Possible Effect of CABG on Moderate Mitral Regurgitation
Ehsan
Shahverdi
Hematologist, Department of Transfusion Medicine, Institute of Immunology and Transfusion Medicine, University Medicine Greifswald, Greifswald, Germany
author
Massoumeh
Maki
Nursing, Department of Nursing and Midwifery, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
author
Maryam
Allahverdi Khani
Nursing, Department of Nursing and Midwifery, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
author
Mahkameh
Rasouli
Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
author
Hadi
Rad
Faculty of Medical Sciences, Islamic Azad University -Tonekabon Branch, Mazandaran, Iran
author
text
article
2019
eng
Introduction: Mitral valve insufficiency in adults is often a complication of ischemic heart disease. Coronary artery bypass grafting (CABG) is performed as a strategy for the treatment of coronary artery disease. The aim of this study was to evaluate mitral regurgitation (MR) before and after CABG. Materials and Methods: This Experimental study was conducted on 100 patients who underwent CABG in University Hospitals of Tehran, Iran, from 2009 to 2013. Statistical Package for the Social Sciences (SPSS) version 16 (SPSS Inc. Chicago, IL) for Windows was used for data analysis.. Results: Out of 100 patients (i.e., 60 males and 40 females) with the mean age of 64.97±10.64 years, 11 males (18.3%) and 12 females (30.0%) were identified with MR +2 after the surgery. There was no significant relationship between renal insufficiency and MR before the operation (P= 0.370). Furthermore, in patients with and without renal insufficiency, 2 (50.0%) and 21 (21.9%) subjects were identified with MR +2 after the operation, respectively. Out of 100 patients, 75 (75%) cases with MR +2 before the surgery were identified with MR +1 after the operation. Moreover, 23 (23%) subjects with MR +2 before the surgery were still reported with MR +2 after the operation. In this regard, there was a significant relationship before and after the surgery in MR severity (P=0.02). Conclusion: It is necessary to have sufficient knowledge of the risk factors in dealing with MR for the determination of the best therapy.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
462
468
https://jctm.mums.ac.ir/article_13707_8175b75141e9dd3f543c123e8676efb9.pdf
dx.doi.org/10.22038/jctm.2019.40567.1226
Prevalence and Causes of Mediastinal Reexploration for Excessive Bleeding after Cardiac Surgery Procedures
Hamid
Hoseinikhah
Cardiac surgeon, Department of Cardiac Surgery, Faculty of Medical Science. Mashhad University of Medical Sciences, Iran
author
Omid
Javdanfar
Resident of cardiac surgery, Department of Cardiac Surgery, Faculty of Medical Science. Mashhad University of Medical Sciences, Iran
author
Mohamadreza
Akbari
Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Kayhan
Mizani
Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad
author
Mahsa
Moallemi
Student Research Committee, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Aliasghar
Moeinipour
Cardiac surgeon, Department of Cardiac Surgery, Faculty of Medical Science. Mashhad University of Medical Sciences, Iran
author
text
article
2019
eng
Introduction: Postoperative bleeding in cardiac surgery is not an uncommon complication and can be evaluated with surgical and nonsurgical causes. Although any type of coagulopathy should be treated before, during, and after the surgical procedure, cardiac surgeons should have perfect surgical techniques for step by step hemostasis to minimize blood loss. Materials and Method: This retrospective study was conducted on 85 patients out of 1075 (0.07%) ones required Reexploration of the Mediastinal to control the excessive bleeding after different cardiac procedures in Imam Reza Hospital in Mashhad of Iran from January 2018 to January 2019. Results: Out of 85 patients who required Mediastinal Reexploration, 61 (71%) and 24(29%) patients underwent the off-pump procedure and cardiopulmonary bypass, respectively. The most common sites for surgical bleeding in the order were missed branches of left internal mammary artery / saphenous vein graft (65%), proximal or distal coronary anastomosis (18%), and aortic /atrial suture line (16%). The death in patients under study was 7 (8%), half of which were not related to Mediastinal Reexploration. Conclusion: The possibility of postoperative bleeding can be minimized through correction of clotting factor deficiencies, improvement of surgical techniques in hemostasis.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
469
473
https://jctm.mums.ac.ir/article_13708_70d353a7bb93b5e77ba1f5dd9335af5c.pdf
dx.doi.org/10.22038/jctm.2019.40840.1232
A Propensity Score Analysis of Renal Dysfunction in Patients after On-Pump and Off-Pump Coronary Artery Bypass Surgery
Rajkamal
Vishnu
Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Guruprasad
Rai
Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Arvind
Bishnoi
Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Ganesh
Sevagur
Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Pranav
Balakrishnan
Department of Cardiovascular Thoracic Surgery,Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
yogesh
gaude
Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Navin
Patil
Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
Lokvendra
Budania
Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
author
text
article
2019
eng
INTRODUCTION- Cardiovascular disease has emerged as a major health burden worldwide with coronary artery disease [CAD] causing highest mortality and morbidity. Coronary revascularization is the preferred treatment for patients with multivessel CAD. Based on the application of cardiopulmonary bypass [CPB], Coronary revascularization can be on-pump [OPCAB] or off-pump [CABG].The CPB is known to have multifactorial effects on all end-organ functions due to nonpulsatile flow and inflammation response. Renal function alteration is one of the multiple deleterious effects. There have been reports on superior renal function using off-pump CABG . The present study aimed to investigate and compare the prevalence of renal dysfunction in the two techniques [OPCAB versus CABG].METHODS- This was a single-center retrospective study conducted with the data from 199 patients categorized into two groups of off-pump [n=106] and on-pump [n=93]. Renal parameters were monitored on the days 0, 1, 3, 5 after the operation using Glomerular Filtration Rate [GFR]. Creatinine clearance [CrCl] of patients with diabetes, hypertension, both diabetes and hypertension, and normal patients was also correlated.RESULTS- Two groups of on-pump and off-pump were combined and classified according to Propensity Score. Renal functions were compared between the two groups no significant difference in renal function between the off-pump and on-pump groups.CONCLUSION-In the present study, there were no significant differences between the two techniques in renal outcomes. Both groups shared an almost similar change of trends in renal functions.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
474
483
https://jctm.mums.ac.ir/article_13864_fb580d376e89c2a6c982ba661b66869b.pdf
dx.doi.org/10.22038/jctm.2019.40561.1233
Association Between Left Anterior Descending Artery Length with Coronary Artery Dominance: An Angiographic Study
Ahmad
Separham
Cardiologist , Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
author
Masoud
Nouri-Vaskeh
MD, Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
author
Mehdi
Maleki
Fellowship of Interventional Cardiology, Cardiovascular Research Center, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
author
text
article
2019
eng
Introduction: Although left anterior descending (LAD) artery supplies a large portion of the myocardium, the amount of blood supply provided by LAD is depended on the length of the LAD. The aim of the current study was to evaluate the association between coronary artery dominance and LAD anatomic types in patients with normal epicardial coronary arteries. Methods: This retrospective study was conducted at a tertiary teaching hospital on a total of 252 patients with normal coronary artery angiographic findings between April 2018 to March 2019. Patient’s medical records were utilized to collect demographic and catheterization data, as well as their clinical characteristics. Qualitative and quantitative catheterization data, including the anatomical type of LAD, dominance, LAD slow flow phenomenon, LAD ectasia, and Muscle Bridge were obtained from the angiographic examination. The three anatomical LAD types, including type I (LAD terminating before the apex), type II (LAD reached the apex), and type III (LAD wrapping around the apex) were compared in the left and right dominant coronary artery patients. Results: The mean age of patients was 58.06±10.89 years (age range: 27-79 years). The slow flow phenomenon was more significantly observed in patients with type C LAD (P=0.015); however, there was no significant difference between LAD types regarding LAD Muscle Bridge (P=0.099) and ectasia (P=0.810). In total, 54.8% and 45.2% of the patients had right and left dominant coronary artery systems, respectively. Moreover, there was a statistically significant association between wrap-around LAD and left coronary artery dominance (P<0.001). Conclusion: The type C LAD is more prevalent in patients with left dominant coronary artery.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
484
490
https://jctm.mums.ac.ir/article_13709_ba9a552313d85283df04a12fed478bf8.pdf
dx.doi.org/10.22038/jctm.2019.41313.1236
Effects of Rivaroxaban on Coagulation Assays in Patients with Small Pulmonary Embolism and Deep Vein Thrombosis in Relation to Body Mass Index
Shima
Ghahremani
MD, Faculty of Medicine, Mashhad Medical Sciences Branch,Islamic Azad University, Mashhad, Iran
author
Esmat
Asaei
Cardiologist, Department of cardiology, Mashhad Medical Sciences Branch,Islamic Azad University, Mashhad, Iran
author
Mahmoud
Shabestari
Cardiologist, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Majid
Jalalyazdi
Cardiologist, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
text
article
2019
eng
Introduction: Rivaroxaban is a new anticoagulant medication for pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT). There are limited data on the effect of body mass index (BMI) on the pharmacokinetics of rivaroxaban. This study aimed to assess the effect of rivaroxaban on coagulation assays in relation to BMI in PTE and DVT patients. Materials and Methods: the present cohort studywas conducted on patients with DVT and PTE who were planned to receive rivaroxaban (15 mg bid). Demographic characteristics, as well as anthropometric measurements, were recorded before the rivaroxaban administration. Prothrombin time (PT), partial thromboplastin time (PTT), and international normalized ratio (INR) were measured before and after 4-6 days of treatment with rivaroxaban. The data were analyzed using paired t-test and analysis of covariance in SPSS software, version 20 (IBM Inc., Chicago, Il, USA) Results: This study was carried out on 100subjects (i.e., 45 males and 55 females) with the mean age of 38.8±1.7 years. The majority of the subjects (68%) had normal creatinine clearance. The results of the research revealed a significant increase in PT, PT, and INR after the administration of rivaroxaban in both normal-weight and obese subjects (P40 years), gender, and creatinine clearance (i.e., normal and abnormal) groups (P Conclusion: The findings of this study indicated a significant increase in coagulation assays in both normal weight and obese subjects; however, the final PT increment was reduced by BMI.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
491
498
https://jctm.mums.ac.ir/article_13760_505d2f81fefda24564a0db877e1baf4c.pdf
dx.doi.org/10.22038/jctm.2019.41968.1239
A Rare Etiology of Drug Rash in a Patient Receiving Anti-Tuberculosis Treatment
Rakhee
Sodhi Khanduri
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Varuna
Jethani
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Rashmi
Jindal
Dermatologist, Department of Dermatology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Shirazi
Nadia
Pathologist, Department of Pathology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
text
article
2019
eng
Anti-tuberculosis medications can cause various side effects, including drug rash. When a patient on anti-tuberculosis treatment (ATT) develops rash, we usually stop all medicines, rechallenge the patient with medications individually, and find the offending agent. It should be mentioned that drug rash can be also a manifestation of other diseases. Herein, we report a case of tuberculosis who developed rash while on ATT regimen but was later diagnosed to be concomitantly suffering from leprosy.
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
499
502
https://jctm.mums.ac.ir/article_13710_0060df562d2a2ff804f39af6a7a78c64.pdf
dx.doi.org/10.22038/jctm.2019.41142.1234
Rare Etiology of Cough and Chest Pain in a Young Male
Rakhee
Sodhi
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Suchita
Pant
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Varuna
Jethani
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Shirazi
Nadia
Pathologist, Department of Pathology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Mamta
Aggarwal
Radiologist, Department of Radiology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
Sushant
Khanduri
Pulmonologist, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Indian
author
text
article
2019
eng
Chronic cough and chest pain should be dealt seriously in a young adult. Sometimes we may miss a diagnosis in such patients. We present a case of Pulmonary Langerhans Histiocytosis who presented with complaints of cough and chest pain
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
503
506
https://jctm.mums.ac.ir/article_13711_3a508a55fd3ddbd276b5e0ae062f905d.pdf
dx.doi.org/10.22038/jctm.2019.41199.1235
Concurrent Mediastinal Masses in a Patient
Reza
Bagheri
Thoracic Surgeon, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2019
eng
A 16-year-old female with a history of neck hemangioma surgery presented with irritable coughs. A computed tomography scan showed anterosuperior and middle mediastinal masses (Figure 1). The patient underwent surgery and the upper and middle mediastinal lesions were removed (Figure 2A). Pathological examination confirmed that the upper and middle mediastina contained hemangioma (Figure 2B) and pericardium cyst (Figure 2C)
Journal of Cardio-Thoracic Medicine
Mashhad University of Medical Sciences
2345-2447
7
v.
3
no.
2019
507
508
https://jctm.mums.ac.ir/article_13893_7abf040e8894a278f22dfdd2f8b30482.pdf
dx.doi.org/10.22038/jctm.2019.43141.1245