RESUMO
To determine the rate of pneumothorax post CT-guided fine needle aspiration biopsy and the contributing factors. This descriptive retrospective study was held at King Hussein Medical Center in the period between April 2012 and March 2014, and included 105 patients who were diagnosed to have lung nodules. All patients had a CT-guided fine needle aspiration biopsy for histological diagnosis. Operator, site and location of the nodule, emphysematous lung condition, and pneumothorax detection by CT-scan and chest X-ray were all reviewed. There were 83 males [79%] and 22 females [21%]. Age ranged from 35 to 77 years [mean 62 +/- 10.2]. Right sided nodules constituted 50.3% of the studied sample, 79.1% of the nodules were located peripherally [83 patients] and 19% had associated emphysematous lung changes, 19 patients [18.1%] had post fine needle aspiration biopsy pneumothorax. Of those, seven patients [36.8%] were detected immediately on CT-scan table, eight patients [42.1%] were detected four hours later on chest X-ray, four patients were missed and 13 patients were treated with chest drain. Eleven patients [57.9%] out of the 19 who had pneumothorax had central lesions while eight [42.1%] had peripheral lesions and only six patients [31.5%] had emphysematous changes. Pneumothorax post CT-guided fine needle aspiration is still a common complication in our center and there was no single factor contributing to it
RESUMO
Our study was designed to compare the outcome of aortic valve replacement with or without coronary artery bypass grafting at Queen Alia Heart Institute with internationally published data. This was a retrospective single-center analysis which looked at patients who underwent aortic valve replacement with or without coronary artery bypass grafting at Queen Alia Heart Institute over a one year period from January 2011 till December 2011. Patients' demographic characteristics, risk factors for coronary artery disease, preoperative symptoms, left ventricular ejection fraction, hospital stay, complications [in hospital and at 30 days mortality] were reviewed. A total of 193 patients were included in this analysis. Age ranged from 12-75 years with a mean of 53.2 [SD 12.2] years. Eighty three patients had aortic valve replacement alone using a prosthetic valve, while 11 had a tissue valve. The average number of grafts was 2.5 per patient. Surgical on pump time was an average of 104 minutes. Patients who had only AYR had on pump time of an average of 60 minutes, while patients who had combined AVR with CABG had an average on pump time of 128 minutes [P < 0.005]. Patients who only had CABG had an average of on pump time of 45 minutes. Hospital stay averaged 10.2 days. Patients who only had AVR stayed for an average of 7.2 days while patients who had AVR and CABG stayed for an average of 10.5 days [P < 0.005]. Patients who had CABG stayed on average for 5.8 days, 29 [15%] developed post operative atrial fibrillation, 12 [6.2%] had wound infection, five [2.6%] had pleural effusion, two [1.0%] needed permanent pacemaker, one [0.5%] developed acute renal failure but did not need haemodialysis, nine [4.7%] needed reopening and six [3.1%] had a thromboembolic event. Overall in hospital mortality was 4.1% [n=8]. No deaths were recorded at 30 day follow up. Aortic valve replacement alone or in combination with coronary artery bypass grafting surgery and/or other valve surgery remains a major challenging procedure and the more complex the procedure by combining [AVR and CABG and/or MVR] the longer the hospital stay with higher morbidity and mortality rate. Queen Alia Heart Institute data are similar to the internationally comparable published data