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Management of Pulmonary Arterial Hypertension Associated with Congenital Heart Disease in Children
Abdulsalam Y. Taha,
Ahmed M. Ibraheem
Issue:
Volume 2, Issue 4, November 2016
Pages:
15-21
Received:
6 May 2016
Accepted:
7 August 2016
Published:
11 October 2016
DOI:
10.11648/j.ijcts.20160204.11
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Abstract: Background Pulmonary arterial hypertension (PAH) is a serious complication of unrepaired congenital heart disease (CHD). The aim of this retrospective study was to evaluate the management of PAH associated with CHD (APAH-CHD) in the Iraqi Center for Heart Disease, Baghdad. Methodology Twenty children with APAH-CHD were surgically treated over 2 years (1st June 2013 to 1st June 2015).Clinical evaluation was followed by chest radiography and transthoracic echocardiography (TTE). Suspected inoperable patients were subjected to cardiac catheterization and Oxygen test. Total surgical correction was elected in children with mild to moderate PAH while young children with low body weight and severe PAH were offered pulmonary artery banding (PAB) reducing PA pressure to 50% of the systemic pressure. All patients were looked after carefully in the ICU. TTE was used in the follow up. Results There were 12 females (F: M=1.5:1) The ages ranged between 4 and 84 months with a mean of 16.4 ± 20.1 months. Seventy % were infants. Five patients (25%) underwent cardiac catheterization. Ventricular septal defect was the commonest underlying anomaly (90%). Twelve patients had full correction and they were significantly older than those treated by PAB. Three totally corrected kids died (25% death) whereas no child died after PAB. Pulmonary hypertensive crisis was accused once. The remaining 17 patients were followed up for 6-18 months; 14 were alive when this paper was written. Conclusion PAB may be a good option for the very young and sick children who might not tolerate a lengthy total correction.
Abstract: Background Pulmonary arterial hypertension (PAH) is a serious complication of unrepaired congenital heart disease (CHD). The aim of this retrospective study was to evaluate the management of PAH associated with CHD (APAH-CHD) in the Iraqi Center for Heart Disease, Baghdad. Methodology Twenty children with APAH-CHD were surgically treated over 2 yea...
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Bleeding Complications in Organs Outside the Heart After Open Heart Surgery
Ihsanul Amal,
Heroe Soebroto
Issue:
Volume 2, Issue 4, November 2016
Pages:
22-25
Received:
4 September 2016
Accepted:
8 October 2016
Published:
17 October 2016
DOI:
10.11648/j.ijcts.20160204.12
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Abstract: Bleeding complications after open heart surgery are not unusual. However, bleeding complications that occur in other organs, such as brain and gastrointestinal tract, are rare. It is associated with significant morbidity and mortality after open heart surgery. These case series reported two patients who experienced complications after open heart surgery in the form of massive intracerebral hemorrhage and massive gastrointestinal tract bleeding. The similarity in both cases is prolonged cardiopulmonary bypass time.
Abstract: Bleeding complications after open heart surgery are not unusual. However, bleeding complications that occur in other organs, such as brain and gastrointestinal tract, are rare. It is associated with significant morbidity and mortality after open heart surgery. These case series reported two patients who experienced complications after open heart su...
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Pulmonary Schistosomiasis Presenting as a Solitary Fibrous Tumor
Shady Ashraf,
Imad Ben Moujeeb,
Amer Chaikhouni
Issue:
Volume 2, Issue 4, November 2016
Pages:
26-28
Received:
21 July 2016
Accepted:
4 November 2016
Published:
30 November 2016
DOI:
10.11648/j.ijcts.20160204.13
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Abstract: A 37 years old man presented with shortness of breath on mild exertion. Chest X-ray and CT-scan showed a large mass in the right chest. CT-guided fine needle biopsy was suggestive of solitary fibrous tumor of the pleura. Excision through right thoracotomy was done, and histopathology reported a solitary fibrous tumor with Schistosoma eggs. This case report may be the first in the English literature of a patient with pulmonary schistosomiasis presenting as a solitary fibrous tumor.
Abstract: A 37 years old man presented with shortness of breath on mild exertion. Chest X-ray and CT-scan showed a large mass in the right chest. CT-guided fine needle biopsy was suggestive of solitary fibrous tumor of the pleura. Excision through right thoracotomy was done, and histopathology reported a solitary fibrous tumor with Schistosoma eggs. This cas...
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Right Non-recurrent Inferior Laryngeal Nerve Discovered During Carotid Endarterectomy: A Case Report and Literature Review
Deborah Ongaro,
Stefano Elia,
Roberto Cazzaniga,
Lucio Taglietti
Issue:
Volume 2, Issue 4, November 2016
Pages:
29-33
Received:
5 October 2016
Accepted:
29 November 2016
Published:
21 December 2016
DOI:
10.11648/j.ijcts.20160204.14
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Abstract: The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incidence between 0.3% and 1.6%. It is commonly caused by an embryologic anomaly of the aortic branches and, for this reason, it occurs most on the right and is closely associated with an aberrant subclavian artery (also named arteria lusoria). The peculiar anatomy of this nerve must be well-known by surgeons, in order to prevent accidental injuries and avoid post-operative complications, such as vocal cords paralysis. There are other anomalies of cervical nerves (i.e. sympathetic-inferior laryngeal nerve anastomotic branches, SILAB) that simulate the NRILN and it is of paramount importance for the surgeon to distinguish them. In this article, we present the case of a patient undergoing a carotid endarterectomy (CEA), in which a right NRILN was found intraoperatively. We found that this NRILN was associated with no right aberrant subclavian artery, but with an anomalous origin of the brachio-cephalic trunk. Key points in differential diagnosis, embryological origin and surgical implications are discussed.
Abstract: The recurrent inferior laryngeal nerve (RILN) origins from the vagus trunk and, recurring into the mediastinum, courses then into the larynx. Sometimes this nerve can assume an unusual pathway, coursing directly into the larynx. This anomaly is the so-called non-recurrent inferior laryngeal nerve (NRILN) and represents a rare entity, with an incide...
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Successful CPR in a Patient with Left Main Coronary Stenosis and Severe Aortoilliac Disease Following Intubation
Nadine Kawkabani,
Rula Darwish,
Bassem Ayyache,
Bassam Abu Khalil
Issue:
Volume 2, Issue 4, November 2016
Pages:
34-36
Received:
27 November 2016
Accepted:
9 December 2016
Published:
5 January 2017
DOI:
10.11648/j.ijcts.20160204.15
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Abstract: The incidence of pre-bypass ischemia in patients undergoing coronary artery bypass grafting ranges between 10% to 50% [1]. We report in this paper a successful cardiopulmonary resuscitation (CPR) for a 75-year- old male patient with left main coronary disease who developed an asystolic cardiac arrest during induction, immediately after laryngoscopy and intubation. The arrest was managed by an immediate CPR and a prompt initiation of cardiopulmonary bypass. The patient had a very smooth and uneventful post operative course and was discharged from our institution 5 days after surgery without any organ damage. We discuss in this case report the factors that may have precipitated the arrest as well the elements -barbiturates, immediate CPR and tepid hypothermic bypass- that may have contributed to the excellent outcome.
Abstract: The incidence of pre-bypass ischemia in patients undergoing coronary artery bypass grafting ranges between 10% to 50% [1]. We report in this paper a successful cardiopulmonary resuscitation (CPR) for a 75-year- old male patient with left main coronary disease who developed an asystolic cardiac arrest during induction, immediately after laryngoscopy...
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