Journal of the Egyptian Society of Cardio-Thoracic Surgery最新文献

{"title":"Plating versus wiring for fixation of traumatic rib and sternal fractures","authors":"Mostafa Kamel Abd-Elnaim, Ahmed Elminshawy, M. Osman, M. M. Ahmed","doi":"10.1016/J.JESCTS.2017.08.005","DOIUrl":"https://doi.org/10.1016/J.JESCTS.2017.08.005","url":null,"abstract":"","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"63 1","pages":"356-361"},"PeriodicalIF":0.0,"publicationDate":"2017-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85278378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic endovascular repair in management of traumatic aortic dissection. A 10 years experience","authors":"Ashraf Fawzy Mahmoud MD (Professor of cardiothoracic surgery)","doi":"10.1016/j.jescts.2017.04.006","DOIUrl":"10.1016/j.jescts.2017.04.006","url":null,"abstract":"<div><h3>Background</h3><p>Results of surgery in descending aortic dissection is usually not safe. Recently after introducing the thoracic endovascular stents the outcome marvelously improved. Our objective was to evaluate the results of our 10 years experience of using the endovascular stents in trauma patients.</p></div><div><h3>Methods</h3><p>In Saudi German Hospital in Madinah Munawarah, from 2007 to 2016 13, cases of traumatic aortic dissection were subjected to thoracic endovascular aortic repair (TEVAR). All cases were victims of blunt trauma in road traffic accidents (RTAs). All had descending thoracic aortic dissection just after the left subclavian artery. Medtronic TEVAR was used in all cases. The data of those patients were collected and revised. CT angio, echocardiography and abdominal ultrasonography were the main tools in the diagnosis.</p></div><div><h3>Results</h3><p>All cases were males, middle aged, victims of RTAs and all were associated with other injuries.12 cases survived, one died due to major head injury. The survived cases had no paraplegia either before or after stenting. No intra-thoracic bleeding occurred after the procedure. All cases had no coronary artery or valvular involvement. All cases had good landing zones most were within the range of 2 cms or even more. There was no mortality or morbidity related to the procedure.</p></div><div><h3>Conclusions</h3><p>The TEVAR is a reliable, safe, convenient and with less complications than the surgical management for traumatic aortic dissection. No incidence of paraplegia was encountered. It is mandatory in all cases presented in RTAs to be surveyed for traumatic aortic dissection.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 91-99"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.04.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75953629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, patterns and different modalities in extraction of aero-digestive tract foreign bodies in patients attending Alexandria Main University Hospital","authors":"Habashy Abd Elbaset Elhamady ,&nbsp;Abd Elmaguid Mohammad Ramadan ,&nbsp;Alaa Hazem Gaafar ,&nbsp;Ayman Ibrahim Baess ,&nbsp;Sally W. Hammad","doi":"10.1016/j.jescts.2017.05.002","DOIUrl":"10.1016/j.jescts.2017.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Aero-digestive tract foreign bodies (FB) are commonly seen either in children or in elderly age group. Various methods have been described in literature for their removal. In our study we aimed to analyze the incidence, risk factors, site, clinical presentations, different modalities used to extract tracheobronchial and esophageal foreign bodies in patients presented with FB aspiration or ingestion to the Emergency, Cardiothoracic Surgery, ENT and Chest disease departments in Alexandria Main University Hospital during the period between 1-11-2014 to 1-11-2015.</p></div><div><h3>Methods</h3><p>A review of ninety patients with alleged FB aspiration and one hundred patients with alleged FB ingestion underwent complete history taking including personal data, date of presentation, date of aspiration or ingestion, circumstances of aspiration or ingestion, and past history of any previous medical or surgical conditions. Clinical assessment included vital signs and complete physical examination &amp; investigations e.g.; complete blood count, random blood sugar, coagulation profile, renal function tests and liver function tests. Imaging including plain X-ray, CT scan, ultrasound, and virtual bronchoscopy were done. Some patients underwent rigid esophagoscopy/bronchoscopy under general anesthesia, based on clinical and radiological evidence. Some patients underwent surgical interventions.</p></div><div><h3>Results</h3><p>Regarding FB aspiration, we found that sex difference was statistically significant in teenagers and adult group; females were found to be more commonly affected than males. Also most of cases of pin aspiration were teenagers (&gt;10–20 years) and adults (&gt;20 years). We noticed that right main bronchus FB was found more frequently in children below 10 years. Rigid bronchoscopic extraction of the FBs was the most common modality of extraction seen in 70 patients (77.8%). Regarding FB ingestion we noticed that females were commonly affected than males, coins were the most commonly ingested FB; and upper oesophageal sphincter (UES) was the commonest site of FB entrapment.</p></div><div><h3>Conclusions</h3><p>FBs in the aero-digestive tract constituted a constant hazard in all age groups especially in children and the elderly, which demanded immediate action and management.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 154-162"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91412779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent post sternotomy chest pain: Does sternal wire removal have a role?","authors":"Mohamed M. Abo El Nasr PhD,&nbsp;Abdelhady Taha PhD","doi":"10.1016/j.jescts.2017.04.004","DOIUrl":"10.1016/j.jescts.2017.04.004","url":null,"abstract":"<div><h3>Background</h3><p>Persistent post sternotomy pain is a disabling phenomenon and its cause is unclear. It may be related to hypersensitivity reaction to wire, scar entrapped neuralgia, sternal irritation, chondritis or protruding wires. We aimed to evaluate the effectiveness of sternal wire removal on poststernotomy pain relief.</p></div><div><h3>Methods</h3><p>It is a retrospective study conducted on 48 patients who underwent removal of sternal wires due to persistent post sternotomy anterior chest pain. All wires were removed after exclusion of myocardial ischemia, sternal instability and wound infection. Patients were followed up after 3 months and were divided into 3 groups according to pain response: complete improvement, partial improvement and no improvement.</p></div><div><h3>Results</h3><p>The mean age of patients involved in the study was 39.77 ± 9.44. 66.7% of patients were males. 72.9 %underwent valve surgery. Time lag between primary operation and removal of wires was 23.65 ± 9.26 months. No patients had history of allergy. Regarding response to treatment, patients were asked 3 months after operation about pain relief: 64.6% of patients showed complete improvement, 22.9% had improvement with minimal symptoms, 12.5% showed no improvement thus there was significant improvement in 87.5% of cases.</p></div><div><h3>Conclusions</h3><p>Removal of sternal wires is safe, simple and effective procedure that should be offered to patients with persistent post sternotomy chest pain after exclusion of myocardial ischemia, wound infection and sternal instability.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 142-146"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87550492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary pulmonary vein leiomyosarcoma presenting as left atrial mass: A case report","authors":"Nezar B. El-Hassan MD, FRCS ,&nbsp;Ahmed A. Faragalla MD ,&nbsp;Sahar Elfadil MD ,&nbsp;Azza A. Abdel Satir MD ,&nbsp;Omer A. Ibnaof","doi":"10.1016/j.jescts.2017.03.006","DOIUrl":"10.1016/j.jescts.2017.03.006","url":null,"abstract":"<div><p>We represent a case of 47 years old known diabetic Sudanese lady with a 6 months history of productive cough with blood tinged sputum. Her initial chest X ray and CT scan revealed a right pleural effusion which was negative for TB and malignancy. Two months later she experienced increasing dysponea. A huge left atrial mass was discovered during echocardiographic evaluation which proved to be Leiomyosarcoma after surgical excision and histopathological examination.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 109-113"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91280481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rupture diaphragm: Early diagnosis and management","authors":"Ashraf Fawzy Mahmoud MD ,&nbsp;Mohamed Mohey Eldin Raeia FRCS ,&nbsp;Mahmoud A. Abo Elmakarem MD","doi":"10.1016/j.jescts.2017.05.003","DOIUrl":"10.1016/j.jescts.2017.05.003","url":null,"abstract":"<div><h3>Background</h3><p>This kind of pathology is uncommon and even may pass unnoticed in casualty patients or iatrogenic after major abdominal surgeries. The repair of such pathology is simple in most cases.</p></div><div><h3>Methods</h3><p>Over 10 years in Saudi German Hospital in Madinah, KSA; we reviewed retrospectively 39 cases of diagnosed diaphragmatic tears due to many causes. The cases were reviewed regarding preoperative, operative and postoperative variables.</p></div><div><h3>Results</h3><p>The outcome of the repair of the diaphragm was good relieving the symptoms with no complications related to the repair of the diaphragm. The morbidity and mortality were due to the associated injuries.</p></div><div><h3>Conclusions</h3><p>Early diagnosis and avoiding misdiagnosis as pneumothorax are crucial in the management. Plain CXR and even CT chest without contrast are mandatory in cases of blunt trauma with other multiple system injuries even to the abdomen alone.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 163-170"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73757559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm postoperative follow-up after surgical correction of hypertrophic cardiomyopathy in infancy and childhood","authors":"Mohamed Mahmoud Abdullah MD,&nbsp;Tarek Salah MD,&nbsp;Yasser Mohamed Menaissy MD,&nbsp;Hesham Abdel Fattah Shawky MD,&nbsp;Mohamed Abdel- Raouf Khalil MD","doi":"10.1016/j.jescts.2017.05.004","DOIUrl":"10.1016/j.jescts.2017.05.004","url":null,"abstract":"<div><h3>Background</h3><p>Surgical septal myectomy has been considered the gold-standard therapeutic option for symptomatic drug refractory patients with hypertrophic obstructive cardiomyopathy (HOCM) for over 50 years. However, it is being challenged by less- invasive interventional tools in the last 2 decades. The late effects of myocardial scar from alcohol septal ablation are unknown and, therefore, are not recommended in children and young adults.</p></div><div><h3>Methods</h3><p>A total of 9 patients underwent surgical interventions for HOCM. All patients were below 12 years of age. The patients were operated upon in Cairo University Hospitals, Egypt; in the period between April 2014 and February 2016. Pre-operative and operative data were collected and analyzed statistically. Post-operative evaluation was documented at different periods and data collected and analyzed in comparison with pre-operative data as well as at these different follow up periods.</p></div><div><h3>Results</h3><p>Mean age of all patients was 6.1 ± 2.6 years. 77.8% were males. All the patients were symptomatic. Preoperative mean pressure gradient (PG) was 95.4 ± 15.2 mmHg. Mean septal wall thickness (SWT) was 1.52 + 0.45 cm, mean degree of mitral regurge (MR) was 1.7 ± 0.83. Immediate postoperative assessment showed significant clinical improvement and significant reduction of PG to 20.0 ± 14 mmHg, SWT to 0.98 ± 0.38 cm, and mean degree of MR to 0.89 ± 0.33. Short-term and mid-term follow up showed sustained improvement. There were no deaths.</p></div><div><h3>Conclusions</h3><p>Surgical procedures for HOCM are generally safe and effective for improvement of symptoms, LVOT gradient, mitral regurge. Early surgical intervention is advocated to prevent progression of valve disease.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 133-141"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84081622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome variables of right anterolateral mini-thoracotomy versus complete sternotomy in atrial septal defect closure: A randomized controlled trial","authors":"Saleh Raslan ,&nbsp;Mohammed Sharaa ,&nbsp;Medhat Refaie ,&nbsp;Warda Demerdash Khalifa Ali ,&nbsp;Abdelsalam M. Elhenawy","doi":"10.1016/j.jescts.2017.03.004","DOIUrl":"10.1016/j.jescts.2017.03.004","url":null,"abstract":"<div><h3>Background</h3><p>Over the last decades, atrial septal defect repair (ASD) as one of the most congenital anomalies has been customarily repaired via sternotomy incision. This technique is associated with very low operative risks and excellent outcomes but with poor esthetic results for the patients. Consequently, right anterolateral mini thoracotomy was invented as a substitute technique aiming for superior cosmetic results. Our study aim was to compare the perioperative outcomes for different approaches.</p></div><div><h3>Methods</h3><p>Forty patients (15 males, 25 females) with ASDs were randomly assigned to have either one of these two approaches at our institution from March 2013 until May 2016. The patients' ages ranged from 2 to 53 years old. Based on their randomization, group I (20 patients), had right anterolateral mini-thoracotomy (RALT) and group II (20 patients) who had sternotomy for surgical closure of ASD. We collected the different demographic, baseline, perioperative and postoperative characteristics.</p></div><div><h3>Results</h3><p>The patients in both groups were similar in age preoperative comorbidities and ejection fraction but more females were in RALT group. There was a highly statistically significant prolonged pump-run time in the thoracotomy group than the sternotomy group with p-value = 0.004. Interestingly, in the thoracotomy group, mechanical ventilation time (hours) was shorter with p-value = 0.002. There were similar blood transfusion rate, chest tube drainage, intensive care unit stay and hospital length of stay. However, more wound infection was found in the sternotomy group which was statistically significant (p-value = 0.035). There were no patients requiring conversion to full sternotomy, no residual defect across the atrial septum and all patients were alive on a month follow-up of the hospital discharge.</p></div><div><h3>Conclusions</h3><p>Right anterolateral mini-thoracotomy is safe, cosmetic, effective and technically feasible and not inferior to the formal median sternotomy to repair ASDs surgically.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 121-127"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90994716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical isolation of the left atrial appendage: A new technique","authors":"Ahmed A. Faragalla MD ,&nbsp;Azza Katta MD","doi":"10.1016/j.jescts.2017.03.007","DOIUrl":"10.1016/j.jescts.2017.03.007","url":null,"abstract":"<div><p>Atrial fibrillation (AF) is a dismal arrhythmia. Thirty to forty percent of patients with mitral valve diseases have chronic AF at the time of surgery with increased incidence of morbidity and mortality postoperatively. Thromboembolism is well known among patients with AF despite adequate anticoagulation therapy and the left atrial appendage (LAA) has been proposed to be its main source. In 2014 LAA has been considered for surgical closure in the AF treatment guidelines. Several surgical techniques have been adopted to exclude LAA during surgery and none of them proved to be completely effective. The main goal of our described new technique is to completely separate the LAA from general circulation avoiding failures of other techniques.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 105-108"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.03.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88587645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and outcome of junctional ectopic tachycardia in pediatric cardiac surgery","authors":"Khouloud A. Al-Sofyani MD, AFS, AFSA ,&nbsp;Raghad I. Jamalaldeen MD ,&nbsp;Shimaa M. Abusaif MD ,&nbsp;Ahmed Abdelrahman Elassal MD ,&nbsp;Osman O. Al-Radi MD, MSc, FRCSC","doi":"10.1016/j.jescts.2017.05.001","DOIUrl":"10.1016/j.jescts.2017.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Junctional ectopic tachycardia (JET) is a plausible life-undermining tachycardia. It mostly happens more often than not in the initial 24–48 h after surgical adjustment of inherent heart deformities when systolic and diastolic capacity of the heart is weakened. The aim of the study was to determine the overall incidence of JET in pediatric patients post open cardiac surgery, possible preoperative and intraoperative risk factors linked with JET, and the effect of JET on morbidity and mortality.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study of all pediatric patients, age ranged from 0 to 14 years, who underwent open cardiac surgery between 2011 and 2015 in our institution at King Abdul-Aziz University Hospital at Jeddah city, KSA. JET patients were compared with other patients underwent open cardiac surgery who did not develop JET regarding possible risk factors and outcomes.</p></div><div><h3>Results</h3><p>The overall incidence of JET in pediatric post open cardiac surgery was 13.8%. Longer cardiopulmonary bypass (CPB) time (90.22 ± 37.8 min, 95% CI 0.92–35.6) was independently associated with JET. Multivariate analyses showed that longer aortic cross clamp (ACC) time (64.6 ± 25.9 min, 95%CI 0.32–29.2) increased risk of developing JET. Patients who developed JET had longer time of ventilation, intensive care unit stays, and hospitalization course (p = 0.006, p = 0.028, p = 0.027, respectively).</p></div><div><h3>Conclusions</h3><p>Longer surgical procedure demonstrated in this study by longer CPB time and longer ACC time contributed to the overall risk of developing JET. Developing JET was associated with worse outcomes.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 2","pages":"Pages 128-132"},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87930536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}