Background: Mitral valve replacement (MVR) is a surgical procedure that is often performed in patients with severe mitral valve disease, to replace the damaged valve with a new artificial valve. Left Atrial Volume Index (LAVI) is a measurement of the size of the left atrium of the heart, normalized to the body surface area which is often used as an indicator of left atrial enlargement, which is a common finding in patients with mitral valve disease. There is a significant relationship between LAVI and Atrial Fibrillation (AF) after MVR in patients with mitral valve disease. Aim of the study: The aim of this study was to evaluate the relationship between LAVI and the occurrence of atrial fibrillation after mitral valve replacement in patients with mitral valve diseases. Methods: This prospective observational study was conducted in the department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka from March, 2018 to February, 2019. Total 60 patients were divided into two groups, out of them 30 patients had LAVI e”39 ml/m² (Group-A) and 30 patients had LAVI d” 39ml/m² (Group-B). Result: In patients with post-operative AF after MVR, was evaluated by ECG in the presence or absence of pwave and irregular R-R interval and measurement of LAVI more or less than cutoff value 39 ml/m². On postoperative day 3, 7 (23.33%) patients in Group A and 02(6.66%) patients in Group B developed post-operative AF. In Group A there was reduction in the LAVI but not below the cutoff value whereas in Group B, the LAVI was reduced below the cutoff value (< 39 ml/m2). On overall evaluation, after mitral valve replacement increased LAVI is significantly associated with post-operative AF occurrence and is a better predictor than LA diameters. From univariate analysis in our cohort, high inotropes support, MVT, ACT, CPB time and postoperative LAVI were significantly associated with occurrence of AF. But multiple logistic regression analysis revealed postoperative LAVI to be only significant predictor of occurrence of AF after Mitral valve replacement. Conclusion: Our study shows that postoperative LAVI measured by 2-D echocardiography is positively and independently associated with the occurrence of postoperative AF following MVR. Moreover, clinical risk factors are fairly good predictors of the occurrence of AF after MVR, but postoperative LAVI was the most significant independent predictor of postoperative AF in our study. Bangladesh Heart Journal 2023; 38(1): 38-45

Background: Video-assisted thoracoscopic surgical decortication (VATS Decortication) is one of the technique for treating empyema thoracis. Objective: The purpose of the present study was to assess radiologic and functional short-term outcomes of VATS decortication in comparison with open decortication among empyema thoracis patients. Methodology: This comparative type of observational study was done at Department of Thoracic Surgery at National Institute of Diseases of Chest and Hospital (NIDCH), Dhaka, Bangladesh from July 2018 to June 2019 for a period of one year. Patients with empyema thoracis in stage II or III were included. Short-term outcomes were measured according to collection of chest drain tube in post-operative observational days (PODs), post-operative lung expansion, time taken for chest drain tube removal, postoperative hospital stay and post-operative pain (numeric rating scale) observations up to discharge from hospital. Result: A total number of 70 patients were recruited. The mean age was 36.20 ± 12.50 years. In post-operative phase apical chest drain tube collection followed by VATS procedure was found significantly lower than that of open decortication (2nd POD: p= 0.04; 3rd POD: p =0.039). Both the apical (p=0.001) and basal (p=0.039) chest drain tubes were removed earlier in patients with VATS decortication. Again, patients with VATS decortication had to stay less days in post-operative time (p=0.01). The mean post-operative pain scores was significantly higher among the patients underwent open decortication (p<0.001). Conclusion: VATS decortication has shown better outcome in terms of collection of chest drain tube in post- operative days, time taken for chest drain tube removal, post-operative hospital stay and post-operative pain in managing patients with empyema thoracis. Journal of Current and Advance Medical Research, July 2021;8(2):100-105