Medicine and Health Sciences Commons^™

Identifying The 'Vulnerable Plaque' In Asymptomatic Carotid Artery Disease Patients, Zia Ur Rehman

Department of Surgery

No abstract provided.

Endoleaks: Current Concepts And Treatments - A Narrative Review, Zia Ur Rehman

Department of Surgery

Endoleaks are the most common complications following endovascular aneurysm repair. Depending upon their origin, there are five types of endoleaks, types I-V, which can also be classified as direct and indirect endoleaks. Direct endoleaks (type I and III) have higher risk of aneurysm rupture due to rapid sac expansion, and require immediate correction. Indirect endoleaks ( type II, IV and V) have a relatively benign course compared to direct endoleaks. Most of them resolve with time and very few need interventions upon sac enlargement. Type V endotension is a special situation where there is sac enlargement despite no demonstrable endoleak. …

Hypoglossal Nerve Paraganglioma Depicting As Glomus Tumor Of Neck, Zaid Ahmed Shamsi, Fareed Ahmed Shaikh, Muhammad Wasif, Mustafa Belal Hafeez Chaudhry, Nadeem Ahmed Siddiqui, Ziad Sophie

Department of Surgery

Introduction: Paraganglioma are infrequent neuroendocrine tumors that are most commonly found in the carotid body, ganglia of the vagus, jugular and tympanic nerve. Very rarely they can involve other cranial nerves outside the cranial cavity, we present one such case of hypoglossal nerve paraganglioma in neck.
Case report: A 48 years old male presented with 1-month history of right sided stroke and aphasia. Ultrasonography of neck revealed a highly vascular mass on the right side of the neck. CT angiogram confirmed a highly vascular mass arising above the carotid bifurcation. With the working diagnosis of Glomus tumor, he underwent right …

Proximal Subclavian Artery Injury Managed Without Performing Median Sternotomy: A Case Report, Zia Ur Rehman

Department of Surgery

No abstract provided.

Inferior Vena Cava Injuries - A Clinical Review, Zia Ur Rehman

Department of Surgery

Inferior vena caval (IVC) injuries are uncommon and challenging to treat. Less than 5% of patients with penetrating abdominal trauma and less than 0.5% of patients with blunt abdominal trauma have this injury. Patient can present with intraperitoneal haemorrhage or with a contained retroperitoneal haematoma. Mostly it is associated with other abdominal structures injuries. Most commonly injured segment is infrarenal IVC. Operative strategy is different for each segment of injured vein. Infrahepatic injuries are exposed by medial visceral rotation. Retrohepatic and suprahepatic injuries need infrequent exposures. Mortality remains high and range between 31-51% for the patient brought alive to the …

Cephalic Vein Transposition: An Effective Surgical Option For Dealing With The Cephalic Vein Stenosis, Zia Ur Rehman

Department of Surgery

No abstract provided.

Outcome Of Traumatic Inferior Vena Caval Injuries: A Case Series, Zia Ur Rehman, Rimsha Farooq

Department of Surgery

Inferior vena caval (IVC) injuries are uncommon and challenging. The objective of the study is to evaluate outcomes of patients operated for inferior vena caval injuries at a university hospital. This is a retrospective case series of all adult patients aged >18 years who had been operated for traumatic IVC injuries at a university hospital between Jan 1998 to December 2018. During the study period, 9 patients with IVC injuries were operated with mean age of 26±10.3 years and all were males. Five (55.5%) patients had penetrating injuries while 4 (44.4%) had blunt trauma. Four (44.4%) patients had infra-renal while …

A Retrospective Analysis Of The Outcomes Of Extracorporeal Cardiopulmonary Resuscitation (Ecpr)., Rachel Wills, Kennedy Gallagher, James A. Burke Md, Timothy S. Misselbeck, James K. Wu Md

Department of Surgery

No abstract provided.

Superior Septal Approach Versus Left Atrial Approach For Mitral Valve Replacement: A Retrospective Cohort Study, Tooba Ansar, Taimur Asif Ali, Saneeha Shahid, Saulat H. Fatimi, Ghulam Murtaza

Department of Surgery

Abstract

OBJECTIVE:

To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement.

METHODS:

This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]. Patients with prior history of dysrhythmia, low ejection fraction (<30%), emergency/redo mitral valve replacement and concomitant coronary artery bypass grafting were excluded. SPSS 19 was used for data analysis.

RESULTS:

Of the 78 patients, 52(66.67%) were of superior septal approach and 26(33.33%) of left atrial approach. Both groups were comparable for …

Retrograde Bullet Migration From Inferior Vena Cava Into Right Common Iliac Vein Following Gunshot: A Case Report, Ibrahim Zahid, Hamza Abdur Rahim Khan, Omar Irfan, Benish Fatima,, Maha Tahir, Muhammad Tariq, Fazal Wahab Khan, Saulat H. Fatimi

Department of Surgery

Abstract

Bullet embolization cases are rare and even rarer are its retrograde migration in the veins. We report the case of a 14 year old male with a gunshot wound to the left side of his chest. CT scan revealed bilateral haemothorax and foreign body in the right common iliac vein. The patient was immediately taken to the operating theatre and median sternotomy performed. Bullet entry tear was found in the inferior vena cava however, the bullet was found lodged in the right common iliac vein and slipped down against the flow of blood. The bullet was left in situ …

Primary Melanotic Schwannoma With Typical Histology, Usman B. Mahmood, Fazal Wahab Khan, Benish Fatima, Muhammad Usman Tariq, Saulat Hasnain Fatimi

Department of Surgery

Abstract

We present a case of a 17-year male with a soft tissue density spreading from the neural foramina (T3) of the spinal cord and involving the right upper thoracic cavity. We managed the patient through surgical intervention and resected the complete tumor. Gross definition and microscopic findings of the resected tissue revealed the definitive diagnosis of melanotic schwannoma. The histological characteristics in this case were very specific and harbour an important diagnostic clue for this rare disease. Malignant melanoma was ruled out on the basis of histological findings. The patient recovered completely and was healthy on one-year follow-up.

Resection Of Posterior Mediastinal Tumors By Video Assisted Thoracic Surgery, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem

Department of Surgery

Abstract

This case report illustrates successful Video Assisted Thoracic Surgery (VATS) performed on a 45-year-old woman and 52-year-old man presenting with a mass in left and right paravertebral space on the CT scan respectively. VATS has many benefits over traditional open operation (thoracotomy), resulting in less pain and shorten recovery time. However, VATS has higher equipment cost but when an experienced surgeon performs the surgery, better outcomes are achieved. VATS is not common in Pakistan's surgical setup as it is an expensive method of eradicating mediastinal pathologies and not every patient undergoes VATS. The primary objective of presenting these cases …

Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem, Wasiq Faraz Rawasia

Department of Surgery

Abstract

Endocarditis is characterized by vegetations, which is a mass of platelets, fibrin, micro-colonies of micro-organisms, and inflammatory cells, in the endocardium. Over the past three decades, the incidence of right-sided endocarditis has risen dramatically in Pakistan. We report a 36-year woman with a history of repeated intravenous analgesic injections for low back pain, presenting with high grade fever, sepsis and a white cell count of 44,000 with 90% neutrophils. Echocardiography showed large mobile vegetations on TricuspidValve (TV). Tricuspid Valve Endocarditis (TVE) is generally responsive to medical treatment; however, about 25% of TVE patients require surgical intervention. Long-term survival of …

Successful Long-Term Extracorporeal Cardiopulmonary Membrane Oxygenation Without Anti-Coagulation, Janissa Nair, Dorothea T. Watson Do, Rita Pechulis Md, Fccp, Nicholas M. Rini Pa-C, Timothy S. Misselbeck, Kenneth Miller Rrt, James K. Wu Md

Department of Surgery

No abstract provided.

Causes Of Death In Surgically Treated Patients With Type A Aortic Dissection - A Ten Year Review, James K. Wu Md, Eilizabeth Depaolo Bs, Theodore G. Phillips Md, Timothy S. Misselbeck

Department of Surgery

No abstract provided.

De-Branching Of The Aortic Arch During Thoracic Endovascular Aortic Repair, James K. Wu Md, Caitlin O'Connor Bs, Timothy S. Misselbeck, Theodore G. Phillips Md

Department of Surgery

No abstract provided.

Conventional Isolated Aortic Valve Replacement In Octogenarians: A 10-Year Single Center Experience, James K. Wu Md, Justin D. Roberts Do, Gregory S. Troutman Bs, Michael J. Weiss Mph, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Timothy S. Misselbeck, Raymond L. Singer Md

Department of Surgery

No abstract provided.

Critical Assessment Of Outcomes In Acute Aortic Dissection (Type A) At A Community Hospital: A 10 Year Review, Timothy S. Misselbeck, James K. Wu Md, Stephen Deturk Ba, Michael F. Szwerc Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Gary W. Szydlowski Md, Raymond L. Singer Md

Department of Surgery

No abstract provided.

Risk Factors Affecting Outcomes In Patients Undergoing Hypothermic Circulatory Arrest During Aortic Surgeries, Bree Ann Young, James K. Wu Md, Martin E. Matsumura Md, Timothy S. Misselbeck, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Raymond L. Singer Md

Department of Surgery

No abstract provided.

Treatment Of Acute Aortic Dissection At A Community Hospital: A 10 Year Review Of Outcomes., Timothy S. Misselbeck, Stephen Deturk, Matthew Wilson, Theodore Phillips Md, Michael Szwerc Md, Sanjay Mehta Md, Gary Szydlowski Md, Raymond Singer Md, James Wu Md

Department of Surgery

No abstract provided.