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

{"title":"Mid-term results of three dimensional annuloplasty ring repair in treating functional tricuspid valve regurgitation","authors":"Osama Rashwan ,&nbsp;Abdallah Nosair ,&nbsp;Hosam Fathy ,&nbsp;Kareem Mahmoud ,&nbsp;Alaa Omar","doi":"10.1016/j.jescts.2017.11.002","DOIUrl":"10.1016/j.jescts.2017.11.002","url":null,"abstract":"<div><h3>Background</h3><p>Functional tricuspid regurgitation (TR) is caused by annular dilatation mainly in the posterior annulus. However, ring annuloplasty does not always prevent the recurrence of TR. Tricuspid repair with 3-dimensional Contour 3D ring is claimed to improve functional TR yet the mid and long-term results of repair need to be assessed.</p></div><div><h3>Methods</h3><p>From March 2013 to March 2015, 50 patients with Functional TR secondary to left-sided valve disease underwent tricuspid annuloplasty using the Contour 3D (Medtronic, Minneapolis, MN) ring. All patients underwent concomitant left-sided valve surgery. Follow-up of TR and right ventricular (RV) function were done before hospital discharge and after 12 and 24 months.</p></div><div><h3>Results</h3><p>Mean ring size was 30.5 mm (range 28–36). Hospital mortality was 4%. The follow-up period was 26 ± 6 months. Echocardiography at hospital discharge documented no or mild, moderate, and moderate to severe TR in 76%, 16% and 4% of the patients respectively. Follow-up after one year revealed mild TR in 16% of patients, moderate TR in 16% patients. At 24 months, moderate TR was present in 12% patients, no patient had any evidence of severe TR at 12 and 24 months. Freedom from TR≥ +3 was 100% after 24 months.</p></div><div><h3>Conclusions</h3><p>Tricuspid annuloplasty with the Contour 3D ring provided satisfactory early results in functional TR which remained stable at mid-term follow up. Still long-term results need further follow up and assessment.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 4","pages":"Pages 316-322"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123138900","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":"Should all candidates with operable non-small cell pulmonary malignancy undergo cervical mediastinoscopy preoperatively?","authors":"Ihab Ali ,&nbsp;Faisal Mourad ,&nbsp;Augustine Tang","doi":"10.1016/j.jescts.2017.06.005","DOIUrl":"10.1016/j.jescts.2017.06.005","url":null,"abstract":"<div><h3>Background</h3><p>Mediastinoscopy is the procedure of choice for the assesment of mediastinal lymph node (MLN) metastatic disease. Cervical mediastinoscopy allows exploration of lymph nodes in the paratracheal and pretracheal regions, in the tracheobronchial angles, and in the anterior aspect of the subcarinal space. So we aimed to investigate the role of mediastinoscopy in the diagnosis of MLN involvement in patients with non small cell lung cancer.</p></div><div><h3>Methods</h3><p>This study is a cross-sectional, randomized study. Inclusion criteria included patients with potentially operable bronchogenic carcinoma who showed no evidence of MLN involvement using the CT scan. PET scan was added as an investigative tool as a routine in all patients with lung cancer.Exclusion criteria included patients who were preoperatively known to have small cell lung cancer, and patients with negative MLN affection (N0/N1) by the FDG- PET. Cervical mediastinoscopy was done to all included patients.</p></div><div><h3>Results</h3><p>34 patients were full filling our inclusion criteria for mediastinoscopy.</p><p>31 Patients proved to have MLN metastasis by mediastinoscopy, and were referred back to the chest oncologist for neo-adjuvant chemo or radiotherapy.</p><p>3 patients, were negative on mediastinoscopy underwent surgery for resection. Their post operative MLN sampling had shown that they had no MLN metastasis. Their pathology results had shown that, two of them had adenocarcinoma and one squamous cell carcinoma.</p></div><div><h3>Conclusions</h3><p>Patients with operable NSCLC with negative mediastinal CT scan, should perform PET scan and mediastinoscopy if they are highly suspicious of having occult N2 disease to prevent an unnecessary thoracotomy.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 270-277"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74739324","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":"Tracheal resections and anastomosis for benign tracheal stricture. A seven-year experience in a single tertiary institute","authors":"Ahmed Mostafa ,&nbsp;Nevine Abdelfattah","doi":"10.1016/j.jescts.2017.08.003","DOIUrl":"10.1016/j.jescts.2017.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Tracheal stenosis is one of the major complications following prolonged endotracheal intubation. Tracheal resection and anastomosis (TRA) is a definitive solution for this serious problem. This study aimed to review the experience of our institute in 7 years with patients presenting with postintubation tracheal stenosis.</p></div><div><h3>Methods</h3><p>A retrospective analysis of patients with post-intubation tracheal stenosis who presented to the pulmonology and Thoracic Surgery departments, Ain Shams University Hospitals, Cairo, Egypt during the period from January 2009 to January 2016. All patients were subjected to diagnostic bronchoscopy, and radiological evaluation. TRA was performed as a primary treatment. Sixty patients were selected and data were collected from their files.</p></div><div><h3>Results</h3><p>Age range was 2–72 years with mean age of 29.76 ± 17.04 years, 42 were males (70%) and 18 were females (30%), 40 patients (66.7%) had previous bronchoscopic dilatations, 35 patients (58.33%) had tracheostomies, 4 patients (6.7%) had history of tracheal stenting. Twenty-five patients (41.67%) had cricotracheal resection (CTR) for subglottic stenosis. Patients were followed up for 6 months. Anastomotic success rate was (96.6%). Two patients died during the in-hospital stay (3.3%).</p></div><div><h3>Conclusions</h3><p>TRA proved to be a safe and reliable solution for post-intubation tracheal stenosis. This procedure should be considered first in developing countries where there is frequent rush for tracheostomies and tracheal stenting. Quality of life improved dramatically following this definitive surgery.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 278-284"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119010589","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":"Tracheal resections and anastomosis for benign tracheal stricture. A seven-year experience in a single tertiary institute","authors":"A. Mostafa, N. Abdelfattah","doi":"10.1016/J.JESCTS.2017.08.003","DOIUrl":"https://doi.org/10.1016/J.JESCTS.2017.08.003","url":null,"abstract":"","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"72 1","pages":"278-284"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86324368","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":"Self-expandable metal stent for palliation of malignant dysphagia & quality of life improvement in advanced cancer esophagus: Upper Egypt experience","authors":"M. Abdelshafy, Mohammed A Omar, M. A. Bary, Mohamed Mostafa Wahaman, R. Bakheet","doi":"10.1016/J.JESCTS.2017.06.003","DOIUrl":"https://doi.org/10.1016/J.JESCTS.2017.06.003","url":null,"abstract":"","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"12 1","pages":"262-269"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86605921","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":"Comparative study between CardiaMed valves (freely floating valve leaflets) versus St. Jude Medical (fixed valve leaflets) in mitral valve replacement surgery","authors":"Mostafa Ahmed ,&nbsp;Ezzeldin A. Mostafa ,&nbsp;Ahmed Abd el Aziz Ibrahim ,&nbsp;Ayman Mahmoud Ammar ,&nbsp;Ramy Mohamed Reda Khorshid ,&nbsp;Moataz E. Rezk","doi":"10.1016/j.jescts.2017.08.004","DOIUrl":"10.1016/j.jescts.2017.08.004","url":null,"abstract":"<div><h3>Background</h3><p>With the availability of a wide variety of valve prostheses, surgeons are still searching for the ideal valve, striving for improved hemodynamics, durability and thrombogenicity.</p><p>The purpose of this prospective, randomized, comparative study was to evaluate the early post-operative hemodynamic function and major clinical events in patients receiving CardiaMed™ prosthetic valves in comparison to St. Jude Medical™ (SJM) valves in the mitral valve position.</p></div><div><h3>Methods</h3><p>Between Sept 2013 and Sept 2015, 60 elective mitral valve replacement (MVR) patients in Ain Shams Hospital, Cairo, Egypt were divided into two groups of 30. Group I received the CardiaMed valve and Group II received the SJM valve. All patients were followed up at discharge from hospital, and at three and six months post-operatively.</p></div><div><h3>Results</h3><p>There were no statistical differences between groups regarding the demographic data, preoperative clinical and functional NYHA class, cardiac assessment or mitral valve pathology. By the end of the follow up, there was no valve-related co-morbidity. Early post-operative complications were seen in 4 patients (13.3%) in Group I and in 5 patients in Group II (16.7%), namely; re-exploration for bleeding, rhythm disturbance, or wound infection. The PPG and MPG were slightly higher in Group I (10.9 ± 1.2 and 5.3 ± 0.9) than in Group II (10.2 ± 2.3 and 5.2 ± 1.3); p = 0.798 and 0.107 respectively. There was no significant statistical difference between the groups regarding the post-operative echo follow-up data.</p></div><div><h3>Conclusions</h3><p>CardiaMed freely floating leaflet prostheses showed good hemodynamic characteristics. The prosthesis adequately corrects hemodynamics and is safe and no worse than the St. Jude Medical valve in the mitral valve position.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 242-248"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87927369","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 impact of total arterial revascularization off pump coronary bypass grafting in impaired left ventricular function","authors":"I. Moursi,&nbsp;K. Al Fakharany","doi":"10.1016/j.jescts.2017.05.005","DOIUrl":"10.1016/j.jescts.2017.05.005","url":null,"abstract":"<div><h3>Background</h3><p>The Arterial grafts have the advantage of durability and may have a protective effect by reducing the progression of native coronary artery disease (CAD) in grafted vessels. This study aimed to evaluate the impact of total arterial revascularization off pump coronary artery bypass grafting (CABG) in impaired left ventricular (LV) function patients with Ejection Fraction (EF) ≤ 35% concerning the short-term results.</p></div><div><h3>Methods</h3><p>From August 2006 to August 2015, 287 patients with EF ≤ 35% out of 1950 patients underwent CABG in our Department of Cardiac-Thoracic Surgery, Zagazig University hospital, Egypt, for myocardial revascularization procedures were studied with a prospective registry of their data. Group 1 included 137 patients subjected to total arterial revascularization off Pump (TAROP) and Group 2 included 150 patients subjected to conventional technique (C-CABG).</p></div><div><h3>Results</h3><p>Hospital mortality was less in group 1 (4.37% versus 4.66%). The duration of intensive care unit stay and the hospital stay were shorter in the group 1, with statistical significance. The mean graft patency rate for 113 (82.5%) patients of group 1 (TAROP) and 113 (75.3%) group 2 (C-CABG, utilizing internal mammary and venous grafts) at one month were 98.2% and 80.5% respectively. The short-term outcome revealed that the mean postoperative LVEF improved significantly, from 29% ± 1.7% to 41.0% ± 2.0% (p &lt; 0.05) for group 1 with an improvement of the NYHA classification of the patients in both groups.</p></div><div><h3>Conclusions</h3><p>Total arterial revascularization off-pump CABG in impaired left ventricular function can be achieved in most cases with low complication and mortality rates and accepted results.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 177-184"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72622553","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":"Bridging saphenous vein harvesting versus conventional techniques in patients undergoing coronary artery bypass grafting in Suez Canal university hospital","authors":"Ali Ali Mohamed Elbassioni,&nbsp;Mohamed A. Amr,&nbsp;Hassan Salah Hassan,&nbsp;Hany Anis Eldomiaty","doi":"10.1016/j.jescts.2017.06.006","DOIUrl":"10.1016/j.jescts.2017.06.006","url":null,"abstract":"<div><h3>Background</h3><p>Ischemic heart disease (IHD) is a common cause of death, which encourages us to improve continuously the techniques adopted for coronary artery bypass grafting (CABG). Still the most commonly used graft is saphenous vein harvested by different techniques.</p></div><div><h3>Methods</h3><p>This prospective randomized study included 60 patients with IHD in need of CABG classified into two equal groups: group A (saphenous vein harvesting with conventional technique) and group B (saphenous vein harvesting with lens assisted bridging technique [LABT]). We compared the two groups in terms of preoperative, intraoperative and postoperative data then we statistically analysed the findings.</p></div><div><h3>Results</h3><p>Our study showed that LABT had significantly less pain, less infection, more cosmetic, less hospital stay with more patient satisfaction and without any additional costs.</p></div><div><h3>Conclusions</h3><p>Our study showed that lens assisted bridging vein harvesting was a good substitute for conventional technique.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 210-216"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.06.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73196753","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":"Effect of terminal warm reperfusion (hot shot) and remote ischemic preconditioning, either separately or combined, on myocardial recovery in adult cardiac surgery","authors":"Mohamed Elgariah,&nbsp;Mohamed Abo El Nasr,&nbsp;Hosam Fawzy,&nbsp;Ehab Wahby,&nbsp;Abdelhady Taha","doi":"10.1016/j.jescts.2017.07.005","DOIUrl":"10.1016/j.jescts.2017.07.005","url":null,"abstract":"<div><h3>Background</h3><p>Reperfusion injury is a major contributor to morbidity and mortality after cardiac surgery. Among the myocardial protective modalities, terminal warm reperfusion (hot shot) and remote ischemic pre-conditioning techniques were found to protect myocardial function and improve better postoperative outcomes. The aim of this study was to compare the effect of terminal hot shot cardioplegia, the effect of remote ischemic preconditioning and the effect of both techniques on myocardial recovery after adult cardiac surgery.</p></div><div><h3>Methods</h3><p>One hundred forty-five patients were divided into four groups comparing hot shot group, remote ischemic preconditioning group, combined hot shot and remote ischemic preconditioning group and the control group. The data collected included preoperative demographic and clinical characteristics, intraoperative data and postoperative short term outcome including inhospital mortality.</p></div><div><h3>Results</h3><p>Patients of the combined group were found to have significantly better outcome including fewer ventricular arrhythmias, less intra-operative need of intra-aortic balloon pump, low cardiac output, and less length of ICU stay. The in-hospital mortality showed a significant difference between the 4 groups. Among patients without hot shot, the incidence of postoperative temporary epicardial pacing was higher and decreased in patients underwent hot shot and remote ischemic preconditioning but didn't reach a statistical significance.</p></div><div><h3>Conclusions</h3><p>Both remote ischemic preconditioning and terminal hot shot reperfusion before removal of the aortic cross clamping improved outcome of on-pump adult cardiac surgery patients. There was a significant effect on the in-hospital mortality and there were fewer incidences of arrhythmias and less requirement for postoperative inotropic support with this technique.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 230-235"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83269335","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":"A simple technique for aortic valve replacement plus mitral valve repair in a totally calcified infected aortic homograft: A case report","authors":"Ahmed Attia,&nbsp;Farouk Oueida,&nbsp;Mustafa Alrefae,&nbsp;Khalid Eskander","doi":"10.1016/j.jescts.2017.07.003","DOIUrl":"10.1016/j.jescts.2017.07.003","url":null,"abstract":"<div><p>We report a case of aortic valve replacement (AVR) with a sutureless valve in an infected degenerated heavily calcified aortic homograft. This technique simplifies this technical challenge, allows rapid AVR in a heavily calcified aortic root, and avoids performing a redo Bentall operation with its known difficulties and saves time for concomitant heart procedures.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"25 3","pages":"Pages 249-251"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88381777","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}