Chest trauma and early thoracotomy

This study was carried out on 235 patients. Conservative management was adopted in 111 patients. Intercostal tube drainage was applied in 99 patients. Only 8 patients underwent early thoracotomy, 3 for repair of bronchial injury, 2 for early decortication of clotted hemothorax, 2 for pericardiotomy for recurrent hemopericardium and one for massive lung laceration. The overall mortality in this study was 14%. It was concluded that adequate initial management of chest injuries minimizes life threatening complications. Bronchial lesions should be treated by early thoractomy and suture. Also, clotted hemothorax, recurrent hemopericardium and severely lacerated lung should be managed by early thoracotomy

Left ventricular performance at rest and during exercise and after aortic valve replacement

Sixty five patients of rheumatic aortic valve disease were operated upon 42 males and 32 females, their age ranged from 15 to 50 years with a mean of 36 years. They were evaluated preoperatively and reevaluated 1 to 8 months postoperatively by echo-Doppler to assess left ventricular [LV] function before and after surgery at rest and during exercise. The echocardiographic parameters used were left ventricular end systolic dimension [LVESD], left ventricular end diastolic dimension [LVEDD], ejection fraction [EF] and fractional shortening [FS], at rest and during exercise. The preoperative echo- Doppler data at rest had no correlation with postoperative outcome. However, delta FS% [change of fractional shortening from rest to exercise carry a good correlation with preoperative resting data. It was concluded that this parameter [delta FS%] can be used to predict the outcome of the surgery