Spontaneous Intramural left atrial hematoma that mimics a primary or metastatic cardiac tumor is a very rare entity. We report a case of a 60-year-old man suffering from chronic myeloid leukemia, who was admitted for prolonged chest pain and fatigue. Transthoracic echocardiography revealed a left atrial mass in close proximity to the posterior mitral annulus and failed to provide an ethiological diagnosis. Surgical management was utilized to outrule the atrial neoplasm and to prevent emboli, obstruction and mitral valve insufficiency. This is the first case in the literature in which robot-assisted minimally invasive surgery was adopted to manage such a rare entity.
The authors conducted a prospective, observational study to evaluate the correlation of fluid responsiveness with commonly used carotid doppler-derived indices like carotid artery blood flow (CBF), carotid corrected flow time (FTc), respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) in patients undergoing CABG. They claimed that altough only ΔVpeak demonstrated some predictive power with areas under receiver operating characteristic (AUROC) of 0.671, carotid doppler ultrasound indices were found to be not dependable as a substitute for invasive methods to assess fluid responsiveness. The presence of studies advocating quite different sentiments in the literature regarding feasibility and reliability show that there is a long way gone and a long way to go.
The authors performed a detailed retrospective analysis of diabetic patients undergoing isolated coronary artery bypass graft surgery (CABG) aiming to investigate the association of the preoperative Glycosylated hemoglobin with occurance of postoperative atrial fibrillation. Altough statistical analysis showed a weak relationship between HbA1c values of 9.06% or above and PoAF, they concluded that serum level of HbA1c could not be used as a predictor for the development of PoAF. But there are many questions to be asked and answers to be found.
The authors present an revolutionary study aiming to evaluate the effect of alterations in potassium concentrations in transfused packed red blood cells (PRBC) on neonate and infant potassium levels after congenital cardiac surgery. By establishing a strict protocol which restricts the rate of transfusion, the age of the transfused PRBC, and not transfusing a PRBC with a potassium level above 15 mmol/L, they accomplished to suggest a safe and easy way for preventing transfusion associated hyperkalemia.