Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is...Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is to evaluate the use of intercostals muscle flap as a successful method to fill the lung cavity for reduction of symptoms and treatment of patients presented with symptomatic pulmonary cavity and to avoid the risk of pulmonary resection. Methods: This is a prospective study conducted between 2009 to 2012, in department of cardiothoracic surgery, Zagazig University Hospital. The study included 32 patients suffering from cavitary lung lesions divided into two groups, group (A): 14 patients treated by using intercostal muscle flap to fill the defect after Cavernostomy without lung resection;and group (B): 18 patients treated by traditional methods by lung resection. Patients with high risk of lung resection, suspicion of dense adhesion, symptomatic chronic lung abscess and patients with bad pulmonary function tests were included in group (A). Results: 20 patients were male and 12 were females in both groups, the large numbers of cases were lung abscess in group A (4 cases 28.5%) followed by Aspergilloma and TB cavity (3 cases 21.4%). Hemoptysis, persistent cough and expectoration were the main presentation of our patients. Poor pulmonary function was significant finding in group A (7 cases 50%). Complications reported in our study were bleeding, recurrent symptoms and one case mortality in group B after Pneuomenectomy. Conclusion: Using the intercostal muscle flap implanted inside the lung cavity after cavernostomy is a successful alternative curative method especially in cases with high risk of lung resection.展开更多
Patients with severe mitral regurgitation (MR) should undergo surgery when they present symptoms or if asymptomatic when there is objective evidence of left ventricular dysfunction. In this work, we analyze the midter...Patients with severe mitral regurgitation (MR) should undergo surgery when they present symptoms or if asymptomatic when there is objective evidence of left ventricular dysfunction. In this work, we analyze the midterm results of leaflet augmentation in mitral valve repair of rheumatic valves with gluteraldehyde preserved autologous pericardium. Patients and Methods: In our department 48 patients were exposed to mitral valve repair by leaflet augmentation either anterior or posterior beside other technique and all patients supported by flexible annuloplasty ring and followed for five years clinically and by echocardiography. Results: Age of the patients ranging from 12 to 47 years, mean age 25.9 ± 8.9 and there were 12 males (25%) and 36 females (75%) with male to female ratio of 1:3. All patients presented with shortness of breath (100%);with 14 patients were in NYHA class III (29.17%) and 34 patients were in NYHA class IV (70.83%). During follow-up period 5 patients needed reoperation by valve replacement, causes of reoperation were restrictive valve motion in one patient, left atrial thrombus in 1 patient and sever mitral regurgitation in 3 patients. Freedom from reoperation was 87.5%. At 5 years, (92.9%) were in New York Heart Association functional class I, three patients (7.1%) were in class II. Echocardiography at follow-up showed satisfactory mitral valve function. Conclusion: leaflet augmentation is a simple and reproducible method of valve repair for rheumatic MR with good midterm result.展开更多
文摘Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is to evaluate the use of intercostals muscle flap as a successful method to fill the lung cavity for reduction of symptoms and treatment of patients presented with symptomatic pulmonary cavity and to avoid the risk of pulmonary resection. Methods: This is a prospective study conducted between 2009 to 2012, in department of cardiothoracic surgery, Zagazig University Hospital. The study included 32 patients suffering from cavitary lung lesions divided into two groups, group (A): 14 patients treated by using intercostal muscle flap to fill the defect after Cavernostomy without lung resection;and group (B): 18 patients treated by traditional methods by lung resection. Patients with high risk of lung resection, suspicion of dense adhesion, symptomatic chronic lung abscess and patients with bad pulmonary function tests were included in group (A). Results: 20 patients were male and 12 were females in both groups, the large numbers of cases were lung abscess in group A (4 cases 28.5%) followed by Aspergilloma and TB cavity (3 cases 21.4%). Hemoptysis, persistent cough and expectoration were the main presentation of our patients. Poor pulmonary function was significant finding in group A (7 cases 50%). Complications reported in our study were bleeding, recurrent symptoms and one case mortality in group B after Pneuomenectomy. Conclusion: Using the intercostal muscle flap implanted inside the lung cavity after cavernostomy is a successful alternative curative method especially in cases with high risk of lung resection.
文摘Patients with severe mitral regurgitation (MR) should undergo surgery when they present symptoms or if asymptomatic when there is objective evidence of left ventricular dysfunction. In this work, we analyze the midterm results of leaflet augmentation in mitral valve repair of rheumatic valves with gluteraldehyde preserved autologous pericardium. Patients and Methods: In our department 48 patients were exposed to mitral valve repair by leaflet augmentation either anterior or posterior beside other technique and all patients supported by flexible annuloplasty ring and followed for five years clinically and by echocardiography. Results: Age of the patients ranging from 12 to 47 years, mean age 25.9 ± 8.9 and there were 12 males (25%) and 36 females (75%) with male to female ratio of 1:3. All patients presented with shortness of breath (100%);with 14 patients were in NYHA class III (29.17%) and 34 patients were in NYHA class IV (70.83%). During follow-up period 5 patients needed reoperation by valve replacement, causes of reoperation were restrictive valve motion in one patient, left atrial thrombus in 1 patient and sever mitral regurgitation in 3 patients. Freedom from reoperation was 87.5%. At 5 years, (92.9%) were in New York Heart Association functional class I, three patients (7.1%) were in class II. Echocardiography at follow-up showed satisfactory mitral valve function. Conclusion: leaflet augmentation is a simple and reproducible method of valve repair for rheumatic MR with good midterm result.
