journal of cardio-thoracic medicine最新文献

{"title":"Right sided heart evaluation after successful mitral valve replacement.","authors":"Hedieh Alimi, A. Fazlinejad, M. Emadzadeh, L. Bigdelu","doi":"10.22038/JCTM.2019.42308.1240","DOIUrl":"https://doi.org/10.22038/JCTM.2019.42308.1240","url":null,"abstract":"Introduction: It is well-documented that right-sided heart dysfunction and significant tricuspid valve regurgitation (TVR) have adverse effects on patient outcomes after left-sided heart valve surgery. Therefore, the evaluation of right ventriclular (RV) function and TR severity in patients who had undergone mitral valve replacement (MVR), associated with/without concomitant surgery on tricuspid valve, could be helpful for deciding on the necessity of concomitant tricuspid valve intervention before surgery. Materials and Methods: A total of222 patients with MVR for rheumatic disease were evaluated in our Echocardiography Lab in Ghaem Hospital, Mashhad, Iran, within 2013-2018. The patients were divided into four groups, according to their type of concomitant TVR. The subjects (n=11) with concomitant indications for coronary artery bypass grafting (CABG) or history of coronary artery disease were excluded from the study. Results: Significant (at least moderate) TVR was found in 60% of the patients. All patients with rheumatic tricuspid valve had significant TVR. After excluding the patients with significant pulmonary hypertension, there was no difference in the prevalence of significant TR, between the patients with tricuspid valve repair and those without any intervention on tricuspid valve (P=0.178). Furthermore, no difference was observed between the patients with/without any intervention on tricuspid valve considering RV size and function. Conclusion: In patients with left valve surgery concomitant with TR, tricuspid valve repair and replacement could preserve RV size and function, for a long time. During the correction of the left-side valvulopathy, it seems rational to adopt more interventional consideration for patients with tricuspid valve regurgitation, especially those with rheumatic tricuspid valve involvement.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130199409","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":"Comparison of in-Hospital Outcome after Percutaneous Coronary Intervention Between Patients with Anterior Myocardial Infarction and Those With or Without Ramus Intermedius","authors":"A. Separham, Saeid Jodi","doi":"10.22038/JCTM.2019.42473.1241","DOIUrl":"https://doi.org/10.22038/JCTM.2019.42473.1241","url":null,"abstract":"Introduction: Primary percutaneous coronary intervention (PPCI) is used for the treatment of ST segment elevation myocardial infarction (STEMI). Anterior STEMI is associated with adverse outcomes, and it is possible that the presence of ramus intermedius (RI) would inversely affect the outcome. This research involved the evaluation of the influence of RI presence on clinical outcomes in patients with anterior STEMI and culprit lesion in the left anterior descending artery (LAD). Matherials and Methods: This study was conducted on 105 patients with acute anterior STEMI undergoing PPCI in Shahid Madani Hospital, Tabriz, Iran, from April 2016 to March 2018. The recorded data included the patients’ demographic and baseline data, angiographic features, presence of RI, the occurrence of heart failure (HF), cardiogenic shock, and in-hospital and one-year mortality. All data were analyzed, using SPSS software (version 23; SPSS Inc., Chicago, IL). Chi-square test, Fischer’s exact test, independent t-test, or Mann-Whitney U test were employed to compare data between the two groups. A p-value ​less than 0.05 were considered statistically significant. Results: In this research, RI was present in 53 patients (50.5%). The RI presence was mostly detected in male patines than in their female counterparts (88.7% vs. 69.2%; P=0.01). In addition, those with RI presence had a lower rate of single-vessel disease (60.4% vs. 80.8%; P=0.01) and higher proximal LAD involvement (71.7% vs. 32.7%; P<0.001). After the intervention, ST segment decreased more than 50% and was significantly higher in patients with RI, compared to those without it (52.8% vs. 25.5%; P=0.004). Furthermore, there were no significant differences between the groups regarding cardiac enzymes, ejection fraction, HF, cardiogenic shock, and in-hospital and one-year mortality rates. Conclusion: The presence of RI was associated with more proximal LAD lesions and less frequent single-vessel disease. However, RI did not seem to influence in-hospital and one-year outcomes.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124404180","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":"Effect of topical Vancomycin on consolidation of sternum surgical fracture in open-heart surgery","authors":"L. Machuca, Luis Campos, Andrea V. Vaca, Mario Sanchez, C. Castillo, G. Díaz, Rafael Vilchis, J. Aceves, J. L. A. Chimal","doi":"10.22038/JCTM.2019.43065.1244","DOIUrl":"https://doi.org/10.22038/JCTM.2019.43065.1244","url":null,"abstract":"Introduction: The physiological process of sternum surgical fracture consolidation in patients undergoing cardiac surgery could be prolonged by the invasion of gram-positive saprophytic bacteria which perpetuates the local inflammatory process despite the standardized aseptic and antiseptic measures in cardiac surgery. In this regard, the topical application of Vancomycin can exert a positive effect and prevent the perpetuation of the local inflammatory process by the elimination of these bacteria which in turn reduces bone consolidation time.The purpose of the current study was to determine the effect of topical Vancomycin on sternum surgical fracture consolidation in patients undergoing to open-heart surgery. Materials and Methods: Patients who underwent open heart surgery were assigned into groups receiving the topical application of bone wax or Vancomycin mass in the spongy tissue exposed by surgical sternotomy, prior to sternal closure. The bone consolidation processes were assessed by two expert radiologists with simple chest computed tomography (CT) in the postoperative period (4, 8, and 12 weeks). Results: The study was conducted on 55 patients in Vancomycin (n=33) and bone wax group (n=19). The computerized axial tomography (CAT) scan revealed a higher number of patients with early bone consolidation (Medullar and bone continuity, and callus bone) in Vancomycin group, as compared to bone wax group (p values between 0.004-0.02 at 4 weeks and 0.01-0.06 at 8 weeks). However, no difference was observed at 12 weeks (P=0.09-0.11). Moreover, The magnitude effect of topical Vancomycin was high (>90%) at 3, 8, and 12 weeks of follow up, compared to the patients who received bone wax (<90%). Conclusion: The topical Vancomycin application had a positive effect on sternal surgical fracture and promotes an early bone consolidation in patients undergoing open-heart surgery.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124999060","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":"Mycotic aortic aneurysm as a postsurgical complication: report of a case and review of the literature","authors":"D. Farrokh, Fatemeh Sadeghi Ardakani, F. Yousefi, seyedeh Hanieh Afzalabadi","doi":"10.22038/JCTM.2019.44493.1253","DOIUrl":"https://doi.org/10.22038/JCTM.2019.44493.1253","url":null,"abstract":"Mycotic aneurysms are localized and irreversible dilatations of the arteries caused by weakening and damaging the arterial wall by an invasive organism establishing infective arteritis. Mycotic aneurysm of the thoracic aorta is a rare event; however, it can be fatal if not diagnosed early or not treated appropriately. Clinical findings are usually nonspecific; however, contrast-enhanced computed tomography (CT) is a common imaging modality of choice for the detection of mycotic aneurysms. Current management consists of antibiotic therapy and surgical treatment or endovascular interventions as early as possible. Herein, we present a case report of mycotic aneurysm of the thoracic aorta as a postoperative complication in a 60-year-old female with a clinical history of the cardia and esophageal carcinoma who underwent thoracic surgery. The presence of mycotic aneurysm was detected after performing a contrast-enhanced thoracic CT scan","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133795327","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":"Rare Etiology of Cough and Chest Pain in a Young Male","authors":"R. Sodhi, S. Pant, V. Jethani, S. Nadia, M. Aggarwal, S. Khanduri","doi":"10.22038/JCTM.2019.41199.1235","DOIUrl":"https://doi.org/10.22038/JCTM.2019.41199.1235","url":null,"abstract":"Chronic cough and chest pain should be dealt seriously in a young adult. Sometimes we may miss a diagnosis in such patients. We present a case of Pulmonary Langerhans Histiocytosis who presented with complaints of cough and chest pain","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127938459","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":"Prevalence and Causes of Mediastinal Reexploration for Excessive Bleeding after Cardiac Surgery Procedures","authors":"Hamid Hoseinikhah, Omid Javdanfar, M. Akbari, Kayhan Mizani, Mahsa Moallemi, Aliasghar Moeinipour","doi":"10.22038/JCTM.2019.40840.1232","DOIUrl":"https://doi.org/10.22038/JCTM.2019.40840.1232","url":null,"abstract":"Introduction: Postoperative bleeding in cardiac surgery is not an uncommon complication and can be evaluated with surgical and nonsurgical causes. Although any type of coagulopathy should be treated before, during, and after the surgical procedure, cardiac surgeons should have perfect surgical techniques for step by step hemostasis to minimize blood loss. Materials and Method: This retrospective study was conducted on 85 patients out of 1075 (0.07%) ones required Reexploration of the Mediastinal to control the excessive bleeding after different cardiac procedures in Imam Reza Hospital in Mashhad of Iran from January 2018 to January 2019. Results: Out of 85 patients who required Mediastinal Reexploration, 61 (71%) and 24(29%) patients underwent the off-pump procedure and cardiopulmonary bypass, respectively. The most common sites for surgical bleeding in the order were missed branches of left internal mammary artery / saphenous vein graft (65%), proximal or distal coronary anastomosis (18%), and aortic /atrial suture line (16%). The death in patients under study was 7 (8%), half of which were not related to Mediastinal Reexploration. Conclusion: The possibility of postoperative bleeding can be minimized through correction of clotting factor deficiencies, improvement of surgical techniques in hemostasis.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117181627","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":"Possible Effect of CABG on Moderate Mitral Regurgitation","authors":"E. Shahverdi, M. Maki, Mahkameh Rasouli, M. Khani, H. Rad","doi":"10.22038/JCTM.2019.40567.1226","DOIUrl":"https://doi.org/10.22038/JCTM.2019.40567.1226","url":null,"abstract":"Introduction: Mitral valve insufficiency in adults is often a complication of ischemic heart disease. Coronary artery bypass grafting (CABG) is performed as a strategy for the treatment of coronary artery disease. The aim of this study was to evaluate mitral regurgitation (MR) before and after CABG. Materials and Methods: This Experimental study was conducted on 100 patients who underwent CABG in University Hospitals of Tehran, Iran, from 2009 to 2013. Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. Chicago, IL) for Windows was used for data analysis.. Results: Out of 100 patients (i.e., 60 males and 40 females) with the mean age of 64.97±10.64 years, 11 males (18.3%) and 12 females (30.0%) were identified with MR +2 after the surgery. There was no significant relationship between renal insufficiency and MR before the operation (P= 0.370). Furthermore, in patients with and without renal insufficiency, 2 (50.0%) and 21 (21.9%) subjects were identified with MR +2 after the operation, respectively. Out of 100 patients, 75 (75%) cases with MR +2 before the surgery were identified with MR +1 after the operation. Moreover, 23 (23%) subjects with MR +2 before the surgery were still reported with MR +2 after the operation. In this regard, there was a significant relationship before and after the surgery in MR severity (P=0.02). Conclusion: It is necessary to have sufficient knowledge of the risk factors in dealing with MR for the determination of the best therapy.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129646226","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":"Association Between Left Anterior Descending Artery Length with Coronary Artery Dominance: An Angiographic Study","authors":"A. Separham, Masoud Nouri-Vaskeh, M. Maleki","doi":"10.22038/JCTM.2019.41313.1236","DOIUrl":"https://doi.org/10.22038/JCTM.2019.41313.1236","url":null,"abstract":"Introduction: Although left anterior descending (LAD) artery supplies a large portion of the myocardium, the amount of blood supply provided by LAD is depended on the length of the LAD. The aim of the current study was to evaluate the association between coronary artery dominance and LAD anatomic types in patients with normal epicardial coronary arteries. Methods: This retrospective study was conducted at a tertiary teaching hospital on a total of 252 patients with normal coronary artery angiographic findings between April 2018 to March 2019. Patient’s medical records were utilized to collect demographic and catheterization data, as well as their clinical characteristics. Qualitative and quantitative catheterization data, including the anatomical type of LAD, dominance, LAD slow flow phenomenon, LAD ectasia, and Muscle Bridge were obtained from the angiographic examination. The three anatomical LAD types, including type I (LAD terminating before the apex), type II (LAD reached the apex), and type III (LAD wrapping around the apex) were compared in the left and right dominant coronary artery patients. Results: The mean age of patients was 58.06±10.89 years (age range: 27-79 years). The slow flow phenomenon was more significantly observed in patients with type C LAD (P=0.015); however, there was no significant difference between LAD types regarding LAD Muscle Bridge (P=0.099) and ectasia (P=0.810). In total, 54.8% and 45.2% of the patients had right and left dominant coronary artery systems, respectively. Moreover, there was a statistically significant association between wrap-around LAD and left coronary artery dominance (P<0.001). Conclusion: The type C LAD is more prevalent in patients with left dominant coronary artery.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114388568","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":"A Rare Etiology of Drug Rash in a Patient Receiving Anti-Tuberculosis Treatment","authors":"R. Khanduri, V. Jethani, R. Jindal, S. Nadia","doi":"10.22038/JCTM.2019.41142.1234","DOIUrl":"https://doi.org/10.22038/JCTM.2019.41142.1234","url":null,"abstract":"Anti-tuberculosis medications can cause various side effects, including drug rash. When a patient on anti-tuberculosis treatment (ATT) develops rash, we usually stop all medicines, rechallenge the patient with medications individually, and find the offending agent. It should be mentioned that drug rash can be also a manifestation of other diseases. Herein, we report a case of tuberculosis who developed rash while on ATT regimen but was later diagnosed to be concomitantly suffering from leprosy.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132092824","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":"Concurrent Mediastinal Masses in a Patient","authors":"R. Bagheri","doi":"10.22038/JCTM.2019.43141.1245","DOIUrl":"https://doi.org/10.22038/JCTM.2019.43141.1245","url":null,"abstract":"A 16-year-old female with a history of neck hemangioma surgery presented with irritable coughs. A computed tomography scan showed anterosuperior and middle mediastinal masses (Figure 1). The patient underwent surgery and the upper and middle mediastinal lesions were removed (Figure 2A). Pathological examination confirmed that the upper and middle mediastina contained hemangioma  (Figure 2B) and pericardium cyst (Figure 2C)","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"495 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123407760","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}