الأبحاث والمنشورات
New
Article
Full-text available
Short term outcome of coronary artery bypass graft surgery: Evaluation of recently established cardiac center
2018
Journal of the Egyptian Society of Cardio-Thoracic Surgery
Yusuf S.E. Khalifa
·
Karam M. Eisa
·
Mohamed Abdel Bary
·
Hossam Eldin M.M. Ismail
·
Abdallah M. Taha
Abstract
Background
Overall, coronary artery bypass graft (CABG) surgery achieves excellent outcomes regarding anginal relief and resumption of normal activities. In general, completeness and stability of revascularization are superior with surgical revascularization versus percutaneous interventions.
This study aimed at assessment of the early postoperative outcome of the first 100 CABG cases grafted in the cardiothoracic surgery department, Qena university hospital, Qena, Egypt.
Results
This study was conducted on 100 patients with coronary artery disease. Only 5 patients had single vessel disease and 95 patients had multi-vessel disease, two or more. No one had left main disease. There was a great prevalence of diabetes mellitus (55%), hypertension (69%), dyslipidaemia (55%) and smoking (58%). Operatively, we used left internal mammary artery to left anterior descending coronary artery anastomosis in the majority of cases. In only two cases, right internal mammary artery was used, and great saphenous vein graft was used in anastomosis of remaining diseased vessels. Most cases underwent elective CABG. An intra-aortic balloon pump was used only in 2% of cases. Septicaemia was a significant complication. After 6 months, 97% of the patients were alive.
Conclusions
Institutional results are essential to enable surgeons and interventionists to decide if international data is keeping with local findings or not. However, the likenesses between international data and our results confer confidence in our findings.
Overall, coronary artery bypass graft (CABG) surgery achieves excellent outcomes regarding anginal relief and resumption of normal activities. In general, completeness and stability of revascularization are superior with surgical revascularization versus percutaneous interventions.
This study aimed at assessment of the early postoperative outcome of the first 100 CABG cases grafted in the cardiothoracic surgery department, Qena university hospital, Qena, Egypt.
Results
This study was conducted on 100 patients with coronary artery disease. Only 5 patients had single vessel disease and 95 patients had multi-vessel disease, two or more. No one had left main disease. There was a great prevalence of diabetes mellitus (55%), hypertension (69%), dyslipidaemia (55%) and smoking (58%). Operatively, we used left internal mammary artery to left anterior descending coronary artery anastomosis in the majority of cases. In only two cases, right internal mammary artery was used, and great saphenous vein graft was used in anastomosis of remaining diseased vessels. Most cases underwent elective CABG. An intra-aortic balloon pump was used only in 2% of cases. Septicaemia was a significant complication. After 6 months, 97% of the patients were alive.
Conclusions
Institutional results are essential to enable surgeons and interventionists to decide if international data is keeping with local findings or not. However, the likenesses between international data and our results confer confidence in our findings.
New
Article
Full-text available
Traumatic diaphragmatic hernia challenging diagnosis and early management
2018
Journal of the Egyptian Society of Cardio-Thoracic Surgery
Mohamed Abdelshafy
·
Yusuf S.E. Khalifa
Abstract
Background
Early diagnosis and management of traumatic diaphragmatic hernia (TDH) can be challenging for the emergency department or the trauma surgeon, as these injuries are often clinically masked by other associated severe injuries.
Methods
We retrospectively reviewed data of 50 patients diagnosed with an acute traumatic hernia from September 2014 to September 2017.
Results
50 patients were included in this study. Blunt trauma was the main cause in 40 patients (80%) patients. TDH occurred more on the left side; in 72% of patients. The diagnosis was preoperative in 20 patients (40%). In our study, 74% of cases were repaired through abdominal approach and 26% patients through thoracic approach. Complications of TDH occurred in 30 patients (60%) and were mainly pneumonia in 16 patients (32%), only 8 patients (16%) died (6 patients of them had delayed referral and 3 patients of them had severe head injury).
Conclusions
TDH may be masked by associated injuries in multiple trauma patients and may lead to life-threatening intestinal and gastric strangulation. So, early diagnosis and treatment of TDH are important. Emergency physicians and trauma surgeon should maintain a high index of suspicion of TDH while dealing with patients assessed for abdominal or respiratory symptoms regardless the history of trauma was recent or delayed.
Early diagnosis and management of traumatic diaphragmatic hernia (TDH) can be challenging for the emergency department or the trauma surgeon, as these injuries are often clinically masked by other associated severe injuries.
Methods
We retrospectively reviewed data of 50 patients diagnosed with an acute traumatic hernia from September 2014 to September 2017.
Results
50 patients were included in this study. Blunt trauma was the main cause in 40 patients (80%) patients. TDH occurred more on the left side; in 72% of patients. The diagnosis was preoperative in 20 patients (40%). In our study, 74% of cases were repaired through abdominal approach and 26% patients through thoracic approach. Complications of TDH occurred in 30 patients (60%) and were mainly pneumonia in 16 patients (32%), only 8 patients (16%) died (6 patients of them had delayed referral and 3 patients of them had severe head injury).
Conclusions
TDH may be masked by associated injuries in multiple trauma patients and may lead to life-threatening intestinal and gastric strangulation. So, early diagnosis and treatment of TDH are important. Emergency physicians and trauma surgeon should maintain a high index of suspicion of TDH while dealing with patients assessed for abdominal or respiratory symptoms regardless the history of trauma was recent or delayed.
