Thromboendarterectomy in chronic pulmonary thromboembolism

Chronic pulmonary thromboembolic disease in entrapment of thrombus in pulmonary arteries from a single episode or repeated embolic episodes that subsequently organize, or thrombi that develop inside the pulmonary arteries into firm, fibrous tissue that becomes incorporated into the vessel wall. We operated 7 patients with stage chronic pulmonary thromboembolism over a two year period at our center. Four patients had good function class after operation on follow up at 6 to 12 months and we administered warafarin prophylaxis [with international normalized ratio, INR, of 3] for them. Three patients died in hospital postoperatively. We used extracorporeal membrane oxygenation [ECMO] for one of them but it failed on the third postoperative day

Modified Blalock-Taussig shunt and giant perigraft reaction

This is a case of a modified Blalock-Taussig shunt, which was complicated by perigraft transudative, fibrinous fluid accumulation and recurrence after surgical intervention. Follow-up and expectant management of the patient was successful. Our experience regarding this complication is presented

Arterial homograft and medical therapy in pseudoaneurysm of infrarenal aorta concomitant with recurrent right ventricular thrombus in Behcet's disease

Pseudoaneurysm of the infrarenal aorta due to Behcet s disease is very rare. We report a case of pseudoaneurysm associated with Behcet s disease in a 17-year-old boy with a recurrent right ventricular thrombus successfully treated with revascularization using arterial homograft patch. Echocardiography examination revealed a right ventricular mass, thought to be a thrombus in an unusual location. Postoperatively, the findings of the pathologic examination confirmed the mass as a thrombus. When the patient was subsequently re-admitted to the emergency unit with complaints of severe abdominal pain, fever, fatigue, sinus tachycardia, and a pulsating and tender abdominal mass, a right ventricular thrombus and a large pseudoaneurysm of the abdominal aorta were found on echocardiography and angiography. The patient underwent resection of the aortic aneurysm and aortoplasty, using arterial homograft patch, and received immunosuppressive and anticoagulation therapy. The thrombus of the right ventricle disappeared 4 months later. This case indicates that a right ventricular thrombosis in Behcet s disease may be managed by medical therapy

Anti-zona pellucida antibodies in infertile patients in relation to multiple puncture of ovaries and unexplained infertility

Auto antibodies to zona-pellucida [AZA] seem to be important autoantibodies implicated in reproduction, with substantial role in both endocrine and reproductive functions of the human ovary. There are some debates on the relation of AZA with infertility, repeated In Vitro Fertilization [IVF] attempts, and outcome of it. In this study, we assessed the presence of AZA in the follicular fluids [FFs] of women who underwent intra cytoplasmic sperm injection [ICSI], in relation to etiology of infertility and multiple puncture of ovaries. In this prospective study, follicular fluids were evaluated from 96 infertile women, [19-40 years old, 31.5 +/- 5.1], who were c and idates for ICSI based on the etiology of infertility. From these 80 women had explained infertility whereas 16 had unexplained infertility. All FFs were evaluated for presence of AZA by ELISA test. Twenty patients [20.8%] were positive for AZA in follicular fluid. In patients with unexplained infertility, AZA antibody in follicular fluid, was significantly higher than the group with proven etiology of infertility [p=0.001]. In addition, 20.4% of patients who had been punctured previously showed AZA in their FFs which is statistically similar to the patients who were punctured for the first time. The high incidence of AZA in infertile women, especially women with unexplained infertility has to be considered. Relation of the presence AZA and repeated puncture of ovaries is still debatable. Determinations of AZA are highly recommended in evaluation of infertile couples especially in patient with unexplained infertility