http://www.annals.in/currentissue.asp Table of Contents:Ann Card Anaesth 2010 - 13(2) Annals of Cardiac Anaesthesia Medknow Publications0971-9784 Murali Chakravarthy Editorial Annals of Cardiac Anaesthesia 2010 13(2):87-88doi:10.4103/0971-9784.62925 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62925 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=87;epage=88;aulast=Chakravarthy http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=87;epage=88;aulast=Chakravarthy132 87 88 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=87;epage=88;aulast=Chakravarthy Murali Chakravarthy

Annals of Cardiac Anaesthesia 2010 13(2):87-88

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=87;epage=88;aulast=Chakravarthy Deepak K Tempe Editorial Annals of Cardiac Anaesthesia 2010 13(2):89-91doi:10.4103/0971-9784.62926 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62926 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=89;epage=91;aulast=Tempe http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=89;epage=91;aulast=Tempe132 89 91 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=89;epage=91;aulast=Tempe Deepak K Tempe

Annals of Cardiac Anaesthesia 2010 13(2):89-91

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=89;epage=91;aulast=Tempe Alexander JC Mittnacht Ingrid Hollinger Review Article Annals of Cardiac Anaesthesia 2010 13(2):92-101doi:10.4103/0971-9784.62930 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62930 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=92;epage=101;aulast=Mittnacht http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=92;epage=101;aulast=Mittnacht132 92 101 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=92;epage=101;aulast=Mittnacht Alexander JC Mittnacht, Ingrid Hollinger

Annals of Cardiac Anaesthesia 2010 13(2):92-101

Fast-tracking in cardiac surgery refers to the concept of early extubation, mobilization and hospital discharge in an effort to reduce costs and perioperative morbidity. With careful patient selection, fast-tracking can be performed in many patients undergoing surgery for congenital heart disease (CHD). In order to accomplish this safely, a multidisciplinary coordinated approach is necessary. This manuscript reviews currently used anesthetic techniques, patient selection, and available information about the safety and patient outcome associated with this approach.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=92;epage=101;aulast=Mittnacht Gaurab Maitra Saikat Sengupta Amitava Rudra Saurabh Debnath Review Article Annals of Cardiac Anaesthesia 2010 13(2):102-109doi:10.4103/0971-9784.62933 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62933 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=102;epage=109;aulast=Maitra http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=102;epage=109;aulast=Maitra132 102 109 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=102;epage=109;aulast=Maitra Gaurab Maitra, Saikat Sengupta, Amitava Rudra, Saurabh Debnath

Annals of Cardiac Anaesthesia 2010 13(2):102-109

Non-valvular heart disease is an important cause of cardiac disease in pregnancy and presents a unique challenge to the anesthesiologist during labor and delivery. A keen understanding of the underlying pathophysiology, in addition to the altered physiology of pregnancy, is the key to managing such patients. Disease-specific goals of management may help preserve the hemodynamic and ventilatory parameters within an acceptable limit and a successful conduct of labor and postpartum period]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=102;epage=109;aulast=Maitra Yashwant S Verma Sandeep Chauhan Akshay K Bisoi Parag Gharde Usha Kiran Sambhu N Das Original Article Annals of Cardiac Anaesthesia 2010 13(2):110-115doi:10.4103/0971-9784.62935 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62935 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=110;epage=115;aulast=Verma http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=110;epage=115;aulast=Verma132 110 115 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=110;epage=115;aulast=Verma Yashwant S Verma, Sandeep Chauhan, Akshay K Bisoi, Parag Gharde, Usha Kiran, Sambhu N Das

Annals of Cardiac Anaesthesia 2010 13(2):110-115

To determine the most effective dose regimen of aprotinin for infants undergoing arterial switch operation for transposition of the great arteries in reducing blood loss and postoperative packed red blood cell (PRBC) requirements. A total of 24 infants scheduled for arterial switch operation for transposition of the great arteries were included in the study. The infants were randomly assigned to one of the three groups. Group I (n = 8) patients received aprotinin in a dose of 20,000 kallikrein inhibiting units (KIU)/kg after induction of anesthesia, 20,000 KIU/kg was added to the pump prime, and 20,000 KIU/kg/hour infusion for three hours after weaning from bypass; group II (n = 8) patients received aprotinin 30,000 KIU/kg after induction of anesthesia, 30,000 KIU/kg was added to the pump prime and 30,000 KIU/Kg/hour infusion for three hours after weaning from bypass; group III patients (n = 8) received aprotinin 40,000 KIU/kg after induction of anesthesia, 40,000 KIU/kg was added to the pump prime and 40,000 KIU/kg/hour infusion for three hours after weaning from bypass. Postoperatively, the cumulative hourly blood loss and PRBC requirements were noted up to 24 hours from the time of admission in the intensive care unit (ICU). Use of blood and blood products were noted. Coagulation parameters such as hematocrit, activated clotting time (ACT), fibrinogen, prothrombin time (PT), international normalized ratio (INR), platelet count, and fibrin degradation products (FDP) were investigated before cardiopulmonary bypass (CPB), after protamine administration, and at four hours postoperatively in the ICU. The number of infants reexplored for increased mediastinal drainage was recorded. Renal functions were monitored by measuring urine output (hourly) and serum urea (mg%) and serum creatinine (mg%) at 24 hours. The sternal closure time was comparable in all the three groups. Cumulative blood loss (ml/kg/24 hours) was greatest in group I (17.30 ± 7.7), least in group III (8.14 ± 3.17), whereas in group II, it was 16.45 ± 6.33 (P = 0.019 group I versus group III; (P = 0.036 group II versus group III). Postoperative PRBC requirements were significantly less in high dose group III (P = 0.008, group I versus III; p = 0.116, group II versus group III) . Tests for coagulation performed at four hours postoperatively, viz. ACT, PT, INR, FDP, and platelets were comparable in the three groups. Urine output on CPB was comparable in all the groups. Serum urea and creatinine showed no significant difference between the three groups twenty four hours postoperatively. Aprotinin dosage regimen of 40,000 KIU/kg at induction, in CPB prime and postoperatively for three hours was most effective in reducing postoperative blood loss and PRBC transfusion requirements. Aprotinin does not have any adverse effect on renal function.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=110;epage=115;aulast=Verma Thomas M Hemmerling Carmelo Minardi Cedrick Zaouter Nicolas Noiseux Ignatio Prieto Original Article Annals of Cardiac Anaesthesia 2010 13(2):116-122doi:10.4103/0971-9784.62938 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62938 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=116;epage=122;aulast=Hemmerling http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=116;epage=122;aulast=Hemmerling132 116 122 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=116;epage=122;aulast=Hemmerling Thomas M Hemmerling, Carmelo Minardi, Cedrick Zaouter, Nicolas Noiseux, Ignatio Prieto

Annals of Cardiac Anaesthesia 2010 13(2):116-122

Background: Volatile anesthetics provide myocardial protection during cardiac surgery. Sevoflurane and desflurane are both efficient agents that allow immediate extubation after off-pump coronary artery bypass grafting (OPCABG). This study compared the incidence of arrhythmias after OPCABG with the two agents. Materials and Methods: Forty patients undergoing OPCABG with immediate extubation and perioperative high thoracic analgesia were included in this controlled, double-blind study; anesthesia was either provided using 1 MAC of sevoflurane (SEVO-group) or desflurane (DES-group). Monitoring of perioperative arrhythmias was provided by continuous monitoring of the EKG up to 72 hours after surgery, and routine EKG monitoring once every day, until time of discharge. Patient data, perioperative arrhythmias, and myocardial protection (troponin I, CK, CK-MB-ratio, and transesophageal echocardiography examinations) were compared using t-test, Fisher's exact test or two-way analysis of variance for repeated measurements; P < 0.05. Results: Patient data and surgery-related data were similar between the two groups; all the patients were successfully extubated immediately after surgery, with similar emergence times. Supraventricular tachycardia occurred only in the DES-group (5 of 20 patients), atrial fibrillation was significantly more frequent in the DES group versus SEVO-group, at five out of 20 versus one out of 20 patients, respectively. Myocardial protection was equally achieved in both groups. Discussion: Ultra-fast track anesthesia using sevoflurane seems more advantageous than desflurane for anesthesia, for OPCABG, as it is associated with significantly less atrial fibrillation or supraventricular arrhythmias after surgery.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=116;epage=122;aulast=Hemmerling Poonam Malhotra Kapoor Vikram Aggarwal Ujjwal Chowdhury Minati Choudhury Sarvesh Pal Singh Usha Kiran Original Article Annals of Cardiac Anaesthesia 2010 13(2):123-129doi:10.4103/0971-9784.62942 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62942 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=123;epage=129;aulast=Kapoor http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=123;epage=129;aulast=Kapoor132 123 129 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=123;epage=129;aulast=Kapoor Poonam Malhotra Kapoor, Vikram Aggarwal, Ujjwal Chowdhury, Minati Choudhury, Sarvesh Pal Singh, Usha Kiran

Annals of Cardiac Anaesthesia 2010 13(2):123-129

Chronic constrictive pericarditis (CCP) due to tuberculosis has high morbidity and mortality in the periopeartive period following pericardiectomy because of left ventricular (LV) dysfunction. Brain-type natriuretic peptide (BNP) is considered a marker for both LV systolic and diastolic dysfunction. We undertook this prospective study in 24 patients, to measure the BNP levels and to compare it with transmitral Doppler flow velocities, that is, the E/A ratio (E = initial peak velocity during early diastolic filling and A = late peak flow velocity during atrial systole), as a marker of diastolic function and systolic parameters, pre- and post-pericardiectomy, at the time of discharge. The latter parameters have been taken as a flow velocity across the mitral valve on a transthoracic echo. There was a significant decrease in the mean values of log BNP (6.19 ± 0.33 to 4.65 ± 0.14) (P = 0.001) and E/A ratio (1.81 ± 0.21 to 1.01 ± 0.14) (P = 0.001) post pericardiectomy, with a positive correlation, r = 0.896 and 0.837, respectively, between the two values at both the time periods. There was significant improvement in the systolic parameters of the LV function, that is, stroke volume index, cardiac index, systemic vascular resistance index, and delivered oxygen index. However, no correlation was observed between these values and the BNP levels. We believe that BNP can be used as a marker for LV diastolic dysfunction in place of the E/A ratio in patients with CCP, undergoing pericardiectomy. However, more studies have to be performed for validation of the same.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=123;epage=129;aulast=Kapoor Subhendu Sarkar Rahul GuhaBiswas Emmanuel Rupert Janak Mehta Award Annals of Cardiac Anaesthesia 2010 13(2):130-137doi:10.4103/0971-9784.62945 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62945 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=130;epage=137;aulast=Sarkar http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=130;epage=137;aulast=Sarkar132 130 137 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=130;epage=137;aulast=Sarkar Subhendu Sarkar, Rahul GuhaBiswas, Emmanuel Rupert

Annals of Cardiac Anaesthesia 2010 13(2):130-137

This prospective randomized study aims to evaluate and compare the effects of isoflurane, sevoflurane and desflurane (study drugs) on left ventricular (LV) diastolic function in patients with impaired LV relaxation due to ischemic heart disease using transesophageal Doppler echocardiography. After approval of the local ethics committee and informed consent, 45 patients scheduled for coronary artery bypass grafting surgery were enrolled in the study. Patients were selected by a preoperative Transthoracic Echocardiographic diagnosis of impaired relaxation or Grade 1 Diastolic Dysfunction. They randomly received fentanyl and midazolam anesthesia with 1 MAC of isoflurane (n=16), sevoflurane (n=14) or desflurane (n=15). Hemodynamic parameters and TEE derived ventricular diastolic relaxation indices before and after the study drug administration were compared. LV filling pressures were kept constant throughout the study period to exclude the effect of the loading conditions on diastolic function. Four patients in the sevoflurane group and three in the desflurane group were excluded from the study, after baseline TEE examination revealed normal diastolic filling pattern. All the three study drugs significantly reduced the systemic vascular resistance index with a significant increase in cardiac index. Mean arterial pressure was reduced by all the drugs, although the decrease was not statistically significant. Hemodynamic changes were comparable between all the three groups. In terms of LV relaxation indices, all three agents led to a significant improvement in diastolic function. Transmitral and Tissue Doppler E/A and Em/Am ratios improved significantly Transmitral and Tissue Doppler E/A and Em/Am ratios improved significantly accompanied by a significant decrease in deceleration time and isovolumetric relaxation time. The effect of all three agents on diastolic relaxation parameters was comparable. In conclusion , Isoflurane, sevoflurane and desflurane, do not appear to have a detrimental effect in patients with early diastolic dysfunction. On the contrary, these inhalational agents actually improve the LV relaxation. A significant reduction in afterload produced by these vapors can be a possible reason for these findings. The positive effect of these inhalational agents on LV relaxation can have a profound effect on the perioperative anesthetic management of patients with diastolic dysfunction.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=130;epage=137;aulast=Sarkar Banashree Mandal Poonam Malhotra Kapoor Ujjwal Chowdhury Usha Kiran Minati Choudhury Janak Mehta Award Annals of Cardiac Anaesthesia 2010 13(2):138-144doi:10.4103/0971-9784.62946 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62946 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=138;epage=144;aulast=Mandal http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=138;epage=144;aulast=Mandal132 138 144 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=138;epage=144;aulast=Mandal Banashree Mandal, Poonam Malhotra Kapoor, Ujjwal Chowdhury, Usha Kiran, Minati Choudhury

Annals of Cardiac Anaesthesia 2010 13(2):138-144

Objectives: The presence of pulmonary artery hypertension (PAH) affects the prognosis of patients; therefore, it is important to treat it. The aim of this study is to compare the acute hemodynamic effects of inhaled nitroglycerine (iNTG), intravenous nitroglycerine (IV NTG) alone and their combination with intravenous dobutamine (IV DOB) during the early postoperative period, in patients with PAH undergoing mitral valve or double valve replacement surgery. Materials and Methods: In the study, 40 patients with secondary PAH were administered iNTG 2.5 μg/kg/min, IV NTG 2.5 μg/kg/min, a combination of iNTG 2.5 μg/kg/min + IV DOB 10 μg/kg/min, and IV NTG 2.5 μg/kg/min + IV DOB 10 μg/kg/min for 10 minutes each following valve replacement surgery, in random order. The hemodynamic parameters were recorded before (T0) and immediately after the intervention. (T1). Results: iNTG effectively decreased mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance index (PVRI), and the PVR / SVR ratio, without affecting arterial pressures, systemic vascular resistance or mixed venous oxygen saturation (SvO 2 ). IV NTG produced both systemic and pulmonary vasodilation along with a significant fall in SvO 2 . The combination of iNTG and IV DOB caused a significant decrease in mPAP and PVRI, with no significant change in SVRI, PVR / SVR ratio, and SvO 2 . A combination of IV NTG + IV DOB caused both pulmonary and systemic vasodilatation with a significant decrease in SvO 2 . None of the drugs caused any significant change in the cardiac index. Conclusion: All drugs were of similar efficacy in reducing the pulmonary vascular resistance index. Only iNTG produced selective pulmonary vasodilatation, while IV NTG and its combination with IV dobutamine had a significant concomitant systemic vasodilatory effect.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=138;epage=144;aulast=Mandal Kundan Sandugir Gosavi Sananta Kumar Dash Bharat N Shah CB Upasani Case Report Annals of Cardiac Anaesthesia 2010 13(2):145-147doi:10.4103/0971-9784.62927 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62927 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=145;epage=147;aulast=Gosavi http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=145;epage=147;aulast=Gosavi132 145 147 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=145;epage=147;aulast=Gosavi Kundan Sandugir Gosavi, Sananta Kumar Dash, Bharat N Shah, CB Upasani

Annals of Cardiac Anaesthesia 2010 13(2):145-147

Partial exchange transfusion during cardiopulmonary bypass, while conducting cardiac surgery may be a useful technique in patients with high level of sickle hemoglobin. Along with this preoperative use of hydroxyurea and alternative analgesic modalities such as transcutaneous electrical nerve stimulation in postoperative period may be beneficial, in our opinion. A 16-year-old female of Turner's syndrome having sickle cell anemia scheduled for closure of arterial septal defect on cardiopulmonary bypass was managed with partial exchange transfusion and warm cardioplegia.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=145;epage=147;aulast=Gosavi Shrinivas Gadhinglajkar Rupa Sreedhar Jayakumar Karunakaran Manoranjan Misra Ganesh Somasundaram Thomas Mathew Case Report Annals of Cardiac Anaesthesia 2010 13(2):148-153doi:10.4103/0971-9784.62929 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62929 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=148;epage=153;aulast=Gadhinglajkar http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=148;epage=153;aulast=Gadhinglajkar132 148 153 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=148;epage=153;aulast=Gadhinglajkar Shrinivas Gadhinglajkar, Rupa Sreedhar, Jayakumar Karunakaran, Manoranjan Misra, Ganesh Somasundaram, Thomas Mathew

Annals of Cardiac Anaesthesia 2010 13(2):148-153

A pacing system infection may lead to infective endocarditis and systemic sepsis. Tricuspid valve surgery may be required if the valve is severely damaged in the process of endocarditis. Although, cardiopulmonary bypass is the safe choice for performing right-heart procedures, it may carry risk of inducing systemic inflammatory response and multi-organ dysfunction. Some studies have advocated TV surgery without institution of CPB. We report tricuspid valve excision using the off-pump inflow occlusion technique in a 68-year-old man. We also describe role of intra-operative TEE as a monitoring tool at different stages of the surgical procedure. .]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=148;epage=153;aulast=Gadhinglajkar Prabhat Kumar Sinha Bhupesh Kumar Praveen Kerala Varma Case Report Annals of Cardiac Anaesthesia 2010 13(2):154-158doi:10.4103/0971-9784.62934 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62934 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=154;epage=158;aulast=Sinha http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=154;epage=158;aulast=Sinha132 154 158 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=154;epage=158;aulast=Sinha Prabhat Kumar Sinha, Bhupesh Kumar, Praveen Kerala Varma

Annals of Cardiac Anaesthesia 2010 13(2):154-158

Ebstein's anomaly (EA) is the most common cause of congenital tricuspid regurgitation. The associated anomalies commonly seen are atrial septal defect or patent foramen ovale and accessory conduction pathways. Its association with coexisting mitral stenosis (MS) has uncommonly been described. The hemodynamic consequences and anesthetic implications, of a combination of EA and rheumatic MS, have not so far been discussed in the literature. We report successful anesthetic management of a repair of EA and mitral valve replacement in a patient with coexisting Wolff-Parkinson-White (WPW) syndrome.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=154;epage=158;aulast=Sinha Rajiv Saini Santosh Saini Sugandha R Saini Brief Communication Annals of Cardiac Anaesthesia 2010 13(2):159-161doi:10.4103/0971-9784.62936 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62936 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=159;epage=161;aulast=Saini http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=159;epage=161;aulast=Saini132 159 161 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=159;epage=161;aulast=Saini Rajiv Saini, Santosh Saini, Sugandha R Saini

Annals of Cardiac Anaesthesia 2010 13(2):159-161

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=159;epage=161;aulast=Saini Sanjay Goel Kanwar Aditya Baloria Nandini Selot Bishnu Panigrahi Interesting image Annals of Cardiac Anaesthesia 2010 13(2):162-164doi:10.4103/0971-9784.62939 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62939 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=162;epage=164;aulast=Goel http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=162;epage=164;aulast=Goel132 162 164 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=162;epage=164;aulast=Goel Sanjay Goel, Kanwar Aditya Baloria, Nandini Selot, Bishnu Panigrahi

Annals of Cardiac Anaesthesia 2010 13(2):162-164

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=162;epage=164;aulast=Goel Mridu Paban Nath Naresh Dhawan Sandeep Chauhan Usha Kiran Interesting image Annals of Cardiac Anaesthesia 2010 13(2):165-166doi:10.4103/0971-9784.62941 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62941 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=165;epage=166;aulast=Nath http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=165;epage=166;aulast=Nath132 165 166 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=165;epage=166;aulast=Nath Mridu Paban Nath, Naresh Dhawan, Sandeep Chauhan, Usha Kiran

Annals of Cardiac Anaesthesia 2010 13(2):165-166

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=165;epage=166;aulast=Nath Deepak K Tempe Devesh Dutta Harpreet Minhas Mukesh Garg Sanjula Virmani Interesting image Annals of Cardiac Anaesthesia 2010 13(2):167-168doi:10.4103/0971-9784.62944 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62944 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=167;epage=168;aulast=Tempe http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=167;epage=168;aulast=Tempe132 167 168 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=167;epage=168;aulast=Tempe Deepak K Tempe, Devesh Dutta, Harpreet Minhas, Mukesh Garg, Sanjula Virmani

Annals of Cardiac Anaesthesia 2010 13(2):167-168

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=167;epage=168;aulast=Tempe Sandeep Chauhan Subin Sukesan Tutorial Annals of Cardiac Anaesthesia 2010 13(2):169-175doi:10.4103/0971-9784.62947 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62947 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=169;epage=175;aulast=Chauhan http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=169;epage=175;aulast=Chauhan132 169 175 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=169;epage=175;aulast=Chauhan Sandeep Chauhan, Subin Sukesan

Annals of Cardiac Anaesthesia 2010 13(2):169-175

The surgical procedures performed with robtic assitance and the scope for its future assistance is endless. To keep pace with the developing technologies in this field it is imperative for the cardiac anesthesiologists to have aworking knowledge of these systems, recognize potential complications and formulate an anesthetic plan to provide safe patient care. Challenges posed by the use of robotic systems include, long surgical times, problems with one lung anesthesia in presence of coronary artery disease, minimally invasive percutaneous cardiopulmonary bypass management and expertise in Trans-Esophageal Echocardiography. A long list of cardiac surgeries are performed with the use of robotic assistance, and the list is continuously growing as surgical innovation crosses new boundaries. Current research in robotic cardiac surgery like beating heart off pump intracardic repair, prototype epicardial crawling device, robotic fetal techniques etc. are in the stage of animal experimentation, but holds a lot of promise in future]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=169;epage=175;aulast=Chauhan Praveen Kumar Neema Manikandan Sethuraman Subrat Singha Ramesh Chandra Rathod Letter To Editor Annals of Cardiac Anaesthesia 2010 13(2):176-178doi:10.4103/0971-9784.62943 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62943 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=176;epage=178;aulast=Neema http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=176;epage=178;aulast=Neema132 176 178 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=176;epage=178;aulast=Neema Praveen Kumar Neema, Manikandan Sethuraman, Subrat Singha, Ramesh Chandra Rathod

Annals of Cardiac Anaesthesia 2010 13(2):176-178

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=176;epage=178;aulast=Neema Khalid Samad Muhammad Faisal Khan Rehan Qureshi M Qamarul Hoda Hameed Ullah Letter To Editor Annals of Cardiac Anaesthesia 2010 13(2):178-179doi:10.4103/0971-9784.62940 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62940 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=178;epage=179;aulast=Samad http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=178;epage=179;aulast=Samad132 178 179 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=178;epage=179;aulast=Samad Khalid Samad, Muhammad Faisal Khan, Rehan Qureshi, M Qamarul Hoda, Hameed Ullah

Annals of Cardiac Anaesthesia 2010 13(2):178-179

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=178;epage=179;aulast=Samad Shrinivas Gadhinglajkar Rupa Sreedhar Letter To Editor Annals of Cardiac Anaesthesia 2010 13(2):180-181doi:10.4103/0971-9784.62937 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62937 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=180;epage=181;aulast=Gadhinglajkar http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=180;epage=181;aulast=Gadhinglajkar132 180 181 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=180;epage=181;aulast=Gadhinglajkar Shrinivas Gadhinglajkar, Rupa Sreedhar

Annals of Cardiac Anaesthesia 2010 13(2):180-181

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=180;epage=181;aulast=Gadhinglajkar Shrinivas Gadhinglajkar Rupa Sreedhar Aveek Jayant Letter To Editor Annals of Cardiac Anaesthesia 2010 13(2):181-184doi:10.4103/0971-9784.62932 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62932 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=181;epage=184;aulast=Gadhinglajkar http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=181;epage=184;aulast=Gadhinglajkar132 181 184 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=181;epage=184;aulast=Gadhinglajkar Shrinivas Gadhinglajkar, Rupa Sreedhar, Aveek Jayant

Annals of Cardiac Anaesthesia 2010 13(2):181-184

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=181;epage=184;aulast=Gadhinglajkar P Bhaskar Rao Mohan Gurjar Afzal Azim Arvind K Baronia Letter To Editor Annals of Cardiac Anaesthesia 2010 13(2):184-185doi:10.4103/0971-9784.62931 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62931 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=184;epage=185;aulast=Rao http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=184;epage=185;aulast=Rao132 184 185 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=184;epage=185;aulast=Rao P Bhaskar Rao, Mohan Gurjar, Afzal Azim, Arvind K Baronia

Annals of Cardiac Anaesthesia 2010 13(2):184-185

]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=184;epage=185;aulast=Rao Hema C Nair Echo Tutorial Annals of Cardiac Anaesthesia 2010 13(2):186-186doi:10.4103/0971-9784.62928 Annals of Cardiac Anaesthesia 10.4103/0971-9784.62928 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=186;epage=186;aulast=Nair http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=186;epage=186;aulast=Nair132 186 186 http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=186;epage=186;aulast=Nair Hema C Nair

Annals of Cardiac Anaesthesia 2010 13(2):186-186

Trans-esophageal echocardiaography is a sensitive, minimally invasive, diagnostic tool which gives real time functional image of the aorta. It helps in the diagnosis of pathologies of aorta like atherosclerosis, aneurysm and aortic dissection.]]> http://www.annals.in/article.asp?issn=0971-9784;year=2010;volume=13;issue=2;spage=186;epage=186;aulast=Nair