Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
The Association between B-type Natriuretic Peptide Family and Successful Percutaneous Transvenous Mitral Commissurotomy: A Systematic Review
319
323
EN
Fereshteh
Ghaderi
Cardiologist, Preventive Cardiovascular Care Research center, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Hadi
Tohidi
Cardiologist, Preventive Cardiovascular Care Research center, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Amir Hossein
Rafighdoost
Cardiologist, Preventive Cardiovascular Care Research center, Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
rafighdousta@mums.ac.ir
10.22038/jctm.2015.4750
B-type natriuretic peptide (BNP) level is known to increase in patients with rheumatic mitral stenosis. In this systematic review, we aimed to discuss the possible association between plasma BNP level and the success rate of percutaneous transvenous mitral commissurotomy. PubMed and Scopus databases were searched systematically, using the following key terms: “B-type natriuretic peptide” OR “BNP” AND “percutaneous transvenous mitral commissurotomy” OR “percutaneous transluminal mitral commissurotomy” OR “PTMC” OR “percutaneous balloon mitral valvotomy” OR “PBMV”. The title, keywords and abstract of relevant articles were searched thoroughly. Among 27 articles found in these databases, 18 studies were excluded during different stages of article selection, based on the inclusion and exclusion criteria. A total of 333 patients were evaluated in the selected studies. Overall, 75 and 191 cases were male and female, respectively. Sex ratio was not specified in two studies, evaluating a total of 67 patients. The obtained results showed that BNP level may decrease after a successful PTMC. Furthermore, post-operative plasma levels of BNP and N-terminal proBNP could be considered as predictors of the success rate of PTMC. Based on the results reported in the evaluated articles, there may be an association between post-operative plasma levels of BNP family and the success rate of PTMC.
B-type Natriuretic Peptide,Mitral Stenosis,Percutaneous Balloon Mitral Valvotomy,Percutaneous Transvenous Mitral Commissurotomy
https://jctm.mums.ac.ir/article_4750.html
https://jctm.mums.ac.ir/article_4750_13d9abd08970a6865488f8ca4372cb1b.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
An Investigation of Safety and Efficacy of Intravenous Paracetamol in Pain Management Following Cardiac Surgery
324
328
EN
Ehsan
Mahdavi
Resident of Anesthesiology, Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
naghavie901@mums.ac.ir
Ghasem
Soltani
Anesthesiologist, Cardio-Thoracic Surgery & Transplant Research, Mashhad University of Medical Sciences, Mashhad, Iran.
Shahram
Amini
Anesthesiologist, Cardio-Thoracic Surgery & Transplant Research, Mashhad University of Medical Sciences, Mashhad, Iran.
aminish@mums.ac.ir
10.22038/jctm.2015.4754
<strong>Introduction:</strong> Optimum pain management immediately after surgeries can lower the possibility of pain syndrome and its following consequences. Opioids are amongst the analgesics used for postoperative pain control; however, their application can bring about several adverse effects. In this study, all the published articles regarding efficacy of Paracetamol in post-cardiac surgery pain management were systematically reviewed. <br/><strong>Materials and Methods</strong>: Pubmed and Scopus were searched for relevant articles. The employed search strategy was as follows: (Paracetamol OR Acetaminophen OR Propacetamol) AND (pain OR analgesia) AND coronary. All the English-language articles (with no time restriction), investigating the effectiveness of Acetaminophen in comparison with other analgesics or placebo, were included in the study. All the articles examining the efficacy of Paracetamol in combination with other analgesics were excluded from the search <strong>results.</strong> Results: On the whole, our electronic search retrieved 192 articles from PubMed and 365 articles from Scopus. After screening the titles, abstracts, and full texts of the search results, only 5 English-language articles met our inclusion criteria. <br/><strong>Conclusion</strong>: Although Paracetamol demonstrated considerable efficacy in minimizing application of post-operative opioids, its strength in soothing post-operative pain is not significantly different from opioids. Further, conducting randomized-controlled-trials with large sample size are necessary to accurately reveal the efficacy of Paracetamol in curtailing application of opioids in post cardiac surgeries.
Acetaminophen,Cardiac Surgery,Pain management,Paracetamol
https://jctm.mums.ac.ir/article_4754.html
https://jctm.mums.ac.ir/article_4754_707c300701b5e00c3e5a4f14472a462a.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
Chronic Asthma and Gastro-Esophageal Reflux Disease: The Treatment Plans
329
333
EN
Leila
Ghofraniha
Pulmonologist, Lung diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Emam Reza Hospital, Mashhad, Iran
ghofraniha@gmail.com
Vahideh
Mozafari
Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
akram.etemadi@yahoo.com
10.22038/jctm.2015.4751
Gastro-esophageal reflux disease (GERD) regularly occurs when stomach acid moves up from the stomach into the esophagus. GERD might be associated with chronic asthma symptoms such as coughing and breathlessness. According to several studies on children and adults, GERD is proven to have a close relationship with asthma. Medication treatment via proton-pump inhibitors (PPIs), such as Omeprazole, H<sub>2</sub> receptor blockers (Ranitidine), and other antireflux medications, is appropriate for ameliorating GERD and asthma. Moreover, surgery is another useful approach to GERD and asthma treatment. In this regard, Nissen fundoplication (laparoscopic) is a principal surgery method. Medical and surgical antireflux therapies are recognized as effective methods in the treatment of GERD-associated asthma. Our review included studies that evaluated treatment of GERD-associated asthma. These studies accentuated the critical role of acid reflux suppression in relieving the patients suffering from a difficult to control asthma.
Asthma,Gastro-Esophageal Reflux Disease,Proton-Pump Inhibitors
https://jctm.mums.ac.ir/article_4751.html
https://jctm.mums.ac.ir/article_4751_78e75f9a44a9c8bfc19614b52f1e3cfd.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
The Role of Pyloromyotomy on Gastric Drainage in Esophagectomy and Gastric Pull-up Procedures: A Randomized Clinical Trial Study
334
339
EN
Mohsen
Sokouti
General thoracic Surgeon, Department of Cardiothoracic Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
sokoutim@yahoo.com
Sina
Zarrintan
0000-0002-3968-0221
General Surgeon, Department of General & Vascular Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
s.zarrintan@yahoo.com
Ziaeddin
Rasihashemi
General thoracic Surgeon, Department of Cardiothoracic Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Babak
Abri-Aghdam
General thoracic Surgeon, Department of Cardiothoracic Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
abriaghdam@yahoo.com
Esmail
Qara-Papaque
Nuclear physician, Department of Medical Physics, Nuclear Medicine Unit, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Hananeh
Orangpour
General physician, Medicine Faculty & Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
oranghananeh@yahoo.com
10.22038/jctm.2015.4752
<strong>Introduction</strong>: Gastric drainage disorder is one of the complications of gastric pull-up and esophagectomy after surgery which might lead to esophageal cancer and benign strictures. The aim of this study was to determine the role of pyloromyotomy on gastric drainage. <br/><strong>Materials and Methods:</strong> In this prospective randomized controlled clinical trial study, we studied 51 patients in two matched groups from July 2008 to August 2010 in ImamRezaHospital, Tabriz,Iran. Twenty-seven patients in group one had no pyloromyotomy and 24 patients in group two had pyloromyotomy after transhiatal esophagectomy and gastric pull-up procedure. The outcomes were measured as the incidence of gastric outlet compromise which was diagnosed 12 months after esophagectomy and gastric pull-up. Regurgitation, fullness, respiratory distress, coughing and, clinical delayed gastric emptying were observed and compared in two groups by radioisotope gastric emptying scanning. <br/><strong>Results:</strong> A total number of 51 patients, 19 (37.25%) male and 32 (62.75%) female were studied in this research. The overall incidence of delayed gastric emptying was 19 /51 (37.25%). Pyloromyotomy did not reduce the incidence of delayed gastric emptying. There was no statistically significant difference in the length of hospital stay in study groups (group 1= 11 days versus 12 days in group 2, P=0.41). There was no statistical difference in anastomotic leak or anastomotic stricture (P= 0.72). Mortality was two (one patient, 3.7%, in group 1 and one patient, 4.2%, in group 2). The incidences of regurgitation and increased gastric emptying were not statistically different in two groups. <br/><strong>Conclusion:</strong> Pyloromyotomy could not reduce the incidence of delayed gastric emptying after transhiatal esophagectomy, and vagotomy.
Esophagectomy,Gastric Emptying,Gastric Pull-Up,Radioisotope Scan
https://jctm.mums.ac.ir/article_4752.html
https://jctm.mums.ac.ir/article_4752_165c57da5275b0377353efb381e16136.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
Optimal Stent Expansion by Stent Balloon Multiple Inflation at Nominal Pressure in Resistant Lesions: A New Technique
340
343
EN
Amir Hossein
Khosh Nasab
Resident of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mahmoud
Mohammadzadeh Shabestri
Cardiologist,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ali
Eshraghi
0000-0002-3642-3553
Cardiologist,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
eshraghia@mums.ac.ir
Majid
Jalalyazdi
Cardiologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
jalalyazdi@yahoo.com
10.22038/jctm.2015.4753
<strong>Introduction</strong>: This study aimed to evaluate the effects of four-time inflation of the stent balloon at nominal pressure on optimal stent expansion in resistant lesions. <br/><strong>Materials and Methods:</strong> This interventional study was conducted on 39 patients with coronary artery lesions, in whom Zotarolimus-eluting stents (N=20), Paclitaxel-eluting stents (N=11) and other stents (N=8) were deployed four times at nominal inflation pressure and increased inflation times (5, 15, 30 and 45 seconds). After the deployments, enhanced stent visualization imaging technique (IC stent) was used to assess stent placement and artery expansion. <br/><strong>Results:</strong> In this study, early success rate was estimated at 79.5% using the enhanced stent visualization imaging technique. In addition, major adverse cardiac event (MACE) was determined at 2.6%. Also, conventional methods resulted in lower success rate and higher MACE in resistant lesions. <br/><strong>Conclusion:</strong> According to the results of this study, four-time stent balloon inflation at nominal pressure could allow adequate stent expansion in resistant lesions leading to lower MACE.
Coronary Artery Disease,Interventional Cardiology,Stent
https://jctm.mums.ac.ir/article_4753.html
https://jctm.mums.ac.ir/article_4753_53fc7ee58d4f4122f999143b4a82d8aa.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
Prediction of Changes in Left Ventricular Ejection Fraction after Off-Pump Coronary Artery Bypass Grafting Surgery by Myocardial Perfusion Single-Photon Emission Computed Tomography
344
349
EN
Maryam
Mirzaie
Resident of Community Medicine, Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
mirzaeim912@mums.ac.ir
Asadollah
Mirzaie
Cardiac Surgeon, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
mirzaiea@mums.ac.ir
Majid
Assadi
Nuclear Physician, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
asadi@bpums.ac.ir
Rasoul
Zakavi
Nuclear Physician, Nuclear Medicine Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/jctm.2015.4756
<strong>Introduction</strong>: Left ventricular ejection fraction (LVEF) is considered to be the single most important prognostic factor in patients with previous myocardial infarction. LVEF is not improved in all patients after coronary artery bypass grafting (CABG). This study aimed to assess the possibility of prediction of LVEF changes after CABG using myocardial perfusion gated signle photon emission computed tomography (GSPECT). <br/><strong>Materials and Methods:</strong> Overall, 48 patients with mean LVEF of 30.2% (±4.7) underwent Echocardiography and GSPECT after injection of Tc-99m-MIBI at rest. Myocardial uptake was evaluated in 17 myocardial segments and was compared with age and gender matched normal data pool. The risks and benefits of CABG were explained to the patients and 16 cases (15 male and 1 female) with the mean age of 61.1 years (±10.8) accepted to undergo off-pump CABG. All the patients were followed-up for at least six months and echocardiography and GSPECT were repeated at the end of follow up. <br/><strong>Results</strong>: The mean LVEF was increased from of 31.1% (±3.5) to 34.5% (±3.6) after surgery (P<0.001). Delta LVEF was defined as ΔLVEF=LVEF (before CABG) - LVEF (after CABG). ΔLVEF was within the range of 0-8% with the mean of 3.4% (±2.5). The number of non-viable myocardial segments was not significantly different between patients with ΔLVEF ≥ 5% and those with smaller changes. Myocardial perfusion was estimated for all segments, and the mean global uptake was defined by adding the mean uptake in all segments, divided by 17. The mean global uptake was 53.1% in our patients. Regression analysis revealed that ΔLVEF after CABG can be predicted reliably using the following formula: ΔLVEF= -33.8 + (0.77 × mean global uptake) (P<0.01). <br/><strong>Conclusion</strong>: Our study showed that change of LVEF after CABG can be predicted reliably using mean global uptake in preoperative myocardial perfusion SPECT at rest.
Coronary artery bypass grafting,Left Ventricular Function,myocardial perfusion imaging
https://jctm.mums.ac.ir/article_4756.html
https://jctm.mums.ac.ir/article_4756_c9047955f898070ff8ec9cfcecd246de.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
Mediastinal Neuroendocrine Carcinoma of Unknown Origin Presenting with Superior Vena Cava Syndrome (SVCS): A Case Report
350
352
EN
Mahnaz
Amini
0000-0002-5205-4647
Pulmonologist, Lung Disease Research Center, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
aminim@mums.ac.ir
Elham
Ghalenavi
Internist, Lung Disease Research Center, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
Mansore
Sobhani
Internal Medicine Resident, Faculty of Medicine Mashhad University of Medicine Sciences, Mashhad, Iran
Hadi
Mohamaddoust
Pulmonologist, Internal Medicine Department, Bojnurd. North khorasan Medical University, Bojnurd, Iran
10.22038/jctm.2015.4757
Primary neuroendocrine carcinoma (NEC) of the mediastinum is a rare type of carcinoma. According to the literature, only five cases of this condition have been reported so far. In this paper, we present a rare case of mediastinal NEC of unknown primary site. The patient was a 34-year-old man with mediastinal NEC, who presented with chronic dry cough and a right-sided mediastinal mass one year prior to hospital admission (winter 1391). His condition was confirmed by cervical lymph node biopsy. The patient refused to undergo chemotherapy treatment. During the hospital admission, the patient presented with severe dyspnea and signs of superior vena cava syndrome. Contrast-enhanced CT scan of the chest revealed a large heterogeneous mass extended from the right superior mediastinum to the right lung base with the encasement of the superior vena cava. After radiotherapy, the patient′s symptoms subsided and he underwent etoposide and cisplatin chemotherapy. After a 20-month patient follow-up, the subject remained alive and symptom-free.
mediastinal tumor,Neuroendocrine Carcinoma,Superior Vena Cava Syndrome
https://jctm.mums.ac.ir/article_4757.html
https://jctm.mums.ac.ir/article_4757_bf9fb43025053d5eb87bc02c5d83d085.pdf
Mashhad University of Medical Sciences
Journal of Cardio-Thoracic Medicine
2345-2447
2322-5750
3
3
2015
09
01
Enlarged Right Atrium Falsely Interpreted as a Mediastinal Mass: A Case Report
353
354
EN
Farid
Zand
Anesthesiologist, Anesthesiology and Critical Care Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
zandf@sums.ac.ir
Mohammad Reza
Sasani
Radiologist, Medical Imaging Research Center, Department of Radiology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Shahrbanoo
Shahbazi
Anesthesiologist, Anesthesiology and Critical Care Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
sh-shahbazi@yahoo.com
Kamran
Hojabri
Resident of Anesthesiology, Department of Anesthesia, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
hozhabrika@sums.ac.ir
Mansour
Jannati
Cardiac Surgeon, Department of Cardiovascular Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
10.22038/jctm.2015.4758
Right atrial dilation due to left heart disease is a common complication among adults. The present review aimed to describe a case of massively dilated right atrium in a female patient presenting with valvular heart disease and no atrial fibrillation. The results of chest X-ray revealed a large opacity filling the lower right hemithorax, falsely interpreted as a mediastinal mass. During the transesophageal echocardiography, severe enlargement of the right atrium was detected, and open mitral and tricuspid valve replacements were performed successfully.
Chest X-ray,echocardiography,Heart Atria,Mass,Mediastinal Disease
https://jctm.mums.ac.ir/article_4758.html
https://jctm.mums.ac.ir/article_4758_b63332233d0d53533b070dc90b104e1a.pdf