RCLT is an effective and safe approach for circumflex artery revascularization with excellent short- and mid-term results using either technique. The OPCAB technique is associated with reduced blood product utilization and shorter ICU and hospital length of stay and, therefore, is more cost-effective.

Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), or off pump, has gained popularity by avoiding the postoperative morbidity related to the use of CPB. Previously, we have demonstrated that CABG done on pump using heparin-bonded cardiopulmonary bypass circuits (HBC) with a lower anti-coagulation protocol (LAP) attenuates these effects, reduces homologous blood product requirement, and improves clinical outcome when compared with conventional CPB circuits. Our purpose in this study was to compare off-pump CABG clinical outcomes to on-pump CABG using HBC with LAP. We retrospectively analysed preoperative and postoperative variables of all primary CABG (n=1214) performed at this institution from 1 January 1997 to 28 July 2000. These patients were divided into the on-pump (n=1152) and off-pump groups (n=62). HBC with LAP were used in all on-pump CABG cases. There was no statistical difference in preoperative comorbid risk factors except percentage of females (on pump, 30% vs. off pump, 44%; p=0.02) and body surface area (on pump, 1.94 +/- 0.25 ml vs. off pump, 1.85 +/- 0.22 ml; p=0.02). There was no difference in intraoperative and postoperative complications, risk-adjusted mortality, total blood product usage, or length of stay. The mean number of distal anastomoses performed was significantly different (on pump, 3.5 +/- 0.82 vs. off pump 1.8 +/- 0.82; p < 0.001). Despite similar preoperative risk factors, clinical outcomes and homologous blood requirements were not statistically different between the off-pump and on-pump groups. These endpoints should not be the only criteria to justify performing off-pump CABG.

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Introduction: Trochanteric fractures are extra capsular fractures resulting commonly among elderly patients due to trivial fall. The complications of the surgeries result in severe life threatening conditions, consequently leading to increased disability, mortality and decreased quality of life. This study was done to assess the surgical outcomes of trochanteric fractures using a composite scoring system. Methodology: This cross sectional study was carried out among 40 patients with trochanteric fractures who were treated surgically using Dynamic Hip Screw (DHS) or Dynamic Condylar Screw (DCS). A comprehensive scoring system was developed considering clinical, radiological and functional outcomes assessment. Results: In 40 cases of trochanteric fractures type I and type II were 33 cases constituting an incidence of 82.5% and type III and type IV constituting an incidence of 17.5%. About 36 cases (90%) were operated by dynamic hip screw and plate (DHS) and in 4 cases (10%) dynamic condylar screws and plating (DCS) were deployed. About four participants developed post operative complications. Excellent to good outcomes were obtained in 29 cases (72.5%), fair results in 8 cases (20%) and poor results in 3 cases (7.5%). Conclusion: Management of trochanteric fractures by DHS technique produces better functional outcomes and also improves the quality of life to pre fracture states, especially among older patients.