Blood cyst of the pulmonary valve causing pulmonic valve stenosis.
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Child↗
Biomedical subjects
R Doğan
Publications and source records attributed to R Doğan.
Right ventricular hydatid cyst causing recurrent pulmonary emboli.
A hydatid cyst of the heart is rare. Surgical treatment is the preferable method in the treatment of cardiac echinococcosis. A 27-year-old patient with right ventricular hydatid cyst causing recurrent pulmonary emboli and diagnosed by 2-dimensional echocardiography and treated surgically is presented.
Adult↗
Mitral valve surgery in the presence of pulmonary hypertension.
Mitral valve surgery was performed in 59 patients with severe pulmonary hypertension (average systolic pulmonary artery pressure 77.1 +/- 18.6 mmHg; range 50-115 mmHg) between 1983 and 1990. Thirty-eight patients had been subjected to mitral valve replacement, 16 patients both mitral and aortic valve replacement, and 5 patients had open mitral commissurotomy, with an operative (30 day) mortality of 5.0%. These 3 deaths happened during the early postoperative period. Survivors were followed up for a period ranging from 6 months to 7 years with a mean of 36 months. Four late deaths (7.1%) occurred in patients with valve replacement. Actuarial survival was 93 +/- 3% at 5 years, and 90.7 +/- 4.4% at 7 years. Right ventricular catheterization was performed on 14 patients a mean of 38 months following operation. Systolic pulmonary artery pressure had decreased from a mean of 77.1 +/- 18.6 to 39.7 +/- 14.0 mmHg (p less than 0.001) and 90% of the survivors were in New York Heart Association Class 1 or II compared to 23.7% preoperatively. The clinical and hemodynamic findings in this series suggest that severe pulmonary hypertension is not a contraindication, and pulmonary hypertension decreases significantly after mitral valve surgery.
Adolescent↗
Familial atrial myxoma.
Familial and biatrial myxomas of the heart have rarely been described. We describe a familial atrial myxoma involving a parent with biatrial and a child with a left atrial myxoma. Atrial myxomas were diagnosed preoperatively by echocardiography and successfully removed at operation. Echocardiography can be used in the diagnosis of cardiac myxoma, detection of its possible recurrence and for screening other members of the family.
Adolescent↗
Bronchoscopic removal of foreign bodies in children: retrospective analysis of 822 cases.
At the Department of Thoracic and Cardiovascular Surgery of Hacettepe University, a total number of 822 pediatric bronchoscopies were performed from 1984 through 1990 for suspected foreign body aspiration. Of the children 65.3% were boys and 34.7% were girls ranging in age from one month to 14 years. Definitive statement of foreign-body aspiration was obtained from 394 patients. Unilateral hyperaeration, atelectasis, and unilateral parenchymal infiltration were the most common radiological findings. In all endoscopic procedures, a pediatric rigid bronchoscope was used under general anesthesia and controlled ventilation. Foreign bodies were found in 77.7% of the 822 patients. In the rest of the children inflammatory disorders were confirmed. The foreign bodies most commonly found in 639 patients were sun-flower seeds (21.1%), beans (10.4%), water-melon seeds (10%), and hazelnuts (9.8%). In our presented series, the incidence of non-fatal complication was 1.8%, apart from these patients 5 of them (0.6%) died after the bronchoscopic procedures.
Adolescent↗
De Vega's tricuspid annuloplasty: analysis of 195 patients.
In the years 1984-1989, 195 De Vega tricuspid annuloplasties were performed in association with mitral or mitral-aortic valve procedures. Preoperatively, 9 patients (4.6%) were in New York Heart Association functional class II, 124 (63.6%) were in class III, and the remaining 62 (31.8%) were in class IV. Tricuspid insufficiency was recognized by routine digital palpation of the tricuspid valve during the operation in 42 (21.5%) of the patients. Hospital mortality rate was 7.6% (15 patients). Late deaths occurred in 6 (3.0%) cases during a follow-up period of 3 to 72 months (mean 42 months). 8 patients (4.1%) required reoperation. Tricuspid annuloplasty failure was observed in 4 patients (2%). These valves were replaced with biological valves in three patients and with a mechanical valve in one patient. 112 of the survivors (64.3%) were evaluated by echocardiography and/or right ventriculography. Analysis of postoperative data showed that in 84 of the 112 patients (75%) tricuspid regurgitation disappeared completely after annuloplasty, 88% of surviving patients were in functional class I or II. For the series presented actuarial survival rate at 6 years was 79.1% +/- 14.4%. In the light of this study we recommend De Vega's annuloplasty as the method of choice for moderate to severe functional tricuspid insufficiency.
Adolescent↗
Primary mediastinal liposarcoma. A report of a case and review of the literature.
A case of primary liposarcoma of the mediastinum with a review of the literature is presented. Liposarcomas may attain a large mass and exhibit various kinds of clinical symptoms according to their localisation. Histological typing is very important in determining the type and extent of therapy. Surgical excision of the tumour is the therapy of choice in all cases. Radiotherapy may be of value for the palliation of unresectable cases.
Aged↗
Surgical treatment of bronchiectasis: a collective review of 487 cases.
Pulmonary resection to treat bronchiectasis in a total of 487 patients between December 1976 through June 1988 is reported on. The surgical treatment consisted of pneumonectomy in 190 cases (144 left and 46 right), lobectomy in 202 cases, bilobectomy in 23 cases and lobectomy combined with segmental resection in 72 cases. The overall mortality rate was 3.5%. Patients were followed up for a period ranging between 4 months to 10 years: at the end of the study 71% of the patients were completely asymptomatic. It is concluded that though the first choice of therapy must be conservative, in those patients with bronchiectasis in whom disease progresses despite medical treatment and in those whose disease requires frequent hospitalization, continuing medical treatment is unwarranted and surgery must be the choice of therapy.
Adolescent↗
Surgical treatment of hydatid cysts of the lung: report on 1055 patients.
Of 1055 patients treated surgically for pulmonary hydatid disease, most (950) had isolated lung cysts, the other 105 having both liver and lung cysts. The chest radiograph was most valuable in diagnosis; the Casoni and Weinberg tests and blood eosinophil counts were found to be diagnostically unreliable. One thousand and seventy seven primary operations were performed. Cystotomy and capitonnage were carried out in 906 patients, 40 of whom also had decortication of the pleura. Other procedures included cystotomy with wedge resection of locally damaged lung (29 patients) and cyst removal with capitonnage by Ugon's method (33) or the Perez-Fontana procedure (8) and with costal resection for osteomyelitis in two cases. More radical surgery was carried out in 99 patients for longstanding infection or severe lung destruction. Postoperative complications occurred in 37 patients (3.5%) and the 30 day mortality rate was 1.7%. It is concluded that a lung conserving surgical operation is the treatment of choice for most patients with pulmonary hydatid disease. In patients with coexisting liver cysts the thoracic transpleural approach allowed the lung and liver cysts to be removed at the same session.
Adolescent↗
Surgical treatment of bilateral hydatid disease of the lung via median sternotomy: experience in 60 consecutive patients.
Sixty patients who underwent operation between 1979-1987 for bilateral pulmonary hydatid disease using median sternotomy approach are reported on. Although some authors prefer two-stage thoracotomy and operate on the side with the larger cyst first, or perform simultaneous bilateral thoracotomies, we have preferred one-stage operation via median sternotomy. There were 29 female and 31 male patients, ranging in age from 5 to 55 years (mean 26.4 +/- 6.3). A total of 173 cysts were operated in 120 lungs. The usual operative technique was cystotomy and capitonnage. Operative and postoperative courses were uneventful in all but three cases (5%). The causes of mortality in these patients were excessive hemorrhage, mediastinitis, and septic shock respectively. It is concluded that median sternotomy is a better alternative method for the treatment of bilateral hydatid disease of the lung, as the duration of hospitalisation is shorter, the approach is better tolerated by the patients than thoracotomy, and it possibly prevents a second general anesthesia.
Adolescent↗
Endobronchial lipoma.
The endobronchial lipoma is one of the rarest tumours of the tracheobronchial tree. They are histologically benign tumours. But, they can produce pulmonary damage or irreversible bronchiectasis if diagnosis and treatment are delayed. The treatment of choice in most cases is bronchoscopic removal. A case report of this rare tumour is presented with its clinical features, early clinical course, and treatment.
Biopsy↗
Surgical treatment of childhood pleural empyema.
From June 1977 to January 1987, 175 patients underwent surgical treatment of childhood pleural empyema. The surgical treatment consisted of tube drainage in 159 (90%) cases, decortication in 31 (17%) cases, pleuropneumonectomy in 2, lobectomy in 1, and partial thoracoplasty in one cases. There were 2 hospital deaths (14 and 26 days after admission). Late recurrences didn't occur, except in one case where a partial thoracoplasty was necessary. During the follow-up of 11 to 120 months (mean 32 months) examinations were done by chest radiographs. We believe that, children with loculated empyema can be treated successfully with antibiotics and chest tube drainage in early stage. The tube drainage is a more effective method than the other surgical procedures. Few patients require open drainage, and further surgery is rarely required.
Adolescent↗
[Pulmonary and mediastinal bronchogenic cysts].
Bronchogenic cysts are relatively rare anomalies with a congenital origin resulting in an abnormal branching of the tracheo-bronchial tree. They either develop in the pulmonary parenchyma or in the mediastinal region. Between 1975 and 1987, 21 cases of bronchogenic cysts were operated upon. Eighteen of these cysts had a pulmonary localisation and 3 were mediastinal. Only 8 of these were diagnosed pre-operatively by bronchoscopy. The major reason for delay in diagnosis is persistent or recurrent pulmonary infection. Eight cases were treated by cystectomy, 4 by simple wedge resection, 4 by segmental resection, 3 were extirpated and 2 by lobectomy.
Adolescent↗
Surgical treatment of bronchial adenomas: results of 29 cases and review of the literature.
The low-grade malignant potential of bronchial adenoma has been widely reported in the medical literature. During the past 12 years we have treated 29 patients with this disease, 18 (62%) of whom required conventional lobectomy or pneumonectomy, because most of our cases had come to our center after having inappropriate treatments in other centers and loosing time. In these cases we observed either a total obstruction of a bronchus or a destroyed parenchyma due to recurrent pulmonary infections. For this reason, the number of pulmonary resections is more important than conservative surgical procedures in our center. The other 11 cases (38%) were treated by bronchoplasty or more conservative resectional procedures. There was no recurrence and the survival rate was about 96 per cent at 5 years. We believe that, in our series, we would have mostly been able to perform conservative types of resections if we could have diagnosed the disease in its early stages.
Adenoma↗
Vascular hamartoma of the mediastinum: a case report.
Vascular hamartoma of the mediastinum is a rare benign vascular tumor. A 13-year-old girl presented with back pain, persistent coughing, palpitation, and angina pectoris. Preoperative investigations demonstrated an enlarging mass involving the superior mediastinum extending posteriorly (T6-T8). An encapsulated, 6x5x3 cm dark purplish mass adherent to the aortic wall was found. The main mediastinal mass was totally excised but limited resection was carried out in the paravertebral region. Microscopic examination revealed a vascular hamartoma.
Adolescent↗
Surgical management of congenital lobar emphysema.
Here in nine patients with congenital lobar emphysema who had been treated surgically in the previous 10 years are reported. The ages of the patients at diagnosis ranged from 26 days to 11 months. The six patients whose symptoms started in the neonatal period had more severe dyspnea, cyanosis and respiratory distress. Tube thoracostomy was performed in two of three patients who had been misdiagnosed initially. The affected side was the left upper lobe in five patients, the right upper lobe in three, and the right middle and upper lobes in one patient. Lobectomy was performed in all cases. Dysplasia of the bronchial cartilage was found in six patients and bronchial atresia of the left upper lobe was found in another infant as the etiologic cause of the condition. Although the possibility of conservative management in congenital lobar emphysema has been reported recently, we believe that surgery is the treatment of choice in patients who have persistent or progressive, severe respiratory distress in spite of medical treatment.
Female↗
Anomalous origin of one pulmonary artery branch from ascending aorta ("so-called hemitruncus"): report of an additional case treated surgically.
The aortic origin of one pulmonary artery branch, so-called hemitruncus, is a rare congenital anomaly with poor prognosis. In this report, an additional patient is presented. The patient, a 60-day-old male infant with the right pulmonary artery originating from the ascending aorta was operated successfully. Postoperative catheterization demonstrated normal flow to the right lung and pulmonary artery pressure decreased to normal level.
Cardiac Catheterization↗