Biomedical subjects
S V Srikrishna
Publications and source records attributed to S V Srikrishna.
Tracheal reconstructions.
Surgical reconstruction of the trachea is a relatively complex procedure. We had 20 cases of tracheal stenosis. We have a modest experience of 16 tracheal reconstructions for acquired tracheal stenosis. Two patients underwent laser treatment while another two died before any intervention. The majority of these cases were a result of prolonged ventilation (14 cases), following organophosphorous poisoning (11 cases), Guillain-Barré syndrome, bullet injury, fat embolism and surprisingly only one tumor, a case of mucoepidermoid carcinoma, who had a very unusual presentation. There were 12 males and 4 females in this series, age ranging from 12-35 years. The duration of ventilation ranged from 1-21 days and the interval from decannulation to development of stridor was between 5-34 days. Six of them were approached by the cervical route, 5 by thoracotomy and cervical approach, 2 via median sternotomy and 3 by thoracotomy alone. Five of them required an additional laryngeal drop and 1 required pericardiotomy and release of pulmonary veins to gain additional length. The excised segments of trachea measured 3 to 5 cms in length. All were end to end anastomosis with interrupted Vicryl sutures. We have had no experience with stents or prosthetic tubes. Three patients developed anastomotic leaks which were controlled conservatively. Almost all of them required postoperative tracheo-bronchial suctioning with fibreoptic bronchoscope. We had one death in this series due to sepsis.
Diagnosis of congenital bronchoesophageal fistula during anesthesia.
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Pyogenic meningitis after posterolateral thoracotomy.
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Surgical management of left ventricular myxoma with embolization to the right coronary artery.
We report a rare case of left ventricular myxoma with embolization to the right coronary artery, presenting as an acute myocardial infarction. The tumor was excised from the left ventricle, and the tumor embolus was removed from the right coronary artery. Saphenous vein bypass grafting was also performed successfully.
Modified jet ventilation for rigid endoscopy.
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Acute duodenal perforation after coronary artery bypass grafting.
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Mitral valve replacement in the presence of cold agglutinins.
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Transthoracic and transoesophageal echocardiography in the diagnosis and management of a biatrial myxoma.
A 40-year-old female presented with a year's history of atrial fibrillation. Transthoracic echocardiography identified the presence of a biatrial mass and transoesophageal echocardiography delineated its extent. At surgery, a huge myxoma originating from the fossa ovalis and straddling the inter-atrial septum was removed and the atrial septum repaired. This report highlights the role of transthoracic and transoesophageal echocardiography in the diagnosis and management of this extremely rare cardiac tumour.