-
Pulmonary Arterio-Venous Malformations: Is it Easy to Diagnose and Treat Early
Waheed Etman,
Walid Abu Arab
Issue:
Volume 1, Issue 1, July 2015
Pages:
1-4
Received:
19 May 2015
Accepted:
30 June 2015
Published:
1 July 2015
DOI:
10.11648/j.ijcts.20150101.11
Downloads:
Views:
Abstract: Background: Pulmonary arterio-venous malformation (PAVM) is a rare vascular anomaly that can be confronted with in cardiothoracic surgery patients. This study is a retrospective one that analyses the data of our experience with this entity at cardiothoracic surgery department of Alexandria University during nine years. Patients and methods: This is a retrospective study. The files of patients who presented with PAVMs were studied with special attention to the symptoms, signs, investigations that were performed, management and outcome. Results: Eleven patients were included in this study (seven males and four females). They were presented with various symptoms and were investigated mostly by plain x-ray chest and CT-Chest. CT scan with contrast or recently multi-slice CT was a good investigative tool that we depended on it without need for other diagnostic tool. The management was in the form of surgical resection in seven patients and embolo-therapy in four patients. Follow-up with plain x-ray chest and CT-Chest was completed for seven patients where there was no recurrence in those patients underwent embolo-therapy and no new development of PAVM in those underwent surgical resection Conclusion: We concluded that PAVM is an easy entity to diagnose, treat and manage but needs high clinical suspicion.
Abstract: Background: Pulmonary arterio-venous malformation (PAVM) is a rare vascular anomaly that can be confronted with in cardiothoracic surgery patients. This study is a retrospective one that analyses the data of our experience with this entity at cardiothoracic surgery department of Alexandria University during nine years. Patients and methods: This is...
Show More
-
Evaluation of the use of Tru-Cut Needle Biopsy in the Diagnosis of Chest Wall Tumors
Walid Abu Arab,
Akram Allam,
Khaled Karara
Issue:
Volume 1, Issue 1, July 2015
Pages:
5-8
Received:
4 June 2015
Accepted:
30 June 2015
Published:
1 July 2015
DOI:
10.11648/j.ijcts.20150101.12
Downloads:
Views:
Abstract: Introduction: Chest wall tumors can be either primary, metastatic or radiation induced. Moreover, it can be due to involvement by lung or breast cancer. Although clinical and radiological assessments are important in evaluation of patients with chest wall tumors; the histo-pathological diagnosis remains the most important factor in determining the appropriate management. One of the methods to get tissue biopsy is tru-cut needle biopsy. Aim: This study aimed to determine the efficacy and complications of the use of tru-cut needle biopsy in diagnosis of chest wall tumors. Patients and methods: This is a retrospective study in which the files of patients who underwent tru-cut needle biopsy at cardiothoracic surgery department of Alexandria University were reviewed. Results: Twenty patients (13 males and 7 females) underwent tru-cut needle biopsy for chest wall tumors during the period between January 2003 and December 2008. Age ranged between 17 to 75 years (52.4 ± 13.7 years old). Ninety-five percent of patients were presented with chest wall swelling either alone or with pain. All patients except one had tru-cut needle biopsy without radiological assist. Tru-cut needle biopsy was performed with the aid of fluoroscopy in one patient. Pre-operative tissue diagnosis could be established with accuracy in 90% of patients. In 90% of patients, tru-cut needle biopsy was able to determine if the lesion is benign or malignant while in two patients it was inconclusive. No complications were encountered during or following the procedure. Moreover, no recurrence at the site of biopsy was detected during 3 years follow-up. Conclusion: Tru-cut needle biopsy; with or without radiological assist; is of utmost help in accurate pre-operative histo-pathological diagnosis with minimal complications. Accuracy in determination of diagnosis depends on the skills of the personnel who perform the biopsy and the pathologist. Recurrence at site of the biopsy is rare.
Abstract: Introduction: Chest wall tumors can be either primary, metastatic or radiation induced. Moreover, it can be due to involvement by lung or breast cancer. Although clinical and radiological assessments are important in evaluation of patients with chest wall tumors; the histo-pathological diagnosis remains the most important factor in determining the ...
Show More
-
The Use of Fascia Lata in the Reconstruction of Chest Wall Defects: Is It Effective
Walid Abu Arab,
Ibrahim Khadragi
Issue:
Volume 1, Issue 1, July 2015
Pages:
9-12
Received:
4 June 2015
Accepted:
30 June 2015
Published:
1 July 2015
DOI:
10.11648/j.ijcts.20150101.13
Downloads:
Views:
Abstract: Introduction: Chest wall defects could be encountered after chest wall resection for chest wall tumors or resection of pleural or pulmonary tumors invading chest wall. Moreover, they could result from chest trauma. Chest wall reconstruction can be difficult and challenging for the thoracic surgeon. Different techniques and materials were introduced to carry out reconstruction of chest wall defects. Synthetic materials have been associated with some disadvantages. Fascia lata harvested from the thigh of the patient could replace the synthetic materials for chest wall reconstruction therefore avoiding their disadvantages. Aim: The aim of this study was to determine the efficacy and outcome of the use of fascia lata in the reconstruction of chest wall defects. Patients and methods: Retrospective revision of the files of the patients who underwent chest wall reconstruction for chest wall defects using fascia lata at Cardiothoracic Surgery Department at Alexandria University, Egypt during the period (January 2003- December 2008) was done. Results: Ninety patients (13 males and 6 females) underwent chest wall reconstruction of chest wall defects using fascia lata. Age ranged between 22-75 (49.7±13.7) years. The diameter of chest wall defects was between 5-17 cm. The time range for harvesting fascia lata was 14-20 (15.8±2.6) minutes. Average of postoperative hospital stay was 12±13.1 days. The complication that was encountered at site of harvesting of fascia lata was seroma formation that needed to be aspirated (10.5%). Stability was achieved in 78.9% of patients while small segment of paradoxical movement were encountered in 21.1%. Conclusion: In conclusion, reconstruction of chest wall defects using free graft of fascia lata was found to be safe with low rate of complications. It avoids the risk of infection that encountered with the use of synthetic materials. The stability provided to the chest wall after reconstruction with fascia lata was found to be dependent on the size and site of the chest wall defect. Moreover, it was found that fascia lata could provide acceptable stability for reconstructed chest wall defects that is more pronounced few weeks later following surgery.
Abstract: Introduction: Chest wall defects could be encountered after chest wall resection for chest wall tumors or resection of pleural or pulmonary tumors invading chest wall. Moreover, they could result from chest trauma. Chest wall reconstruction can be difficult and challenging for the thoracic surgeon. Different techniques and materials were introduced...
Show More
-
Does Modified Ultra Filtration Affect Clinical Outcome Following Pediatric Cardiac Surgery
Akram Allam,
Wael Hassanein,
Walid Abu Arab,
Ahmed Othman,
Mohsen AbdelAzeem
Issue:
Volume 1, Issue 1, July 2015
Pages:
13-19
Received:
9 June 2015
Accepted:
30 June 2015
Published:
1 July 2015
DOI:
10.11648/j.ijcts.20150101.14
Downloads:
Views:
Abstract: Background: Modified ultra filtration (MUF) has become widely used in pediatric cardiac surgery. MUF is capable to remove large amounts of fluid with significant improvement in the post-cardiopulmonary bypass status and laboratory parameters of the patients. There is; however; contradicting reports in the overall clinical outcome benefit following MUF. Methods: Thirty patients weighing less than 15 kg and their median age was 10 months. Undergoing open-heart surgery over a one year period was randomized to either MUF group or conventional ultrafiltration group (CUF). Parameters of investigations included perioperative laboratory findings, hemodynamic status, and duration of hospitalization, and morbidity and mortality rates. The volume of fluid removed with each method was standardized as a percentage of effective fluid balance. Results: There was no significant difference between both groups in age, weight, or duration of cardiopulmonary bypass. MUF patients group received less volume than the CUF group (175 + 72 vs. 196 + 111 ml/kg; p =0.05). There was no difference in the percentage of effective fluid balance that was removed in both groups. The MUF group showed significant higher post-cardiopulmonary bypass hematocrit levels and higher mean arterial blood pressure. Moreover, a significant reduction in chest tube drainage (27 + 16 vs 36 + 11 ml/kg p <0.001) was noted in this group. However, no difference was detected between both groups as regard duration on ventilator, number of days at ICU or at hospital. Conclusion: MUF seems to produce temporary improvement in the immediate post cardiopulmonary bypass period. However; its long term effects is similar CUF.
Abstract: Background: Modified ultra filtration (MUF) has become widely used in pediatric cardiac surgery. MUF is capable to remove large amounts of fluid with significant improvement in the post-cardiopulmonary bypass status and laboratory parameters of the patients. There is; however; contradicting reports in the overall clinical outcome benefit following ...
Show More
