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Register a new userThe Surgical Treatment of the Ischemic Aneurysm of the Left Ventricle
نتائج العلاج الجـراحي لأم الدم البطينية الناتجة عن احتشاء العضلة القلبية
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Damascus University ورقة بحثية
Publication date
2003
fields
Medicine
and research's language is
العربية
Authors
يوسف دياب( باحث )
Created by
Shamra Editor
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قمنا بدراسة 67 مريضاً أُجريت لهم عملية استئصال أم دم من البطين الأيسر تالية لاحتشاء عضلة قلبية مابين أعوام 1993 – 2002 . أجرينا 22 عملية استئصال لام دم منعزلة كما أجرينا 45 عملية استئـصال أم دم بالإضـافة إلى مجازات إكليلية مع مداخلة جراحية أو دونها على الدسام التاجي. أبدت الفحوص المتأخرة التي أجريت للمرضى تحسناً ملحوظاً سواء في الحالة السريرية أو في هيموديناميكية القلب. تعزى هذه النتائج الجيدة للاستطباب الواضح لإجراء المداخلة الجراحيـة علـى كـل أم دم تجاوزت 25 % من حجم البطين الأيسر في نهاية الانبساط.
We studied 67 cases of left ventricular aneurysm following a myocardial infarction through 1993 to 2002. 22 Patients had only aneurysmectomy 45 Patients had aneurysmectomy + CABG + Mitral surgery. Death percentage in the first year after surgery was 8.9 %. The good clinical and haemodynamical results are due to the clear indication of surgery on patients who had more than 25% of the LVDV involved by aneurysm.
References used
(Burton, N. A., E.B.Stinson , P.E Oyer, N.E . Shumway: Left ventricular aneurysm. Preoperative risk factors and long-term Post operative results. J . Thorac . Cardiovasc . Surg. 77, 65 (1979
(Frank , G. H . Klein , E .Bednarska , K . Gahl, E . Flohr , G. Trieb, H. G. Borst: Results after resection of Post infarction left ventricular aneurysm . Thorac . Cardiovasc. Surg. 28, 423 (1980
(Majid , P . A , R% . Wardeh , P . J . F . De Feyter , J . P . Roos : Left ventricular aneurysm . Pre – and Post Operative haemodynamic studies at rest and during exercise . Europ . J . Cardiol . 12,125 (1980
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Background: primary percutaneous coronary intervention PCI is the treatment of
choice in civilized countries for acute myocardial infarction, the aim of the treatment here
is the revascularization as soon as possible. Patients and methods: it is re
trospective study
of 133 patients of acute MI have been divided into two subgroups. The first subgroup has
been treated with streptokinase infusion, and the other subgroup has beet treated by PCI.
We monitored the patients within hospitalization , reinfarction, mortality, cardiogenic
shock, heart failure, also we recorded the time needed to apply the method of treatment and
Timi score by diagnostic cardiac catheterization after applying the treatment.
Aim of study: to compare between streptokinase and PCI in our hospitals to know
which way is better in which we can give the best medical care for this critical patients.
Results: 63 patients undergo to pci and 70 patients undergo to streptokinase therapy.
Streptokinase group had higher rates in mortality for noncardiac reasons 100%,
cardiogenic shock 60% , reinfarction 81%, mortality for cardiac reasons 80%, while it was
faster in applying the treatment and equal to pci in timi score. While pci group has higher
rated in hospitalization for cardiac reasons 70% and in cases that has new congestive heart
failure 63%, and nearly equal to streptokinase group in timi score.
Conclusion: pci was better in mortality and cardiogenic shock and reinfarction than
streptokinase but it was worse in hospitalization for cardiac reasons and congestive heart
failure cases . pci was too late than streptokinase in applying the treatment . we notice that
the two methods of treatment was nearly equal in timi score.
The research aims to make a statistical approach to the cases of esophageal atresia by
its types and incidence, and to study the surgical treatment outcome and choose the best
method of treatment and follow up.
The study included 27 newborn patien
ts admitted in the Neonatal Intensive Care Unit
at Al-Assad University Hospital and Tishreen University Hospital in Lattakia, due to
diagnosis of esophageal atresia or tracheoesophageal fistula, from the beginning of January
2010 until the end of 2015. 14 of patients were males and 13 were females. Gross
classification of esophageal atresia was used, type (C) was found in 21 cases, type (A) was
found in 4 cases, type (E) was found in 2 cases, while type (B) and (D) were not seen. We
studied The clinical symptoms in newborn patients with this malformation, radial and
laboratory findings and associated malformations. We used esophageal contrast study
insure the diagnosis when needed. With type (C), we did primary anastomosis in 20 cases
and cervical esophagostomy with gastrostomy in only 1 case. With type (A), we did
esophagostomy with gastrostomy in all cases. With type (E), we closed the fistula with
cervical approach in all cases. The survival rate was 70.4%. Spitz classification was used
for risk assessment. The incidence of complications included anastomotic leakage 30% and
anastomotic stricture 69.2%.
This research tries to the rate of arrhythmia manifested during the first (48) hours of heart infarction and define its nature as well as its relationship with heart infarction in regard to patients subjected to anti-coagulation (streptokinase) ther
apy and patients who were not subjected to it. Moreover, it also aims to detect the relationship between arrhythmia and the death rates of the patients during their stay in the Heart Intensive Care Unit.
The study started in October 2012 and lasted twelve months, up to October 2013.
The sample of study here consisted of (187) patients hospitalized in the Heart Intensive Care Unit having acute myocardial infarction. The sample included (142) males (76 % of the sample) and (45) females (24%). The research reached the following findings:
A hundred and seven of the patients monitored in the study were smokers; and smoking was the most important risk factor causing myocardial infarction.
Ventricular extra systole were the most common symptoms of acute myocardiac infarction arrhythmia during the first (48) hours of hospitalization reaching (79%). The second was increased auto ventricular rhythms rating (43 %).
High rates of dangerous arrhythmia like (VT) and (VF) rating (9%) in patients who were not subjected to streptokinase (anti-coagulation) compared with those subjected to it (4. 5%), and (3.8) respectively.
Decreased (EF) increased the possibility of life-threatening ventricular arrhythmia like (VT).
Diabetes did not increase the dangers of arrhythmia monitored in this research
Study has been made on 121 patients affected by myocardial infarction ( MI ) in
Damascus university hospitals whereas the patients were divided in tow groups :
the first group contained 60 patients treated traditionally without captopril.
the seco
nd group contained 61 patients treated traditionally and by captopril
these patients were examined by Echo – Doppler during the acute phase and
after six months of MI to realize the effect of captopril on contractility and
function of left ventricular (LV) .
The arterial trauma is more accuracy during the war , but maybe happened in
another causes : civilian vascular injuries , surgical anddiagnostic complications ..
In this study , we identified the symptoms of the arterial injuries , the early diagno
sis
, the risk factors of these injuries and the used methods in surgical treatment which is
deferantin every patient , type and the another injuries .
We also carried out a comparison among our study ( 146 cases ) and many
international studies .
In this study , we assured that the emergency vascular surgery is very important in
rescuing many patients lives that are classified to be in high rescue .
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