جستجوی مقالات مرتبط با کلیدواژه « ترمیم جراحی » در نشریات گروه « پزشکی »

Tetralogy of Fallot is the most common type of cyanotic congenital heart disease. The underlying mechanisms that contribute to heart dysfunction in patients with repaired tetralogy of Fallot are incompletely understood. In this study, the cardiac function indexes and residual complications after Fallot tetralogy complete surgical repair was evaluated.

In this cross-sectional study, clinical data and information obtained from cardiac magnetic resonance (CMR) gathered from 150 consecutive patients with repaired tetralogy of Fallot. Cardiac function indexes and residual complications evaluated in the patients.

Mean age of patients was 22.5±9.6 years. 60 patients (40%) were female and 90 patients (60%) were female. Mean of Left ventricular Ejection Fraction and mean of Right ventricular Ejection Fraction was 54.9±7.5 and 38.6±8.3 percent, respectively. Left ventricular Dilatation in 19 (12.7%) and Right ventricular Dilatation in 141 (94%) patients was observed. RVOT dilatation in 143 (95.3), residual pulmonary stenosis in 39 (26%), ASD (Atrial Septal Defect) in 1 (0.7%), VSD (Ventricular Septal Defect) in 40 (26.7%), PDA (Patent ductus arteriosus) in 11 (7.3%) and Delayed Enhancement of RVOT in 125 (83.3%) patients was positive.

Residual complications following repair of tetralogy of Fallot, especially in the right ventricle, are common and CRM may be a diagnostic instrument for follow-up in patients with congenital heart disease after repairing surgery.

Aortic transection is a rare but life-threatening complication of blunt chest trauma. Treatment options include open repair, medical management and most recently, endovascular repair. We report a 33 years old male with a traumatic aortic transection following a car accident. Aortic injury and its pseudo-aneurysm were confirmed by Chest CT scan and TEE in the descending thoracic aorta just below the isthmus. We did not have endovascular repair possibility at our center. The patient was transferred to the operating room for emergent surgery. Aortic transection was repaired by partial left heart bypass and Dacron interposition grafting. Postoperatively, no vascular-related complication was seen. There was temporary recurrent laryngeal nerve palsy that resolved spontaneously. The patient has no problem at 6-year follow-up.

Morgagni Hernia is an uncommon congenital abnormality usually occurring in right side. This paper introduces it in a 15-month old girl admitted to Shaheed Beheshti Hospital of Kashan University of Medical Sciences. With a very are Lt. Side Hernia. A 15-month old girl referred with fever and bloody vomiting. Paraclinical studies including X-ray studies of upper GI system revealed Morgagni Hernia. In celiotomy stomach was not found in the abdomen. If had had passed to Lt chest cavity through a defect in anterior part of diaphragm and was entrapped and strangulated there. It was released and returned to the abdomen and fixed. The baby discharged with a good condition. This Hernia causes repeated lung infections, cough and vomiting, more importantly it may cause strangulation and necrosis of visceral organs and compromise the patients life, so its in time diagnosis is very critical. It is recommended hat whenever there is any abnormality in chest x-ray including air and fluid behind morbidity and mortality.

With respect to need for finding suitable ways for maintenance and survival of neurons after nerve injury, also inadequacy of information for effects of peripheral nerve repair on ultrastructure of sensory neurons, this study was carried out in Iran Medical Sciences University in 2004. In this experimental study, 24 male adult Wistar rat weighing 200-250 grams were randomly assigned in three groups of axotomy, repair, and sham. In axotomy group, left sciatic nerve transected in middle thigh and did not repaired. In repair group, sciatic nerve transected in middle thigh and repaired by epineurial suture. After 8 weeks the fifth left and right (intact) dorsal root ganglion removed. For neuronal counting, after crysel violet staining, neurons were counted with scaled lens. For ultrasrtuctural study, after primary and secondary fixation, dehydration, and impregnation, ganglions embedded with araldehyde resin. After semi thin and thin sections, and dyeing, they were observed through light and transmission electron microscopes. Average of neurons in axotomy group was 27.42±7.7 and in repair group was 33.42±11.4 (P<0.03). Semi thin sections in intact and sham groups had normal appearance. In axotomy group they showed translocation of nucleus and neucleolus, shrinkage, and pyknosis. In repair group these problems decreased completely. Thin sections in intact and sham groups were normal. In axotomy group chromatin condensation, margination and pyknosis as well as abnormal and dilated mitochondria and endoplasmic reticulum were seen. Similar changes were observed in a few of neurons in repair group. Sciatic nerve repair by epineurial suture may cause sensory neuronal loss to decrease after nerve transection, but cannot stop it. Evaluation of effects of other nerve repair techniques on neurons morphology also investigation by histochemistry and immunohistochemistry methods are recommended.