Coronary artery bypass surgery (CABG) in dextrocardia with situs inversus patients is comparatively rare in literature. Abnormalities in the embryonic cardiac loop and other associated congenital anomalies pose challenges in both anaesthesia and surgery. We describe, a successful elective off pump total arterial revascularization coronary artery bypass surgery with RIMA-LIMA en Y configuration with 5 distal anastomosis were performed in a 64-year-old patient with dextrocardia, situs inversus and triple vessel coronary artery disease. The peri-operative periods were uneventful. This report highlights the feasibility, benefits and relative ease of Off-pump RIMA-LIMA en Y graft in such patients

Ankylosing spondylitis (AS) a seronegative inflammatory disease that often presents with co-existing issues like bilateral hip replacements, nephrolithiasis, skin lesions, peripheral vascular disease and coronary artery disease.. We describe a patient with ankylosing spondylitis with bilateral hip replacements in the past who was waiting for an elective coronary artery bypass grafting (CABG) but needed urgent admission with renal colic and unstable angina. In the current COVID pandemic in order to reduce hospital stay and risk of hospital acquired COVID infection we decided to perform simultaneous CABG and removal of ureteric stone. In this case report we discuss the issues in relation to management of patients with coronary artery disease and ankylosing spondylitis.

While there is significant awareness regarding droplet and contact transmission, aerosols are generally underestimated as a potential mode of transmission of SARS-Cov-2 infection. With the gradual resumption of cardiac surgical activities, the cardiac surgical operating room will become an important potential source of infection to the cardiac surgeon and other healthcare workers participating in the operation. There is also diminished awareness about the different aerosol generating procedures (AGP) in the cardiac surgical operating room. In this mini-review we intend to highlight the various aerosol generating procedures that are common in cardiac surgery. This will help increase the awareness among surgeons to AGP. A practical approach to taking preventive measures have also been discussed.