Effect of aortic valve replacement on left ventricular function in chronic aortic regurge

The purpose of this study is to evaluate the effect of aortic valve replacement [AVR] on left ventricular function in patients with chronic rheumatic aortic regurge [AR]. This prospective selected study was conducted in the Department of Cardiothoracic Surgery, Mansoura University Hospitals from January 2005 to March 2007 including follow up period. The study involved 50 patients with chronic rheumatic AR for whom AVR was done. Group I [N = 25 patients] with FF > gt 50%. Group II [N= 25 patients] with EF 50% at the time of surgical intervention. So early surgery is recommended in these patients to provide faster and more significant recovery of the myocardial pump performance. Also, it is associated with shorter hospital and ICU stay and lower incidence of morbidity and mortality

Cardiac myxoma Mansoura experience, results of 17 cases

The study was conducted to evaluate our surgical results and operative outcome after complete excision of cardiac myxoma. This retrospective study was conducted in the Department of Cardiothoracic Surgery, Mansoura University Hospital from march 1996 to January 2007, the study involved 17 patients with intracardiac myxoma for whom excision was done. All patients were subjected to full history taking, clinical examination, routine laboratory and EGG examination. Echocardiography was performed preoperatively, prior to discharge and after a mean duration of 8.47 +/- 2.72 months postoperatively. Seventeen patients of cardiac myxoma were surgically treated. The mean patient age was 37.82 +/- 9.4 years and there was 9 [52.9%] male patients and 8 [47.1%] female patients. The most common preoperative symptom was dyspnea occurring in 7 [41.2%] patients. The mean interval from the onset of symptoms to surgery was 8.29 +/- 4.98 months. The tumor was in the left atrium in 15 [88.3%] patients, in the right atrium in one [5.9%] patient and bilateral myxoma was present in one [5.9%] patient. The heart was approached via median sternotomy in all cases, left atriotomy was done in 15 [88.2%] patients, right atriotomy in one [5.9%] patient while bilateral approach was used in one [5.9%] patient. The tumour was excised completely in all cases and the defective area was repaired directly in 11 [64.7%] cases, and with pericardial patch in 6 [35.3%] cases. The mean cardiopulmonary bypass and aortic cross clamp times were 38.3 +/- 2.36 and 26.4 +/- 2.1 minutes respectively. There was one [5.9%] case hospital mortality due to fatal arrhythmia and 2 [11.8%] cases morbidity in the form of pneumonia and superficial wound infection. All patients underwent echocardiography prior to discharge and at a mean follow up period of 8.47 +/- 2.72 months postoperatively. All survival 16 [94.1%] patients showed no evidence of tumour recurrence clinically or on echocardiographic examination, also ECG abnormalities that were present before surgery had disappeared. In conclusion, in our study there was no recurrence of myxoma after complete excision so surgical excision in considered to be the curative method for treatment of cardiac myxoma that quickly relieves symptoms and must be done early after diagnosis

Surgical management of endobronchial tumors: analysis of 24 patients

To evaluate the variable surgical options performed in the management of endobronchial tumors and the factors determining selection of the appropriate surgical technique. Retrospective study of a series of 24 patients with endobronchial tumors who were diagnosed and underwent surgery in the cardiothoracic surgery department, Mansoura university hospital from January 1985 to March 2006. Full history taking and complete clinical examination, routine laboratory investigations, chest x-ray, and computerized tomography, and bronchoscope were done for all cases. Surgery was the line of treatment for all patients. Close sex distribution with age ranges from 20-64 years. Cough with expectoration was the main presentation. Zonal opacity was the most common radiological finding. CT chest showed sensitivity of 79.2% for detection of endobronchial lesions. Bronchoscopic examination revealed endobronchial lesions in all patients. Benign tumors were detected in 5 patients and malignant lesions in 19 patients, 14 patients were neuroendocrine tumors and 5 patients were other malignant varieties. Surgical interference included bilobectomy [7 patients], lobectomy [5 patients] pneumonectomy [7 patients], and one patient underwent surgical exploration for open biopsy while 4 bronchoplastic procedure were performed. Endobronchial tumors occur over a wide range of age without significant sex differentiation. Endobronchial tumor should be suspected in case of prolonged chest complaint inspite of maximal medical treatment. Bronchoscope is the main diagnostic tool and is important for detection of the provisional plane for surgery. Early diagnosis and screening should be established for early detection of endobronchial tumors and more conservative resectional and bronchoplastic techniques