[Show abstract][Hide abstract] ABSTRACT: We report on the surgical treatment of a patient in whom hydatid cysts inside the right pulmonary artery and multiple right lung involvement were detected. Since the right pneumonectomy carried a high risk of cyst rupture, and migration of the cysts to the opposite lung during ligation of the pulmonary artery, a two-stage surgical approach was scheduled. Hydatid cysts located at the proximal pulmonary artery were removed by performing a longitudinal arteriotomy along the pulmonary artery to the bifurcation. Subsequently, a right pneumonectomy was performed on a safe right pulmonary artery in a different session.
Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 11/2006; 12(5):349-51. · 0.69 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Patients who require coronary artery bypass grafting and who also have vascular disease or lung malignancy constitute a high-risk group, and their management remains controversial. Combining off-pump coronary surgery (OPCAB) with peripheral artery revascularization or lung resection is an attractive proposition, as it avoids the risks associated with cardiopulmonary bypass. This paper presents the results of 26 such combined procedures consisting of simultaneous OPCAB and peripheral revascularization or lung resection, between April 2001 and March 2003. Twenty underwent concomitant carotid endarterectomy and OPCAB, four underwent aortobifemoral bypass and OPCAB, and two underwent pneumonectomy and OPCAB. There was no in-hospital mortality. Prolonged ventilatory support was necessary in one patient who had a lung resection. The median postoperative length of stay in the Intensive Care Unit was 1.3 days (range 1 to 6) and the median length of hospital stay was 5.7 days (range 4 to 16 days). Off-pump coronary surgery clearly has a place for patients with peripheral vascular disease or pulmonary malignancy who additionally require myocardial revascularization.
Middle East journal of anaesthesiology 11/2004; 17(6):1069-77.
[Show abstract][Hide abstract] ABSTRACT: We describe a case of adult coarctation of the aorta, which presented unusually as a poststenotic fusiform aneurysm in a 48-year-old female. She was normotensive and had a history of back pain and palpitations. Under partial cardiopulmonary bypass, the stenosis and the aneurysm were resected and replaced with a Dacron tube graft.
[Show abstract][Hide abstract] ABSTRACT: Descending thoracic aorta-to-femoral artery bypass grafting is considered a good alternative procedure for revascularization in cases of aortic graft failure, graft infection, and other intraabdominal pathologies not amenable to standard aortofemoral revascularization. Its use as the primary mode of treatment in selected cases is still under investigation. From January 1998 to June 2001, 5 patients underwent descending thoracic aorta-to-femoral artery bypass grafting as primary treatment for juxtarenal aortic occlusion. There was no operative mortality nor major morbidity; a groin incision infection occurred in one case. The mean hospital stay was 8.2 days and intensive care unit stay was 2.6 days. Graft failure was not encountered in the short-term follow-up. In spite of the small number of patients, it was concluded that thoracic aortofemoral bypass offers excellent inflow and reliable patency and may be considered for primary revascularization in cases of juxtarenal aortic occlusion.
Asian cardiovascular & thoracic annals 07/2002; 10(2):141-4.
[Show abstract][Hide abstract] ABSTRACT: Concomittant severe coronary artery disease and lung malignancies occur rarely. Combined conventional coronary artery bypass grafting (CABG) with the use of cardiopulmonary bypass (CPB) with lung resection posses several perioperative and postoperative problems related to extracorporeal circulation and heparinization. The avoidance of CPB may be advantageous by decreasing blood loss, pulmonary complications and hospital stay. Further, exposure to the immunosuppressive and inflammatory effects of CPB may have deleterious impact on tumor growth and dissemination. Off-pump CABG makes the combined procedure safer as it abolishes the complications of CPB. We report two patients with the diagnosis of severe coronary artery disease and lung malignancies, underwent off-pump CABG and lung resections in the same surgical setting.
Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové 02/2002; 45(3):119-21.
[Show abstract][Hide abstract] ABSTRACT: Background and Design.- Whether the clinical outcomes of off-pump coronary artery bypass grafting surgery is superior to on-pump coronary arter surgery is still a matter of debate. The aim of this clinical prospective study was to compare the early-term results of off-pump and on-pump techniques for myocardial revascularization. Between 2001 and 2003, 100 patients who needed myocardial revascularization was scheduled to be operated with either conventional technique (n: 50) or off-pump technique (n: 50). In the postoperative period, both groups were compared in terms of blood urea, creatinine, SGOT, SGPT levels, need for (+) inotrop agents, ventilation time, amount of blood and blood products transfusion, hospital and intensive care unit stay and amount of drainage. Results.- Statistically significant difference was found between the two groups, favoring off-pump coronary revascularization, with respect to intensive care unit stay, ventilation time, need for (+) inotropic agents, and hepatic enzyme (SGOT, SGPT) levels in the postoperative early period. Conclusion.- Off-pump coronary revascularization offers important clinical advantages in the early postoperative period compared to conventional technique. However, long-term follow-up is required to assess the future effectiveness of off-pump technique. Köksal C, Çörtelekoğlu T. A, Altan H. S, Sarikaya S, Özcan V, Zengin M. Comparison of early-term results of on- pump and off-pump technique for coronary revascularization. Cerrahpaşa J Med 2005; 36: 7-11.