Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience
177
180
EN
Abolghasem
Daneshvar Kakhki
General thoracic surgeon, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
abolghasemdaneshvar11@gmail.com
Kambiz
Sheikhi
General thoracic surgeon, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
sheikhykambiz@gmail.com
Seyed Reza
Saghebi
General thoracic surgeon, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
sr_saghebi@yahoo.com
Saviz
Pejhan
General thoracic surgeon, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
spejhan@yahoo.com
Farahnaz
Sadegh Beigee
General thoracic surgeon, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
beigeef@hotmail.com
Mohammad Behgam
Shadmehr
General thoracic surgeon, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
mbshadmehr@yahoo.com
Hasti
Karimi
General thoracic surgeon, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
hkarimi.md@gmail.com
Azizollah
Abbasidezfouli
General practitioner, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
azizollahabbasidezfuli@gmail.com
10.22038/jctm.2017.24003.1133
<strong>Introduction:</strong> Tracheoesophageal fistula (TEF) is a rare condition, which could be life-threatening if diagnosed late or mismanaged. Post-intubation TEF is the most common form of acquired, non-malignant TEF and is usually associated with tracheal stenosis, which makes the treatment more challenging. Here, we present our experience of managing 21 patients with post-intubation TEF. <br /> <strong>Materials & Methods:</strong> Twenty one patients including seven women and fourteen men with mean age of 38.05 years, who had post-intubation TEF were managed in our center (Massih Daneshvari Hospital, Tehran, Iran) during 2004-2013. None of the patients were operated before weaning from mechanical ventilation. Single division and closure of the fistula was performed in one patient who did not have accompanying tracheal stenosis. One-stage surgical repair including tracheal resection, anastomosis, primary closure of the esophageal defect, and muscle flap Interposition was the main treatment method in all other cases. Patients were followed up for at least two years.<br /> <strong>Results:</strong> Excellent and good results achieved in 85.7% of our patients. Major complications including permanent vocal cord paralysis and recurrence of tracheal stenosis necessitating T-tube insertion occurred in two patients (9.5%). Severe cachexia and sepsis secondary to sputum retention resulted in one mortality (4.8%).<br /> <strong>Conclusion:</strong> Surgery might provide the best treatment results along with low mortality and morbidity rates in post-intubation TEFs if performed within the proper time.
fistula,Post-intubation,TEF,Tracheal resection,Tracheal stenosis
https://jctm.mums.ac.ir/article_9231.html
https://jctm.mums.ac.ir/article_9231_936ee5bed8389cd7ddaa09ca53b41133.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
The Relationship between Serum Uric Acid and Severity of Chronic Obstructive Pulmonary Disease (COPD)
181
186
EN
Atefe
Vafaei
Medical Student, Department of Internal Medicine, Birjand University of Medical Sciences, Birjand, Iran
atefe.vafayi@yahoo.com
Zeinab
Saremi
Internal Medicine, Department of Internal Medicine, Birjand University of Medical Sciences, Birjand, Iran
z13612002@yahoo.com
Sayyed Gholamreza
Mortazavi Moghaddam
Internal Medicine, Department of Internal Medicine, Birjand University of Medical Sciences, Birjand, Iran
gmortazavi@yahoo.com
Zahra
Javid Arabshahi
Fellowship of Internal Medicine, Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad,Iran
javidarabshahi@yahoo.com
10.22038/jctm.2017.23869.1134
<strong>Introduction:</strong> Some evidence exists about the possible relationship between the serum uric acid (UA) and exacerbation of the chronic obstructive pulmonary disease (COPD). Present study intended to compare the COPD-related variables and the one-year outcome between the two groups of patients with the high and low UA.<br /> <strong>Material and Methods:</strong> This cohort study consisted of 112 patients with COPD exacerbation. The participants were categorized into low (i.e., Afterwards, the patients were followed up for one year and some other variables such as taking oral antibiotic for respiratory infections, admission to hospital or ICU due to COPD exacerbation, and survival were documented monthly.<br /> <strong>Results:</strong> The mean serum level of creatinine was significantly higher in the high UA group (1.1±0.4 mg/dL) than the low UA group (1.01±0.1 mg/dL) (P=0.02). No significant difference was observed between the two groups regarding the GOLD classification, FEV1, oxygen saturation, pCO2, and echocardiographic indices. In the one-year follow-up, 42 cases (82.4%) of the high UA group and 39 patients (63.9%) of the low UA group reported taking oral antibiotics, which was indicative of a significant difference (P=0.03). Hospital admission was likewise significantly higher in the high UA group (30 patients, 58.8%) than in the low UA group (23 cases, 37.7%) (P= 0.03).<br /> <strong>Conclusion:</strong> Those patients with the UA level of ≥ 6.5 mg/dL experienced more hospital admission and were more likely to take oral antibiotics for respiratory infections during a year. However, UA did not correlate with FEV1 or COPD severity.
Chronic Obstructive Pulmonary Disease,Mortality,Outcome,Uric acid
https://jctm.mums.ac.ir/article_9232.html
https://jctm.mums.ac.ir/article_9232_ba60f425751218a69067c951751b9de6.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Outcomes of On-pump Coronary Artery Bypass Grafting in Patients with Metabolic Syndrome in Mashhad, Iran
187
191
EN
Aliasghar
Moeinipour
0000-0002-4208-800X
Atherosclerosis Prevention Research Center, cardiac surgery Imam Reza Hospital, Mashhad University of Medical Sciences,
moinipoora1@mums.ac.ir
Hamid
Hoseinikhah
0000-0003-1812-9200
Assistant professor, Department of cardiac surgery, Atherosclerosis Prevention Research Center ,Faculty of medical science, Mashhad University of Medical Sciences, Iran
hoseinikhahh@mums.ac.ir
Negar
Morovatdar
0000-0003-4308-1931
Assistant Professor of Community Medicine, Faculty of medical science, Imam Reza Clinical Research Units, Mashhad University of Medical Sciences
morovatdarn@mums.ac.ir
Atefeh
Ghorbanzadeh
Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
ghorbanza901@mums.ac.ir
Mohamadreza
Akbari
- Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad,
mra786emam@yahoo.com
Morteza
Mirshahpanah
Veterinary student.mashhad Ferdowsi scenice university
morteza.mshp@gmail.com
Gholamreza
Safarpoor
Assistant professor, Department of cardiac surgery, Faculty of medical science. Hamadan University of
Medical Sciences, Mashhad, Iran.
safarpoor@umsha.ac.ir
10.22038/jctm.2017.22984.1127
<strong>Introduction:</strong> Metabolic syndrome (MS) is considered as an important risk factor for advanced coronary artery disease. This condition can increase the mortality and morbidity in the patients undergoing coronary artery bypass graft (CABG) surgery. The aim of the study was compared mortality and morbidity after off Pump- CABG surgery between patients with and without the Metabolic syndrome.<br /> <strong>Materials & Methods:</strong> This prospective cross-sectional study was conducted on 120 patients, who underwent off-pump CABG surgery between October 2014-October 2016. The participants were equally divided into two groups including the patients with and without MS (MS and non-MS, respectively).<br /> <strong>Results:</strong> According to the results, 68 (56.6%) patients were male. Furthermore, out of the 60 participants with MS, 36 (60%) cases were male. The mean ages of the MS and non-MS groups were 64.96±9.6 and 65.62±10.6 P=0.6 years, respectively. No statistically significant difference was observed between the two groups in terms of the mortality and morbidity (e.g., surgical wound infection, length of Intensive Care Unit and hospital stay, atrial fibrillation rhythm, and bleeding in the first 24 h). The intubation time in patients with Metabolic Syndrome was significantly higher than patients without Metabolic Syndrome (6.66 ± 1.97 vs 5.83 ± 1.93 respectively; P=0.007)<br /> <strong>Conclusion:</strong> Metabolic syndrome was not associated with higher mortality and morbidity after CABG surgery compare to patients without Metabolic syndrome, although patients with Metabolic syndrome had higher risk for long intubation time.
Coronary artery bypass graft,metabolic syndrome,Intubation,Surgery
https://jctm.mums.ac.ir/article_9233.html
https://jctm.mums.ac.ir/article_9233_6654d936166893ba18d4a307937f8912.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Recurrent Venous Thromboembolism as the Initial Clinical Presentation of Gastric Cancer: A Case Report
192
194
EN
Fariba
Rezaeetalab
0000-0003-3836-0944
Pulmonologist, Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
rezaitalabf@mums.ac.ir
Solmaz
Hassani
Residency of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
soolmaz78@yahoo.com
Mahnaz
Amini
0000-0002-5205-4647
Pulmonologist, Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
aminim@mums.ac.ir
Leila
Ghofraniha
Pulmonologist, Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
ghofraniahl@mums.ac.ir
10.22038/jctm.2017.7953
<span>Pulmonary thromboembolism (PTE) is a clinically critical disease, misdiagnosis or delayed diagnosis of which can lead to increased rate of mortality. For prevention of recurrence of PTE, recognition of its risk factors or underlying diseases is of great importance. PTE is common in patients with cancer and has high morbidity and mortality rates. Although cancer is a lethal condition, PTE accelerates death in these patients. In the current study, we reported the case of a 50-year-old male presenting with dyspnea, pleuritic chest pain, and non-massive hemoptysis indicating pulmonary embolism. Anticoagulant therapy was initiated, but after 12 days of treatment, new deep vein thromboses in the left upper and right lower limbs were diagnosed. However, no specific risk factors or laboratory abnormalities were detected. History of weight loss during the recent months encouraged further investigation for ruling out malignancy, which led a diagnosis of gastric adenocarcinoma. He did not have any complaints of gastrointestinal disorders.</span>
Deep Vein Thrombosis,Pulmonary,Pulmonary Thromboembolism
https://jctm.mums.ac.ir/article_7953.html
https://jctm.mums.ac.ir/article_7953_86be8ddfc7178bc6e52be13739dce189.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Heart Carcinoid Disease with Patent Foramen Ovale Treated by Mini Sternotomy
195
197
EN
Juan
Siordia
Research Assistant, University of Arizona College of Medicine, Tucson, Arizona, United States
jas@email.arizona.edu
Sreekumar
Subramanian
Surgeon, University of Arizona College of Medicine, Tucson, Arizona, United States
johny_apple_seed123@hotmail.com
10.22038/jctm.2017.13002.1083
This case report was an attempt to present the importance of diagnostic echocardiography and closure of a patent foramen ovale in carcinoid heart disease. Herein, we present a case of a 48-year-old woman with a carcinoid metastasis presenting with tricuspid regurgitation, pulmonic stenosis, patent foramen ovale, and borderline left ventricular ejection fraction on an echocardiogram. Surgical intervention included closing the patent foramen ovale and replacing the tricuspid valve via mini-sternotomy. The tricuspid valve was repaired and the ejection fraction was preserved. The patient had an uncomplicated post-operative course. As indicated in this report, closing the patent foramen ovale along with fixing malfunctioning valves can improve the ejection fraction and the associated symptoms.
Carcinoid disease,Heart Carcinoid Syndrome,Mini-Sternotomy,Patent foramen ovale
https://jctm.mums.ac.ir/article_9234.html
https://jctm.mums.ac.ir/article_9234_d00483ea62ce40d510cb6dc8f8057e26.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Apical Hypertrophic Cardiomyopathy in a Case with Chest Pain and Family History of Sudden Cardiac Death: A Case Report
198
200
EN
Mostafa
Ahmadi
Cardiologist, Division of Cardiovascular, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
mostafaahmadi75@gmail.com
Ramin
Khameneh Bagheri
Cardiologist, Division of Cardiovascular, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
rkb.ma.95@gmail.com
10.22038/jctm.2017.25214.1137
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, which is caused by a multitude of mutations in genes encoding proteins of the cardiac sarcomere (1). Apical hypertrophic cardiomyopathy (AHCM) is an uncommon type of HCM. The sudden cardiac death is less likely to occur in the patients inflicted with AHCM (2). Herein, we presented the case of a 29-year-old man with AHCM, who had typical exertional chest pain without any cardiovascular risk factors, except for a sudden cardiac death in his older brother at the age of 28 years. After performing complete clinical and paraclinical evaluations, the patient underwent optimal medical treatment with beta-blocker agents without any symptoms.
AHCM,Family history,Sudden cardiac death
https://jctm.mums.ac.ir/article_9235.html
https://jctm.mums.ac.ir/article_9235_61ab4b59965452f102f000fd1afb73df.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
Right-sided Infective Endocarditis with Multiple Large Vegetations in a Case of Ventricular Septal Defect: A Case Report
201
203
EN
Kumari
Priti
Senior Resident, Department Of Cardiology, JLN Hospital, Ajmer, Rajasthan, India
priti30jan@gmail.com
Bhanwar
Ranwa
Cardiologist, Department Of Cardiology, JLN Hospital, Ajmer, Rajasthan, India
bhanwar.ranwa@gmail.com
10.22038/jctm.2017.19727.1119
Herein, we present the case of a 10-year-old child suffering from right-sided infective endocarditis with ventricular septal defect. Echocardiography revealed multiple rare large vegetations on the pulmonary valve extending into pulmonary artery along with a large vegetation over the septal leaflet of the tricuspid valve.
large vegetations,Right-Sided Endocarditis,Ventricular Septal Defect
https://jctm.mums.ac.ir/article_8759.html
https://jctm.mums.ac.ir/article_8759_a8b8b27c32fff8b63f765a2717f80e4a.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
5
3
2017
09
01
An Unusual Presentation of Granulomatosis with Polyangiitis
204
207
EN
Rakhee
Sodhi
0000-0003-4691-3457
Internal Medicine, Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun,Indian
rakhee.sodhi@gmail.com
Sushant
Khanduri
0000-0002-4877-860X
Critical Care Medicine, Department of Critical Care Medicine, Himalayan Insitute of Medical Sciences, Dehradu, Indian
sushant.khanduri@gmail.com
Varuna
Jethani
0000-0003-4434-7850
Senior Resident, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Indian
varuna1212@rediffmail.com
Shirazi
Nadia
Pathologist, Department of Pathology, Himalayan Institute of Medical Sciences, Dehradun, Indian
shirazinadia@gmail.com
Manoj
Kumar
Resident, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Indian
manojchanddey79@gmail.com
10.22038/jctm.2017.24298.1135
The granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a pauci-immune vasculitis involving small- and medium-sized blood vessels. Classically, the patients inflicted with this disease present with a triad of necrotizing granulomatous inflammation of the respiratory tract, cutaneous necrotizing vasculitis, and glomerulonephritis (GN).<br /> The antinuclear (ANA) and anti-neutrophil cytoplasmic antibodies (ANCA) are considered as relatively specific markers of the disease. Herein, we presented the case of a patient who initially presented with sepsis but did not respond to the conventional antibiotics and later diagnosed with GPA.The granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a pauci-immune vasculitis involving small- and medium-sized blood vessels. Classically, the patients inflicted with this disease present with a triad of necrotizing granulomatous inflammation of the respiratory tract, cutaneous necrotizing vasculitis, and glomerulonephritis (GN).<br />The antinuclear (ANA) and anti-neutrophil cytoplasmic antibodies (ANCA) are considered as relatively specific markers of the disease. Herein, we presented the case of a patient who initially presented with sepsis but did not respond to the conventional antibiotics and later diagnosed with GPA.
Antinuclear antibody,Anti-neutrophil cytoplasmic antibody,Granulomatosis With Polyangiitis,Sepsis
https://jctm.mums.ac.ir/article_9236.html
https://jctm.mums.ac.ir/article_9236_b5d86aad598b97d478f58cad806e8335.pdf