We present a case with left isomerism, interruption of the inferior caval vein, anomalous systemic venous drainage with partially anomalous pulmonary venous drainage, and a sinus venosus type of atrial septal defect in the absence of a right superior caval vein. This report is of interest because of a rare combination of these anomalies, which was accurately diagnosed and successfully repaired.

We present two modifications of the “button technique” and proximal aortic conduit suturing for patients undergoing modified Bentall's procedure. We interposed a glutaraldehyde-treated autologous pericardial strip between the graft and native coronary ostia during coronary ostial implantation and placed interrupted aortic annular pledgeted mattress sutures to ensure perfect hemostasis at the suture lines.

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Objective: To study the outcome of normothermic beating heart pulmonary thromboendarterectomy (PTE) performed in patients with chronic pulmonary thromboembolism. Methodology: A retrospective analysis of 15 patients who underwent PTE under normothermic beating heart cardiopulmonary bypass from July 2009 to September 2018 was done. The patients were followed up with clinical assessment, transthoracic echocardiography and computerized tomographicangiography (CTA) for 1 month to 82 months. Results: Data were analysed for 15 consecutive patients. Mean age of the patients was 35.28 years and 10 patients were male. Pre-operatively 6 (40%) patients presented with New York Heart Association (NYHA) class II dyspnoea on exertion symptomatology, 7 (47%) were in NHYA class III, and 2 (13%) were in NYHA class IV. The preoperative and postoperative mean pulmonary artery pressures (mPAP) (mmHg) were 36.50 ± 11.3 and 20.21 ± 7.19, the systolic PAPs (mmHg) were 73.35 ± 14.12 and 35.21 ± 7.89 and the diastolic PAPs (mmHg) were 19.28 ± 8.60 and 12.85 ± 7.26 respectively. 2 (13%) patients had Jamieson's type I and 12 (87%) had Jamieson type II disease. One patient (7%) expired on 9 th postoperative day. All the patients had improved pulmonary gas exchange and did not require oxygen supplementation from 5 th postoperative day; symptoms improved to NYHA class I & II in 12 (80%) & 3 (20%) of patients respectively. There was no reperfusion pulmonary edema or any neurologic complications. Postoperative echocardiogram showed improved right ventricular function and Computerised Tomographic Angiogram showed completeness of the procedure. Conclusion: Pulmonary thromboendarterectomy under normothermic beating heart cardiopulmonary bypass has good immediate postoperative results with significant progressive improvement in hemodynamics and quality of life during the course of follow-up. The results were not only comparable to those of the procedure done How to cite this paper: Bisoi, A