فهرست مطالب

Cardio -Thoracic Medicine - Volume:5 Issue: 1, Winter 2017

Journal of Cardio -Thoracic Medicine
Volume:5 Issue: 1, Winter 2017

  • تاریخ انتشار: 1396/03/01
  • تعداد عناوین: 8
|
  • Vahid Dehestani, Fariba Rezaeetalab, Mahnaz Amini, Davood Attaran, Leila Ghofraniha, Mohammadreza Kasraei Pages 530-532
    Introduction
    Chronic obstructive pulmonary disease (COPD) patients are at increased risk of sleep-disorders. The concomitant occurrence of COPD and obstructive sleep apnea hypopnea syndrome (OSAHS) is named overlap syndrome. This study aimed to evaluate the severity of OSAHS in overlap syndrome patients.
    Materials and Methods
    This cross-sectional study was conducted on adult patients with forced expiratory volume in 1 second (FEV1%)/forced vital capacity
    Results
    Forty patients (62.5% male) with mean age of 59.7±8.3 years participated in the study. Severity of obstructive sleep apnea was low, moderate, and severe in 23 (57.5%), 14 (35%), and 3 (7.5%) cases, respectively and there was no statistical relation between OSAHS and FEV1% (P=0.55).
    Conclusion
    This study showed that there was no significant correlation between apnea–hypopnea index and FEV1% predicted in overlap syndrome patients.
    Keywords: Apnea Hypopnea Index, Body mass index, Chronic Obstructive Pulmonary Disease, Obstructive Sleep Apnea Hypopnea Syndrome, Overlap Syndrome
  • Shima Sheybani, Siamak Boustan, Shahram Amini, Mona Najaf Najafi, Mohammad Abbasi Tashnizi, Nahid Zirak Pages 533-537
    Introduction
    Acute kidney injury (AKI) is a common postoperative complication of cardiac surgery, which is associated with an increased risk of morbidity and mortality. This study investigated the frequency of postoperative AKI in low risk adult patients undergoing off-pump coronary artery bypass grafting (CABG).
    Materials and Methods
    All consecutive adult patients of American Society of Anesthesiologists (ASA) class II and III, who were transferred to the post-operative cardiac surgery ICU after off-pump CABG and were low risk for AKI from October 2013 to September 2014 at Emam Reza Hospital, Mashhad, Iran were enrolled in this prospective cohort study at a teaching hospital. The patients were explored for AKI development, based on risk-injury-failure-loss- end stage kidney disease (RIFLE) and acute kidney injury network (AKIN) criteria, frequency of metabolic acidosis, hypernatremia, hyperchloremia, and length of stay in ICU.
    Results
    According to the results of the present study, 479 patients with the mean age of 60.8±10.75 yrs were included. AKI occurred in 22 (4.4%) and23 (4.8%) patients, based on both the RIFLE and AKIN criteria, respectively with the highest rate of AKI, reported on the third and fourth post-operative days. Additionally, hyperchloremia and hypernatremia were observed in 71 (14.8%) and 76 (15.9%) patients, respectively. Only one case of mortality occurred during the study. Metabolic acidosis was reported in 112 (23.4%) patients with a high anion gap in 60 (12.5%) cases.
    Conclusion
    The current study demonstrated that hypernatremia and metabolic acidosis but not AKI are frequently seen in patients receiving normal saline following off pump CABG with low risk for AKI.
    Keywords: Acute Kidney Injury, AKIN, CABG, Normal Saline, RIFLE
  • Reza Bagheri, Seyed Ziaollah Haghi, Davood Attaran, Fatemeh Ebadi, Yaser Rajabnejad, Ataollah Rajabnejad Pages 538-542
    Introduction
    Video-assisted thoracic surgery (VATS) is now commonly used for primary spontaneous pneumothorax. In the present study we compared the outcomes of this technique with those obtained by conventional thoracotomy.
    Material and
    Methods
    In this cross-sectional stud, forty patients were enrolled into two groups: VATS (n=20) and thoracotomy (n=20). In both groups the blebs were resected and pleural abrasion was performed with putting a mesh on the apical surface of the parietal pleura, finalized by patchy pleurectomy and mechanical abrasion with gas. Two groups were appropriately matched for age, gender, side of bleb, indication for surgery, and the smoking habits. As outcome measures, the conversion from VATS to thoracotomy and the early complications including wound infection, air leakage and intraoperative bleeding were assessed. After discharge, follow up schedule included visits at one, three, six months and one year post-operation to evaluate the recurrence rate.
    Results
    Mean age of these forty patients (34 males and 6 females) was 28.4±8.74 years. There was no conversion from VATS to thoracotomy group. The complications, including prolonged air leakage and wound infection, were seen in three patients of each group (totally 6 patients) (P=0.712). One patient in VATS group experienced the recurrence (P=0.235). Average admission time was 5±0.79 days in the VATS and 5.65±0.81 days in the thoracotomy group (P=0.043), duration of surgery in the open thoracotomy and VATS groups were 76±5.52 and 48.35±4.35 min, respectively (P
    Conclusion
    VATS seems to be superior to thoracotomy, when it is indicated due to the recurrence or other reasons, because in spite of the similar therapeutic efficacy and recurrence rate, VATS is associated with less tissue damage and shorter hospital stay.
    Keywords: Open Thoracotomy, Primary Spontaneous Pneumothorax, Recurrence, Video Assisted, Thoracic Surgery
  • Juan Siordia, Sreekumar Subramanian Pages 543-546
    Certain benefits are clearly associated with the use of off-pump coronary artery bypass grafting (CABG) as compared with the on-pump CABG. The superiority is more evident in patients with multiple co morbidities including renal failure.
    We reviewed the medical records of a 67-year-old male with a past medical history that was significant for multiple cardiovascular diseases and new-onset end-stage renal disease. The case was suffering from dyspnea and work-up was suggestive of non-ST elevation myocardial infarction and congestive heart failure.
    During the hospital course, he developed end-stage renal disease requiring hemodialysis. Further cardiac evaluation presented three-vessel coronary artery disease. The patient underwent off-pump CABG. Post-operatively, the patient had minimal complications and did not receive hemodialysis for 53 days.
    Off-pump CABG has evident short-term benefits for patients with the end-stage renal disease requiring dialysis, including possible improvement in cardiac function and avoidance of hemodialysis.
    Keywords: Cardiac Surgery, Dialysis, Off, Pump CABG
  • Hamid Hoseinikhah, Shima Sheibani, Narges Imani Pages 547-549
    Endocarditis and intracardiac infection have been increased recently especially in dialysis dependent renal failure patients. This is usually intractable infection to broad spectrum Antibiotic therapy and in most cases surgical intervention was necessary. We have presented 45 years old man with intracardiac infection at the tip of dialysis catheter that after catheter removal intracardiac infection was removed.
    Keywords: Cardiac Surgery, Chronic Renal Failure, Intracardiac Infection
  • Seyed Hossein Fattahi Masoom, Marziyeh Nouri Dalouee, Ali Taherian Pages 550-552
    Malignant Fibrous Histiocytoma (MFH) is the most common soft-tissue sarcoma which predominantly surfaces in the retro-peritoneum and extremity. MFH of lung is a very rare condition. The diagnosis is essentially through histologic examination. However, the invasion of the chest wall or other organs might help establish the malignant nature.We report a case of a 77-year-old man who had been presented with a history of dyspnea and non-massive hemoptysis. Computed Tomography (CT) scan of the chest showed a lobulated mass which had developed into the hilum of the lung. Furthermore, the inferior pulmonary artery was invaded. Thus, the final histological diagnosis confirmed MFH. The patient underwent a left pneumonectomy along with the dissection of the regional lymph nodes. Although lung MFH is rather an uncommon condition, it must be taken into consideration in differentiating between the types of lung tumor. What can be concluded is that complete surgical resection is the essential approach.
    Keywords: Malignant Fibrous Histocytoma, Lung Tumor, Surgery
  • Oldooz Aloosh, Haleh Afshar, Niloufar Dadashpour, Arda Kiani, Majid Golestani Eraghi Pages 553-555
    Hydropneumothorax denotes concurrent presence of pneumothorax and hydrothorax in the pleural space, which can be a fatal situation. In this study, we presented the case of a 35-year-old male with history of progressive pleuritic chest pain 30 days before admission with idiopathic hydropneumothorax and spontaneous pneumomediastinum.
    Keywords: Chest pain, Dyspnea, Hydropneumothorax, Pneumomediastinum
  • Ramin Khameneh Bagheri, Leila Bigdelu, Mostafa Ahmadi Pages 556-557
    The patient was a 19 year-old woman with the diagnosis of resistant hypertension, although she was under treatment of three classes of anti-hypertensive drugs (beta blocker, angiotensin receptor blocker, diuretic) for more than one year. In physical examination there was only a significant difference between the systolic blood pressure of upper and lower extremities (200 vs. 120 mmHg), without any other remarkable finding. Three different imaging modalities (echocardiography (Figure 1), CT angiography (Figure 2), conventional aortography (Figure 3) confirmed the aortic coarctation at 30 mm after left subclavian artery origin, with the 3.5-4 mm diameter of the narrowest segment. She underwent implantation of a self-expanding aortic stent and therefore the systolic pressure gradient decreased from 90 to 15 mmHg. After three months, her blood pressure was stable on 110/80 mmHg, while she received only metoprolol 25 mg twice daily and follow-up echocardiography showed 15-20 mmHg pressure gradient through the stent.
    Keywords: Double Valve Replacement, Rheumatic Heart Disease, Starr Edwards Valve, St. Jude Valve