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Year : 2016  |  Volume : 4  |  Issue : 2  |  Page : 43-44

Preface to second issue of Heart India 2016

Department of Cardiology, Heritage Hospital, Varanasi, Uttar Pradesh, India

Date of Web Publication6-Jun-2016

Correspondence Address:
Alok Kumar Singh
Department of Cardiology, Heritage Hospital, Varanasi, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-449X.183501

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How to cite this article:
Singh AK. Preface to second issue of Heart India 2016. Heart India 2016;4:43-4

How to cite this URL:
Singh AK. Preface to second issue of Heart India 2016. Heart India [serial online] 2016 [cited 2022 Jan 21];4:43-4. Available from: https://www.heartindia.net/text.asp?2016/4/2/43/183501

In this issue, we are publishing two review article, two original article, and four case reports and journal watch. Resistant hypertension (HTN) is defined as blood pressure above target goals in patients using three different antihypertensive drugs in maximum tolerated doses including a diuretic. Increased sympathetic nervous system activity has been identified as one potential cause for resistant HTN. Catheter-based renal denervation (RDN) has been studied in different subgroups of patients for the treatment of resistant HTN. In first review article, Khan et al. have extensively reviewed the role of RDN in the management of resistant HTN.

The indications for implantable cardioverter defibrillators (ICDs) for the prevention of sudden cardiac death (SCD) have rapidly expanded over the last two decades. The recently introduced subcutaneous ICD (S-ICD) uses a completely subcutaneous electrode configuration to treat potentially lethal ventricular tachyarrhythmia. Clinical trials have proven its effectiveness in detecting and treating ventricular fibrillation (VF) and tachycardia. The S-ICD offers the advantage of eliminating the need for intravenous and intracardiac leads and their associated risks and shortcomings. However, major disadvantages of this device include inability to provide bradycardia rate support and antitachycardia pacing to terminate ventricular tachycardia. Pande et al. in the second review article have discussed the role of S-ICD in the management of SCD in comprehensive yet in concise manner.

Patients with moderate to severe hepatic dysfunction undergoing cardiac surgery have a high mortality. There is a paucity of data regarding the effects of cardiac surgery either with or without cardiopulmonary bypass (CPB) on patients with hepatic dysfunction. Indeed, the use of CPB with moderate to severe hepatic dysfunction is associated with increased postoperative bleeding, infections, renal failure, respiratory failure, and hepatic decompensation. In large randomized studies, these types of patients usually excluded from the study. In the first original article, Sharma et al. have studied the impact of hepatitis B positivity on overall outcome of cardiac surgery, and they have concluded that there is a considerable increase in mortality and morbidity among patients with hepatitis B infection that underwent open heart surgery. In 1996, Carpentier et al.[1] performed the first video-assisted mitral valve (MV) repair through a minithoracotomy using VF. Lukram et al. in second original research paper compared the quality of MV replacement performed through a submammary right thoracotomy incision with nerve sparing opening and closure to the standard midline sternotomy procedure. Authors of this study have concluded this procedure provides the same quality of treatment through a less traumatic and better cosmetic incision, resulting in less hospital stay and a lower overall cost.

Pulmonary embolism (PE) is the most preventable cause of in-hospital death. Although safe and effective, thrombolytic therapy is relatively contraindicated within 10 days of major surgery due to the risk of bleeding. In first case report, the author successfully managed the case with catheter-directed thrombolysis in submassive PE, within 48 h of surgery, without any bleeding complications. This case demonstrates that thrombolysis may be safely and effectively done in postoperative patients.

Cardiac mass is always challenging, especially in the right side of the heart that should raise suspicion of malignancy. Mouhebati et al. in the second case report reporting a case of 15-year-old poor growth and poor weight gain girl with dyspnea was detected to have a large homogeneous mass in the RV apex on 2-dechocardiography which disappeared 1 week after intravenous heparin therapy. A trial of anticoagulation should be considered when the differential diagnosis is difficult, and thrombus is a possibility.

In third case report, Kale et al. reporting a rare case of pulmonary arteriovenous fistula (malformation), right pulmonary artery to left atrium fistula, with its clinical and imaging findings with multidetector computed tomography pulmonary angiography and dynamic 3.0 T magnetic resonance imaging pulmonary angiography in a 2-year-old female child who presented with central cyanosis at the age of 18 months.

Coronary artery air embolization is a rare complication of cardiac catheterization that leads to catastrophic consequences within seconds after an introduction of air bubbles in the coronary circulation. Rapid and aggressive management is essential to ensure the best chance of recovery in such cases. In fourth case report, Chand et al. reporting an unusual occurrence of large air embolization during elective percutaneous transluminal coronary angioplasty in a 41-year-old male patient. The patient experienced sudden severe retrosternal chest pain, followed by loss of consciousness, hypotension, flattening of aortic pressure curve, and severe bradycardia. Immediate attempts were made to remove the air embolus by performing continuous saline flush through a guiding catheter and using other supportive resuscitation measures. The attempts were successful, which ultimately resulted in relieving patient's symptoms and offering an uneventful recovery. In the last, I am discussing the salient finding of five good original research articles from leading journals which will have an impact on future cardiology practice in significant ways.

  References Top

Carpentier A, Loulmet D, Carpentier A, Le Bret E, Haugades B, Dassier P, et al. Open heart operation under videosurgery and minithoracotomy. First case (mitral valvuloplasty) operated with success. C R Acad Sci III 1996;319:219-23.  Back to cited text no. 1

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