal azotemia in 1 patient (0.76%) • Myoclonic seizures in 1 patient (0.76%) • Chest wound infection in 1 patient (0.76%) • Leg wound infection in 3 patients (2.27%) • Urinary tract infection in 1 patient (0.76%) Conclusions: Our experience of off pump CABG in high risk patients compares well with published results of contemporary cardiac surgery. in India.Background: Patients above the age of 65 comprise a significant proportion of those being referred for CABG. Total arterial revascularization is often not considered an option owing to their age. We have followed the principle of using only arterial conduits in all patients -whatever the age or gender. Our aim is to study the feasibility and the effects of such a policy.

Materials that are difficult to cut possess excellent qualities and machinability, though conventional machining techniques require additional energy to circumvent the problems associated with the turning process. In this study, heat-assisted turning of duplex stainless steel (SS) was carried out. Various heating techniques such as infrared (IR)-, ultraviolet (UV)- and hot air (HA)-assisted heating were adopted. The experiment used an L16 orthogonal array with the most significant parameters such as heating method, feed rate in millimetres per revolution (mm/rev), depth of cut (millimetres [mm]) and cutting speed (metres per minute [m/min])on the cutting force and surface roughness. The technique for order performance by similarity to ideal solution (TOPSIS) and grey relational analysis (GRA), were used to optimise the output performance. The results of TOPSIS showed that the 16th experimental combination, i.e., the HA heating method, with feed rate = 0.175 mm/rev, depth of cut = 0.1 mm and cutting speed = 150 m/min, required a smaller cutting force and resulted in lower surface roughness. In case of the GRA method, the best output performance was observed for the 15th experimental combination, that is, the HA heating method, with feed rate = 0.15 mm/rev, depth of cut = 0.2 mm and cutting speed = 200 m/min. Compared to the non–heat-assisted turning process, the HA- and UV-assisted processes required 10.25% and 7.69% lesser cutting force, respectively, and the surface roughness in case of the HA method was 15.13% lesser.