In order to eliminate the complication of bleeding following open heart surgery we studied a group of patients in whom the pre-operative international normalized ratio (INR) was estimated. Those with INR less than 2 had less bleeding. Those with INR between 2 nd 2.5 need individualized management and may require aprotinin. (Ind J Thorac Cardiovasc Surg, 2004; 20: 132-134)

Background and aim of study: The TTK Chitra mechanical heart valve is being widely used in India. We

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stitches on the pericardium ensured exposure of inferor vena cava and pulmonm T trunk. Aortic and bi caval cannulation was employed for conduct of CBP. Vacuum assisted drainage was used. Under hypothermia, antegrade cardioplegia was infused. Right atriotomy was similar to conventional stermotomy approaches. Retraction stitches on trisuspid annulus/right ventricle (RV) exposed the interior of RV/transannular area. VSD closure, infundibular resection & pericardial patch enlargement were undertaken in the standard way.Results: There was no mortality. Mean length of skin incision was 5 cm. Mean bypass and clamp time were 143+53 mins and 84+42 mins. Median ICU and hospital stay were 2 days and 10 days. No patient required conversion to full sternotomy/femoral cannulation.Conclusions: MS is cosmetically appealing and safe. It does not require any new instruments/femoral arterial cannulations. All transatrial procedures are amenable to this technique. It provides adequate access, visibility & reduces the chances of mediastinitis with sternal instability.