Results of mitral valve reconstruction in Viet Duc hospital

Background: Mitral valve diseases are the most frequent in the cardiac valvular acquired diseases. Valvuloplasty is a very good surgical treatment, also its techniques are difficult. Objective: (1) To describe features of valvular lesion and technique of valvuloplasty. (2) To evaluate the effects of these operations. Subject and Method: 95 cases of mitral valve reconstruction were studied and described retrospectively about pre- operative features, mitral valvuloplasty, and post-operative results. Results: Pre-operative cardiac failure >=2 nd level (NYHA) is 96.8%, with 100% of mitral valve insufficiency, 28.4% associated with valvular stenosis. Mean age of patient is 34.5 +/- 13.2. Each case must do an average 4/15 valvuloplasty techniques, the most frequent are: mitral valvular ring (67.4%), commissurotomy (57.9%), cordage section (45.3%)\u2026 Early post \u2013 operative result is very good: no mortality, mitral valvular function is improved significantly than pre-operative (p<0.001), no severe mitral stenosis or insufficiency. Long-term post operative control (3 months, 3 years, 5 years post \u2013 operation) present the stability of this valvuloplasty with high survival frequency (96.8% in 3 months, 96.2% in 3 years, 93.4% in 5 years), in the 78.5% ranges a good level, re-operation is only required in 3 cases with valvular replacement. Conclusions: Although the difficult technique of valvuloplasty \u2013 especially in rheumatic lesion, mitral valve reconstruction is a good and safe technique to treat the mitral valve diseases.

Results of treatment for mediastinal tumors by video-assisted thoracoscopic surgery (VATS) in Viet Duc Hospital

Background: Video-assisted thoracoscopic surgery (VATS) is a now new, effective approach in diagnosis and treatment of thoracic diseases. Objective: To summarize and evaluate the results of VATS for mediastinal tumors. Subjects and method: A retrospective study included patients with mediastinal tumors who performed VATS in Viet Duc Hospital from March 2006 to August 2007. The measurements about age, sex, hospital-admitted reasons, tumor\u2019s size and location, outcomes and complications were analysed. Results: There were sixteen patients, included 9 males and 7 females. The patients\ufffd?average age was 35.3 years (ranged from 16 to 72 years). Clinical characteristics of mediastinal tumors were chest pain (11 cases), trouble breathing (4 cases), cough (2 cases). CT scanner detected mediastinal tumors in all patients (16 cases). Pathologically, 15 patients had benign tumors and only one had malignant tumor. The average time for postoperative drainage withdrawal was 3.0625 days (ranged from 2 to 5 days). The average time of hospital stay was 5 days (ranged from 3 to 11 days). There was no postoperative complication. Conclusion: VATS for mediastinal tumors obtained good outcomes. This was a selective method with many advantages for mediastinal tumors.

Results of treating flail chest by technique of open fixation

Background: Flail chest is a severe condition of thoracic trauma, and it requires diagnosis and treatment as soon as possible. From year 2000, we developed an improved technique of open fixation in order to adapt the situations of Vietnam health settings. Objectives: To report preliminary results of application of improved open fixation technique in Viet Duc Hospital from 2001 to 2006. Subjects and method: This descriptive, prospective and retrospective study involved 19 patients with flail chest due to closed thoracic trauma or multiple traumas, treated by open fixation technique. The parameters included features of patients, characteristics of this technique and postoperative progression.Results: Of 19 patients, there were 16 males and 3 females, mean age: 47.8 years. All patients presented obvious signs of flail chest preoperatively, but only 9 cases were treated by open fixation technique and pleural drainage immediately. This technique canbe applied in all sugical settings with single local anaesthesia, and any kind of common surgical threads. The most suitable initial pulled weight is 2000 g. All cases of flail chest required pleural drainage. All patients had good outcomes with open fixation technique, no death. There were 3 patients with postoperative complications, all were severe multiple trauma patients. Conclusion: Improved open fixation technique applied in Viet Duc Hospital is simple, effective and safe, and can be widely used in all surgical settings.

Assessing the emergency situation for peripheral vascular wounds/trauma in Viet Duc Hospital from 2004 to 2006

Background: peripheral vascular wounds/trauma is a severe type of surgical emergency, the increasing rate due to the rapid increase of traffic, labor and living accidents. Subjectives and Method: retrospective study, all patients with peripheral vascular wounds/traumas (alone or combination in multiple trauma) were emergency operated at Viet Duc Hospital from January 2004 to June 2006. Results: A total of 310 patients with peripheral vascular injuries in the study, of which accounted for 62.3% of injury, trauma group accounted for 37.7%. The mean age of 30. In first aid, pressed tape accounted for high rate (71.5%). Rate of popliteal vascular trauma due to fractures around the knee accounted for 65.5%, the rate of brachial vascular trauma with fractures around the elbow was 50%. Rate of late diagnosis of arterial trauma was 14.6%, higher than the arterial wounds (2.6%). The rate of ultrasound for forelimbs - where vessels were many wounds, was lower than that for hindlimbs - where vessels were many traumas (44% vs 67.9%). For vascular wounds, more directly vascular connection and more intervention on veins, whereas, for arterial trauma, more vascular graft. Rate of complications was low (7.4%), with no deaths. Conclusions: Overall, the results of emergency surgery for peripheral vascular wounds/trauma were well. No cases was death from vascular lesions, rate of complications was low.

Diagnosis and management attitude for acute peripheral arterial embolism

The study involved 44 patients (22 males, 18 females, aged from 33 to 94 years) with acute ischemia of extremities due to peripheral arterial embolism, who were undergoing surgery for removing clots at ViÖt - §øc Hospital from January 1998 to December 2001. Results: the common clinical signs included the lack of pulse, cold extremities; loss sense and movement were advanced signs. Rate of amputation was high. 5 cases were given preoperative anticoagulation. One had to be amputated. 2 cases were received conservative management with fasiotomy. 2 cases were fail to angioplasty because of necrosis. Maintaining postoperative anticoagulation improved the chance of full extremity repairing prevented from recurrence, especially when the embolism was resolved