Archive

Dermatofibrosarcoma Protuberans: Rare Tumor

Yogesh Yadav; Sheetal Asutkar*

    One of the rarest type of skin cancer - DFSP i.e. Dermatofibrosarcoma Protuberans, is uncommon soft tissue tumor involving dermis and subcutaneous but in some rare condition it involves muscles and fascia./p>


Injury-Induced Epidermal Cyst Located On the Finger - A Rare Case Report

Naveen Singh*; Devyani Dasar

    Examination of the tissue reveals a dermoid cyst characterized by a clearly outlined wall covered with layered squamous epithelium. The hollow space within the cyst might house fully formed adnexal structures originating from mesodermal sources, such as hair follicles, shafts, sebaceous glands, and eccrine glands.


Illustrative Case of External Ear Aural Atresia Clinical Perspectives

Naveen Singh*; Devyani Dasar; Yogesh Yadav

    A 15-year-old female presented at the Shalya Tantra OPD, MGACHRC Wardha, with complaints of a deformed left external ear and an absent ear canal since birth. She had experienced repeated throat infections throughout the year since birth, which had not been completely cured by medication.


A Unusual Clinical Case of Gastroschisis: A Congenital Anterior Abdominal Wall Defect

Yogesh Yadav*; Sheetal Asutkar; Naveen Singh

    A female patient aged 32 years with 36 weeks of pregnancy came to our hospital. She was referred from nearby primary health center because USG suggested of malformation of anterior abdominal wall.


Reviving Mobility: An Ankle Joint Skin Grafting Journey – A Case Report

Naveen Singh*; Devyani Dasar

    Skin grafting at the ankle joint presents unique challenges and complexities due to the joint's constant movement and weight-bearing nature. This delves into the journey of a patient undergoing this rare procedure, highlighting the intricacies of the surgical process


Management of a Vertical Impalement Injury

Selzer Tabea; Grzybowski Leszek; Rocco Barile La Raia; Horst Hahn; Lemke Arne-Joern; Hueseyin Bektas*

    An impalement injury is typically a severe and challenging trauma that necessitates close interdisciplinary collaboration among specialized medical disciplines. The rescue chain involves the mobilization of emergency services, initial treatment by the paramedic, transportation, care, and diagnostics in the emergency department of the appropriate hospital, surgical intervention, and the required follow-up care.


National Trends in Major Bleeding Requiring Transfusion and Permanent Pacemaker Implantation Rates Post-transcatheter Aortic Valve Replacement

Anand Muthu Krishnan*; George Zhang; Toishi Sharma; Harold L Dauerman; Rony N Lahoud

    TAVR has become the favoured Aortic Valve Replacement (AVR) strategy in elderly patients with Aortic Stenosis (AS) and is approaching equipoise with surgical AVR in younger patients [1]. Multiple contemporary studies have shown a significant proportion of patients undergoing TAVR requiring PPMI which led to significantly longer length of stay and incurred higher charges [2,3].


The Incidence and Associated Factors of Patient Cancellation Scheduled for Elective Surgery from February to May at Debremarkos Comprehensive Spetialized Hospital, Debremarkos, Northwest Ethiopia, 2022gc

Yitayal Guadie Ashebir*; Yohannes GodieAshebir; Dires Birhanu

    High rates of cancellation of surgical procedures are common in hospital settings which may subsequently lead to economic loss to hospital besides burden given to patients, their families and medical teams. It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload and wastes operating room time.


The Practice of Multimodal Analgesia Technique for Patients Undergoing Surgery Under General Anaesthesia in Debre Markos Compersive Specialized Hospital Debre Markos, East Gojjam, Ethiopia, 2022. A Cross-Sectional Study

Yitayal Guadie Ashebir*; Abebaw Misganew; Amare Anley Beyable; Samuel Debas Bayable; Yohannes Godie Ashebir

    Practice guidelines for preoperative pain management recommend that multimodal analgesic therapy should be used for postsurgical patients. This method uses different analgesic agents, which may target different components of pain transmission to improve post-operative analgesia and decrease reliance on opiate-based medication.


Does Vitamin D Supplements are Useful for Osseointegration Dental Implants in Patients with Type 2 Diabetes. Literary Review

Hakob Khachatryan DDS; Gagik Hakobyan DMSc, PhD*

    Conduct a literature review to determine the relationship between the level of vitamin D in the blood plasma and the osseointegration of dental implants installed in patients with type 2 diabetes mellitus. In Google Scholar, Medline, Scopus, Web of Sciences, PubMed a systematic review was conducted. Search keywords terms included the relationship between serum vitamin D levels and osseointegration, in relation to vitamin D deficiency and dental implant failure in patients with type II diabetes, the use of vitamin D supplements to enhance osseointegration in patients with type II diabetes.

Well-Differentiated Papillary Mesothelioma Complete Response after Laparoscopic Hyperthermic Intraperitoneal Chemotherapy (LHIPEC) Plus Intraperitoneal Chemotherapy; And a Review of the Literature

Ching-Hsien Ling; Haruaki Ishibashi; Takuji Fujita; Yang Liu; Satoshi Wakama; Syouzou Sako; Toshiyuki Kitai; Yasuo Hirono; Keizou Taniguchi; Daisuke Fujimoto; Yen-Cheng Chen; Yutaka Yonemura*

    Well-Differentiated Papillary Mesothelioma (WDPM) is a relatively rare disease with an indolent nature. However, due to its rarity, treatment policies differ between hospitals. The presented case was diagnosed with well-differentiated papillary mesothelioma after a diagnostic laparoscopy. She was treated with laparoscopic hyperthermic intraperitoneal chemotherapy followed by intraperitoneal chemotherapy and oral S-1 treatment

Large Right-Sided Complete Indirect Inguinal Hernia with Right Primary Vaginal Hydrocele

Shreya Soni*; Sheetal Asutkar; Sandeep kumar Upadhyay

    A male patient of 82 years old came, a Farmer by occupation came to the Outpatient of Shalya Tantra Department of Mahatma Gandhi Ayurved College and research centre with complaints of huge swelling in the Right Inguinoscrotal region which is irreducible in nature for 15 years. Initially, it was painless in nature as years passed dragging pain started and the swelling descended to the scrotum completely. Also, he had constipation for many years with increased frequency and intermittent urination.


The Impact of Mediterranean Diet Intake on Carotid-Intima Media Thickness: A Meta-Analysis

Author Names: Muhammad Ebad Ur Rehman; Nafhat Shaikh; Usama Abdul Ahad Memon; Muhammad Ishtiaq Obaid; Mohammad Saiem Shahzad; Muhammad Salahuddin Usmani; Muhammad Adil Obaid

    Globally, cardiovascular disease is the leading cause of mortality. Lifestyle and dietary habits have significantly proven to influence cardiovascular risk. Studies have shown beneficial effects of Mediterranean diet in cardiovascular patients. However, few studies have reported inverse relation between Mediterranean diet and Carotid intima media thickness, a surrogate marker of atherosclerosis. This has created ambiguity regarding the benefits of Mediterranean diet in cardiovascular patients as it is recommended in guidelines for prevention of cardiovascular disease.


Novel Abu Dhabi Subpectoral Biceps Tenodesis (ADSBT) Technique: Onlay Double Docking System Using Cortical Button

Jisoon Park; William Murrell; Nagib Atallah Yurdi*

    With more widespread use of biceps tenodesis, fairly high rate of mechanical failure and complications have been reported. This has led to a significant number of revision subpectoral tenodesis cases. To address this complication, the senior author, proposed a novel open subpectoral biceps tenodesis technique: Onlay double docking system using cortical button. The technique can be used for primary biceps tenodesis as well as revision indication that requires more reliable and rigid fixation strength and thus improving healing potential.


Clinical Implementations and Complications of Hirudotherapy in Plastic and Reconstructive Surgery and Modern Medicine

Nikoletta Vargas DMD, MS, PhD,*; Victoria Manon, DDS, MBA, MD; Jaime Castro-Núñez, DMD, MSD

    The loss of tissue in esthetic areas such as partial or complete loss of ear, nose, and other facial and body parts can be devastating for the affected individuum and can lead to severe esthetic and functional impairment, as well as psychological trauma. Reattachment of avulsed tissues, flaps in reconstructive plastic surgery, transplantation of body parts using tissue engineering allow patients who suffered complete or partial loss of external organs due to trauma, malignancy, or inherited absence, to have improved quality of life and minimize psychological trauma


Multiple Lipoma on Left Lumbar, Left Chest Region and Left Arm

Dr. Abhishek Mavale*; Dr. Devyani Dasar

    A round or oval-shaped mass of tissue called a lipoma develops immediately below the skin. It is formed of fat, moves readily when touched, and often doesn't hurt. Lipomas can develop anywhere on the body, but the back, torso, arms, shoulders, and neck are where they most frequently occur.


Combination Treatment of ERCP Endoscopic Stent Placement and Percutaneous Transhepatic Procedure for Complicated Bile Leakage after Hepatic Resection: A Case Report

Yu-Ning Lin; Jin-Chiao Lee; Chi-Hsun Hsieh*; Nai-Jen Liu; Kuang-Tse Pan

    Bile leakage is one of the complications that can happen after hepatectomy, which may lead to surgical site infections, abdominal abscess formation, prolonged hospital stay, increase hospital cost, and seriously affect patients' postoperative quality of life.


Histological Analysis of Osseointegrated Zirconia Implant in Human: Case Report

Carolina Mendonça de Almeida Malzoni; Mariana Schaffer Brackmann; Victor Gonçalves; Nicolas Nicchio; Ana Paula de Souza Faloni; Daniel Guião; Elcio Marcantonio Junior*

    Zirconia implants have been considered a viable alternative to traditional titanium implants with the advantage of providing a more favorable esthetics result and less biofilm adhesion when compared with titanium. There are few studies in the literature showing histological analysis of zirconia implants in humans. The aim of this study is to present the biopsy of a zirconia implant that was placed, osseointegrated but had to be removed due to inadequate three-dimensional positioning.


Fibromatosis of the Male Breast: A Case Report

Hina Khalid*; Naveed Ali khan; Abdul Khalique Mahar; Munira Abdul Aziz

    Fibromatosis is a benign lesion of the breast that can rarely occur in men and requires good imaging and biopsy to make a differential diagnosis to breast carcinoma. Fibromatosis is a proliferation of fibroblastic and Mio fibroblastic cells that primarily originate from the fascia or aponeuroses of the abdominal wall. Primary breast fibromatosis predominately affects females but can rarely affect the male breast.


Gastrointestinal Stromal Tumour in a Young Adult: A Case Report

Mohamed Eftal Bin Mohamed Ebrahim

    Gastrointestinal Stromal Tumour (GIST) is the most common mesenchymal tumour. Peak ages are typically 60-65 years hence very few young adults present with GIST. Here, we present a case of a 26-year-old male with an acute chronic history of melena subsequently diagnose with GIST. No pathology was initially identified upon multiple gastroscopies and a colonoscopy. The patient then underwent Magnetic Resonance Imaging (MRI) Enterography which revealed a 5.6cm soft tissue mass in the right pelvis without any established evidence of bowel invasion.


Gangrene of Penile Skin - A Rare Entity

Sonal Kumar Jha*; Alisha Qamar

    Penile gangrene is seen infrequently but is associated with significant morbidity and mortality. Gangrene of the penis may be dry or infective.


Ruptured True Common Femoral Artery Aneurysm and Operative Management

Babak Mohammadian*; Quinn A Nix; Joseph G Brungardt; Axel Thors; Jenny G Cho; Richard C Arnspiger II*

    An 81-year-old male with past surgical history significant for right common femoral to posterior tibial artery bypass as well as aortic aneurysm repair using endograft presented with painful pulsatile right groin swelling. Ultrasound imaging revealed a fluid collection and concern for ruptured right common femoral artery aneurysm with expanding hematoma...


Safety of Suction in Management of Pneumothorax-A Review of the Literature, Evidence and Physiological Basis for Negative Pressure Suction

Brendan D Winkle

    A pneumothorax is a collection of air in the space outside the lungs that is trapped within the thorax. Drainage of this air can be achieved with the insertion of an intercostal catheter or chest tube. Resolution of a pneumothorax may be aided by the use of negative pressure suction applied to an underwater seal drain. This method has long been regarded with caution due to several perceived adverse consequences such as re-expansion pulmonary oedema or tissue damage...


Decompressive Craniectomy and Temporal Lobectomy in a Patient with a Traumatic Brain Injury - A Successful Case History

Kanakka Hewage Dammika Madhusankha*; Dayan Dissanayaka; Sanath Bandara; Dilruk Rathnayaka

    Traumatic brain injury is a common cause of disability among young adults. It causes a huge socioeconomic burden to the society. Management includes a multidisciplinary team approach. Both conservative and surgical options are available as a treatment option, but the outcome is often poor. Decompressive craniectomy is widely practiced surgical option for intracranial hypertension.


Reconstruction of Myofasciocutaneous Defect with Free Latissimus Dorsi Flap

Jose Luis Alvarado Gutierrez; Brenda Arcos Vera*; Alain Paul Velazquez Aleman; Diego Gonzalez Villanueva; Julian Omar Ibarra Lopez; Daniel Hasfield Sarabia

    Introduction: Epidermoid cancer is a common disease with low mortality, which generates a great economic weight in public health due to the high cost of its diagnosis and treatment. This disease commonly occurs in skins that suffer chronic damage and is associated with actinic keratosis. Therefore, the reconstruction of the cutaneous defect with a free latissimus flap is considered, since it constitutes a method of choice for treatment of wide excisional defects.


Rectovesical Fistula after EEA Stapler Misfire During Hartmann's Reversal

Ilango Sethu

    Image shows a retrograde cystogram done in a patient after reversal of a Hartmann's procedure for carcinoma of the rectum. The image shows a fistulous communication between the trigone area of the urinary bladder and the stapled anastomotic site.
Patient underwent a second procedure to repair the fistulous site and hand sewn colo-anal anastomosis. He has done well since then.


Laser Lithotripsy Fundamentals: From the Physics to Optimal Fragmentation

Hugo Lopez-Ramos; Julian Chavarriaga*; Nayib Fakih

    Purpose: Laser Lithotripsy has remained the cornerstone for the management of urolithiasis for more than thirty years. Miniaturization of endoscopic equipment, digital vision, improvement of laser lithotripters, laser fibers has made endourology a field of growing interest, immersed in a technologic revolution. The aim of this article is to do an extense review on laser lithotripsy starting from the physics of the lasers, to translational science apply to lithotripsy fundamentals in order to make lithotripsy safer and more efficient.


Review of Perioperative Anticoagulation in Urology

Akshitha Devaraj*; Shahzad Shah

    An increase in the elderly population with multiple complex co-morbidities, such as atrial fibrillation, stroke or myocardial infarction and on anticoagulation, poses a challenge for urologists managing patients, especially in the perioperative period. It is therefore important for all clinicians to have a clear understanding of the mechanisms of action of common anticoagulants and their pharmacokinetics and pharmacodynamics. This article outlines the various guidelines and recommendations for anticoagulant use in the perioperative period...


Minimally Invasive Treatment of Renal Pelvis Stones in Children: A Case Report

Mesut Demir*; Esma Sehoviç Keçik; Aydın Ünal; Melih Akın; Meltem Kaba; Nihat Sever; Çetin Ali Karadağ; Abdullah Yıldız; Ali İhsan Dokucu

    Recently, nephrolithiasis is increasingly seen in children. Metabolic disease is present in 50% of patients diagnosed with kidney stones in the pediatric population. Other factors include infection, nutritional factors, and anatomical malformations of the urinary system. In addition to the treatment methods used in the adult population, laparoscopic and retroperitoneal approaches can sometimes be considered in children...


Hemopatch® as a New Dural Sealant in Posterior Fossa Neurosurgery; A Clinical Application Observation

Stephan Nowak*; Márton Eördögh; Henry WS Schroeder; Steffen Fleck

    Hemopatch® as a new dural sealant in posterior fossa neurosurgery; a clinical application observation. Objectives: We analyzed our results using Hemopatch as a new dural sealant after neurosurgical procedures via the retrosigmoid approach. Patients and methods: In our prospective single center study, we analyzed all patients (288) who received a retrosigmoid craniotomy between October 2016 and December 2019. We included 161 (55.9%) female and 127 (44.1%) male patients...


Racial Disparities with Survival of Head and Neck Cancer Patients in the SARS-CoV-2 Pandemic

Elise E Zhao; Sarah A Imam; Shaun A Nguyen*

    The SARS-CoV-2 (COVID-19) pandemic caused profound disruption to the delivery of healthcare. Patients with Head and Neck Cancer (HNC) may have experienced cancelled appointments or surgeries. Racial minority patients with HNC experienced unequal access to treatment and poorer outcomes since before the pandemic. In addition, racial disparities are present in the outcome of patients with COVID-19. During the COVID-19 pandemic, racial minority patients with HNC are an especially vulnerable population...


Gender Disparities with Survival of Head and Neck Cancer Patients in the COVID-19 Pandemic

Erick Yuen; Elise E Zhao; Sarah A Imam; Shaun A Nguyen*

    To date, the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in over 860,000 confirmed deaths worldwide. Although infection rates between men and women are similar, men have about twice the risk of death from COVID-19, suggesting that biological sex may be a significant determinant of disease severity. A similar trend has been observed in patients with Head and Neck Cancer (HNC), in which male sex is associated with higher incidence-based mortality rates. Prior studies have sought to ascertain whether these disparities are influenced by physiological or social factors...


Maxillary Sinus Augmentation in the Presence of Retention Cyst: A New Clinical Approach

Francesco Briguglio

    In case of acute atrophy of superior maxillary, the intra-sinus bone regeneration represents a necessary procedure in the execution of a rehabilitation prosthetic - implantation of lateral posterior sectors [1,2]. The presence of big cystic neoformation within maxillary sinus does not permit, except if it is preceded by a surgical review of sinus cavity, the realization of regeneration technique [3,4]. The presence of large cystic neoformations within the maxillary sinuses does not allow, if not preceded by a surgical revision of the sinus cavities, the implementation of the regenerative technique.


Use of Hyperbaric Oxygen Therapy for Reducing Postoperative Swelling: A Randomized Controlled Trial

Dou Huang; Kaide Li; Xiaohui Zheng; Lei Liu*

   To evaluate the effect and risks of hyperbaric oxygen therapy on postoperative swelling. A prospective randomized, non-blinded, controlled clinical trial included 60 patients with single jaw cysts, who were randomly divided into two groups. Patients were treated with conventional surgical treatment in both groups. Only the experimental group received 10-day hyperbaric oxygen therapy.


Novel Draping Technique during Tracheostomy to Minimize Aerosolization in the Times of COVID19 Pandemic

Hitesh Rajendra Singhavi*; Prashant Pawar; Sudeshna Banerjee; Ayesha Khan; Vijay Shetty; Anil Heroor

   To create a transparent flexible barrier to limit the aerosol exposure during open tracheostomy procedures in a resource constraint setting. We offer a novel draping technique within the infrastructural limits of general operation theatre developed by surgical oncology services. It uses simple equipment including 1. L shaped anaesthesia screen (steel rod), 2. Clear Plastic transparent drape, 3. Marker pen, 4. Sterile surgical Scissors, 5. Staplers/micropore tape as described in the preparatory steps.


Ozone + Arthroscopy: Improved Redox Status, Function and Surgical Outcome in Knee Osteoarthritis Patients

Olga Sonia Leon Fernandez*; Gabriel Takon Oru; Juan Carlos Polo Vega; Elizabeth Garcia Fernandez; Renate Viebahn-Hansler; Roberto Torres-Carballeira; Gilberto Lopez Cabreja; Ramona Marzo Mendez

   Ozone preconditioning shows similarities to ischemic preconditioning mechanism which protects against ischemic reperfusion injury that is associated to surgical procedures as well as osteoarthritis clinical condition so the Objective of this study was to compare beneficial effects of medical ozone before and 30 days after of arthroscopy with regard to who were not ozone pretreated.


Surgical Strategy to Transplant the Same Kidney in Two Patients

Matteo Ravaioli*; Giuliana Germinario; Enrico Prosperi; Giorgia Comai; Irene Capelli; Olga Baraldi; Valentina Bertuzzo; Massimo Del Gaudio; Chiara Zanfi; Antonio Siniscalchi; Gaetano La Manna

   This report describes an unsuccessful living kidney transplantation, where the 12-year-old female recipient, who received the kidney from her mother, died on the post-operative day 2, due to cerebral ischemia and became a brain-death donor. The family agreed to a multi-organ donation since the previously transplanted kidney was highly performing.


Involvement of Hereditary Hemorrhagic Telangiectasia (HHT) in kidneys

Habibullah Fitrat; Yuxin Chen*; Abdul Qahar Saleh; Shanglei Ning; Sayed Ismail; Mu Wentao

    Hereditary Hemorrhagic Telangiectasia (HHT) is a rare autosomal dominant vascular condition. The pathophysiology of this condition constitutes lack of capillary beds between arterioles and venules, resulting in direct contact between these vessels. This leads to telangiectases on specific locations such as the face, fingers, mouth, and nasal mucosa...


Extended high hilar resection and enlarged hepatic portal enterostomy in the treatment of hilar cholangiocarcinoma

Abdul Qahar Saleh; Yuxin Chen*; Shanglei Ning; Guo Lingyu; Habibullah Fitrat; Mu Wentao

    Background: Tertiary biliary radical reconstruction and biliary-enteric continuity restoration limits the radical resection of hilar cholangiocarcinoma, because there are multiple biliary radicals in the cut surface of liver and some of them are smaller than 1-2 mm. Enlarged anastomosis orifice might delay the jaundice related to local recurrence which is the main cause of long-term morbidity and mortality...


An unusual presentation of compound odontoma: A case report

Surbhi B Juneja; Suwarna Dangore- Khasbage*; Rahul R Bhowate

    Odontomas are odontogenic tumors that comprises of enamel, pulp, dentin and cementum. They comprises of two varieties complex and compound. Aetiology of odontoma is multifactorial as stated in literature. Usually odontomas are asymptomatic clinically and diagnosed on routine radiographic imaging...


Applicatıon of femoral + sciatic block in high risk patients: Two cases

Elif Doğan Bakı*; Kamil Taşkapılı; Özlem Çetin Akıcı

    Peripheral nerve blocks can be easily applied in many upper and lower limb surgeries, and it is a frequently preferred method of anesthesia for high-risk day-case patients. Combined sciatic femoral nerve block is the technique most commonly used in the lower extremities, as it provides adequate anesthesia, easy recovery, and patient and surgeon satisfaction with low invasive risk.


Outcome of surgery for type A aortic dissection – Twenty year evolution of a single surgeon practice

Ishtiaq A Rahman*; Manhar Khatri; Pradeep Narayan; Alan J Bryan

    Background: This study investigated type A aortic dissection repair outcomes in a single surgical practice focusing on surgical, perfusion and anaesthetic techniques.


Psychological assessment of medical school applicants for general surgery residencies

Charles E Geno; Catherine Skinner; John Burkhardt Gregg; Joseph C Wallace; Andrew G Harrell; Garrett Taylor; Gregg Bell; Daniel M Avery*

    Attrition negatively impacts surgical residencies. Many factors have been reviewed to help understand ways to reduce attrition. This article focuses on how psychological assessment can be used in the area of surgery to help mitigate attrition while also helping to select candidates who are more likely to be successful in a surgical residency.


How can we increase the number of general and rural surgeons in the United States? A study of 789 graduates from 3 campuses who matched into general surgery over 40 Years: 1974 to 2015

Daniel M Avery*; Andrew G Harrell; Joseph C Wallace; Charles E Geno; Garrett Taylor; John Burkhardt Gregg; Catherine Skinner; Melanie Tucker

    Background: There is a national shortage of general surgeons in the United States. The shortage is most profound in rural areas. Fewer general surgery graduates are practicing general surgery today. Attrition from general surgery residencies is a major problem as approximately 1 in 6 surgery residents leave their residency. Furthermore, less medical students are choosing general surgery as a career.


Can we identify medical students and residents at risk for attrition in general surgery and intervene before residents quit?

Charles E Geno; Catherine Skinner; John Burkhardt Gregg; Joseph C Wallace; Andrew G Harrell; Garrett Taylor; Gregg Bell; Daniel M Avery*

    Many general surgery residents contemplate quitting residency at some time during their training. Once a surgery resident decides that general surgery will not provide the desired lifestyle, the chance of him completing his residency decreases significantly and quitting is inevitable. Residency programs must improve their ability to identify those residents contemplating quitting residencies and intervene. Intervention may be possible with early identification of medical students and residents at risk for attrition.


Non vitamin K antagonist oral anticoagulation- The future of anticoagulation following mitral reparative surgery

Ishtiaq A Rahman*; Hunaid Vohra

    Warfarin has established itself as the anticoagulation of choice following mitral valvular surgery in the absence of beneficial effect in randomised controlled trials. Although being cumbersome to the patient its role has been secured in part due to the lack of a suitable alternative option. In 2013, around 2000 mitral valve repairs were performed in Great Britain and Ireland [1] with an associated mortality ranging from 1.09% (isolated mitral valve repair) to 2.79% (combined mitral valve repair and coronary artery bypass grafting (CABG)) [1].


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