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Comparative Evaluation of Mortality and Hemodynamic Performance Between ATS and ST JUDE Mechanical Heart Valves in Mitral and Aortic Positions
Mohammad Rafi Hamidi,
Manizha Meena,
Mezhgan Zaher,
Mohammad Hussain Shiwa,
Abdul Wahid Hussaini,
Assadullah Hassani,
Manochihr Timorian
Issue:
Volume 6, Issue 6, November 2020
Pages:
66-69
Received:
15 October 2020
Accepted:
26 October 2020
Published:
19 November 2020
Abstract: Background: Rheumatic heart disease is the most common heart disease in Asian countries especially in Afghanistan, the age adjusted death rate for this heart disease is 27,57 per 100 000 people as published by data of the World Health Organization (WHO). ST JUDE mechanical heart valve first time implanted in October 1977 and quickly became the gold standard for subsequent valves, and ATS medical international developed a mechanical heart valve that has been in use since 1992, these mechanical heart valves started implantation in Afghanistan during 2012. We presented a result of 148 patients who have undergone valve replacement in mitral and aortic position with ATS and ST JUDE mechanical heart valves at departments of cardiothoracic and vascular surgery amiri medical complex and global medical complex heart institute Kabul Afghanistan. Method and results: we performed ATS and ST JUDE mechanical heart valve replacement in 148 patients between May 2015 and April 2018 at both the Department of Cardiothoracic and Vascular Surgery Global Medical Complex heart institute and Amiri Medical Complex, Kabul Afghanistan. Male patients were 69 (46.6%) and female patients were 79 (53.3%), age range was between 11-65 years, 94 (63.5%) patients under went mitral valve replacement, for 38 (25.6%) patients performed aortic valve replacement and 16 (10.8%) patients required double valve replacement, overall mortality was 16 (10.8%) patients for mitral, aortic and double valve replacement. The early mortality (hospital mortality) was 4.05% and late mortality during a 3 year follow up was 6.7%. Conclusion: there were seen a few prosthetic valve complications after ATS and ST JUDE mechanical heart valve implantation (total number of implanted ATS mechanical heart valve were 70 and total number of implanted ST JUDE mechanical heart valve were 78), early mortality was (hospital mortality) 6 patients (4.05%) and late mortality during a 3 year follow up was 10 patients (6.7%). The international normalized ratio (INR) was maintained between (2.5-3.5) in both ATS and ST JUDE mechanical heart valves for mitral position and (2-3) for aortic position, hemodynamically ATS and ST JUDE mechanical heart valves are very good regarding trans valvular gradient and function but low prosthetic valve noise is just seen in ATS mechanical heart valve.
Abstract: Background: Rheumatic heart disease is the most common heart disease in Asian countries especially in Afghanistan, the age adjusted death rate for this heart disease is 27,57 per 100 000 people as published by data of the World Health Organization (WHO). ST JUDE mechanical heart valve first time implanted in October 1977 and quickly became the gold...
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Vascular Ring; Spectrum of Pathologies and Scenarios for Diagnosis and Management
Mostafa Elhelali,
Mohamed-Adel Elgamal,
Ahmed Mostafa,
Hysam Abdelmohty,
Walid Hassan
Issue:
Volume 6, Issue 6, November 2020
Pages:
70-74
Received:
27 June 2020
Accepted:
9 July 2020
Published:
4 December 2020
Abstract: Background: Vascular rings represent approximately 1% of all congenital cardiac anomalies, with Edward’s classification being the first to outline them into a complete or partial vascular ring. A Complete ring is a combination of patent vessels, atretic vascular segments or ligamentous structures. Methods: We reviewed patients` records from our Pediatric Cardiac Surgery Unit, over 10 years. We encountered 63 patients from January 2009 to January 2019. Our patients were 57 (90.5%) complete vascular rings, 5 (7.9%) pulmonary artery slings, and 1 (1.6%) patient with innominate artery compression. Results: The age of our Patients ranged from 2 to 57 months (mean 16.25±1.3 m), weight ranges from 3k to 26k (mean 9.87±0.8kg). Males were 38 (60.3%) and male: female ratio was 1.5:1. In our series various types of vascular rings were encountered; Double Aortic Arch was the right dominant arch variant in 25 (53.2%) and left arch dominant in 7 (14.9%) whilethe co-dominant variant was 15 (31.9%). Fifty-seven cases of vascular rings operated through left posterolateral thoracotomy. Fivecases of pulmonary artery sling (7.9%) operated by median sternotomy and one case (1.6%) of innominate artery compression. No reported intraoperative mortality in our study. Conclusion: Vascular ring is a rare anomaly that needs suspicion for diagnosis. The operative strategy relies on extensive dissection and division of the non-dominant arch and division of the ligamentum, freeing all fibrous bands between the arch and esophagus and trachea. For augmented results; we need collaboration from pediatricians and pulmonologists who must be aware of such anomalies.
Abstract: Background: Vascular rings represent approximately 1% of all congenital cardiac anomalies, with Edward’s classification being the first to outline them into a complete or partial vascular ring. A Complete ring is a combination of patent vessels, atretic vascular segments or ligamentous structures. Methods: We reviewed patients` records from our Ped...
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Off-pump Surgical Removal of Right Atrial Myxoma Without Hypothermia
Yury Shevchenko,
Gleb Borshchev
Issue:
Volume 6, Issue 6, November 2020
Pages:
75-78
Received:
20 November 2020
Accepted:
2 December 2020
Published:
16 December 2020
Abstract: Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause blood flow obstruction in the right cardiac chamber. 75% to 80% are located on the left side of the interatrial septum. Right-sided cardiac myxomas present surgeons a lot of technical difficult. We report a case of right atrial myxoma. A 75-year-old female with a large right atrial myxoma underwent surgical treatment in our Center. Due to the high risk of embolic complications associated with conventional connection of a cardiopulmonary bypass machine, we decided to preform beating-heart surgery with clamping of major vessels (aorta, pulmonary artery, and venae cavae). This technique is a method of avoiding embolization. The early postoperative period was uneventful. Two days postoperatively, the patient was transferred from the intensive care unit to hospital ward. Nine days postoperatively, she was discharged in satisfactory condition to continue her follow-up at a local outpatient department. The patient was followed up during the next 3 years and had no signs of relapse.
Abstract: Myxoma of the right atrium is a rare heart tumor. Atrial myxomas are associated with a triad of complications, including obstruction, emboli, and constitutional symptoms (such as fever, weight loss). An interdisciplinary approach is very important to optimize the outcome in patients with atrial myxomas. When myxoma present, it can rarely cause bloo...
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The Scope of Clinical Thoracic Surgery Practice in Nigeria: 13-Year Single Center Review
Ikechukwu Nwafor,
John Eze,
Bolaji Akanni,
Ikponmwosa Gold
Issue:
Volume 6, Issue 6, November 2020
Pages:
79-84
Received:
9 November 2020
Accepted:
19 November 2020
Published:
22 December 2020
Abstract: Background: Thoracic surgery as one of the oldest surgical specialties to have branched off from general surgeryhas a relatively wide scope, covering the diagnosis and treatment of the diseases affecting the various regions ofthechest. The practice of this specialty and challenges affecting it in Nigeria is hereby reviewed. Aims/Objective: To review the scope of clinical thoracic surgery practice in Nigeria including its challenges and compare same with international standard. Methods: For a period of 13 years (2007-2019), the practice of clinical thoracic surgery in Nigeria was reviewed with data from the National Cardiothoracic Center of Excellence (NCTCE). The social-demography profile of the involved patients, the congenital and acquired pathologies of the various anatomic regions of the chest, diagnosis and treatmentmethodologies including outcomes and challenges were extracted from the database, reviewed and analyzed. Results: A total of 1883 general thoracic pathologies in 1200 patients were managed. Of this number, pleural pathology accounted for the highest number (n=687, 35.6%). 657 males and 543 females were involved with aM: F ratio of 1:0.8. Of 1883 cases, 1283 (68.1%) had some form of surgical interventions. Within this group, chest tube drainage± pleural biopsy/pleurodesiswasthehighest (n=611, 47.6%). Late presentations of malignant lung diseases, lack of expertise and equipment for minimal access techniques were some of the challenges. Conclusion: General thoracic surgery as a mono-specialty should be embraced, encouraged and upgraded by the training institutions in our sub-region since the workload for experts in the specialty is enormous.
Abstract: Background: Thoracic surgery as one of the oldest surgical specialties to have branched off from general surgeryhas a relatively wide scope, covering the diagnosis and treatment of the diseases affecting the various regions ofthechest. The practice of this specialty and challenges affecting it in Nigeria is hereby reviewed. Aims/Objective: To revie...
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Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires
Udgeath Dhir,
Anand Kumar,
Rakesh Saklani,
Vishal Jain
Issue:
Volume 6, Issue 6, November 2020
Pages:
85-89
Received:
30 November 2020
Accepted:
19 December 2020
Published:
25 December 2020
Abstract: Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of the ZipFix bands with steel wires on postoperative outcomes after sternal closure. This is a real-world evidence study of patients treated using the ZipFix band and steel wires. The sternal closure is performed by fixing of manubrium with straight simple wires, followed with ZipFix 3 or 4 spaces. Demographic characters of patients using the ZipFix band and steel wire and their relation to sternal infections, wound dehiscence, and post-surgical outcomes are studied. From gathered evidence, 2% of patients’ cases were complicated with the incidence of sternal infections. Ninety-nine percentage of patients had a stable and healthy wound while 1% of patients showed sternal wound dehiscence. The mean duration of hospital and intensive care unit stay was 8.53 (± 4.84) days and 3.58 (± 5.01) days respectively. The use of the sternal ZipFix system in combination with stainless steel wire is found to be effective in reducing post-surgical complications.
Abstract: Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of...
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