Showing papers by "Ali Rahman published in 2000"
TL;DR: Results represented in the study indicate that addition of aprotinin (2 million units) into the prime solution during CPB can reduce lung reperfusion injury.
Abstract: Objective: The role of aprotinin in the prevention of lung reperfusion injury was investigated in the patients undergoing cardio-pulmonary bypass (CPB) for coronary artery bypass grafting (CABG) operations. Methods: The study was planned randomly and prospectively. Two hundred milliliters of physiological saline solution was added to the prime solution of patients in group I (na 10) whereas, 200 ml aprotinin (Trasylol, Bayer AG) was given to patients in group II (na 10). In order to measure lung tissue malondialdehyde (MDA) levels, glutathion peroxidase (GSH-Px) activity levels and polymorphonuclear leukocytes (PMNs) numbers, lung tissue samples were taken before CPB and 5 min after removing the cross clamp. In addition, alveolo-arterial oxygen difference (AaDO2) for tissue oxygenation was calculated by obtaining arterial blood gas samples. Results: MDA levels before CPB increased from 41.72 ^ 21.00 nmol/g tissue to 66.71 ^ 13.44 nmol/g tissue in group I and from 43.44 ^ 5.16 nmol MDA/g tissue to 53.22 ^ 10.95 nmol MDA/g tissue in group II after cross clamp removal (Pa 0:001 and Pa 0:021, respectively). The increase in group II was found to be significantly lower than group I (Pa 0:048). With the initiation of reperfusion, GSH-Px activity decreased in group I from 3.05 ^ 0.97 to 2.31 ^ 0.46 U/mg protein (Pa 0:015) whereas GSH-Px activity in group II decreased from 3.18 ^ 1.01 to 2.74 ^ 0.81 U/mg protein (Pa 0:055). This decrease in the group II was less than group I (Pa 0:049). AaDO2 significantly increased in the group I and II (Pa 0:012 and Pa 0:020, respectively), but elevation in the group I was significant than in the Group II (Pa 0:049). In histopathological examination, it was observed that neutrophil counts in the lung parenchyma rose significantly following removal of cross clamp in both groups (Pa 0:001). The increase in group I was significantly larger than in group II (Pa 0:050). Conclusion: Results represented in our study indicate that addition of aprotinin (2 million units) into the prime solution during CPB can reduce lung reperfusion injury. q 2000 Elsevier Science B.V. All rights reserved.
54 citations
TL;DR: Heart transplantation after previous open cardiac surgery is entirely justified in terms of outcome and graft function even in time of profound organ scarcity.
Abstract: Objectives: The aim of this study was to evaluate the preoperative management and long-term survival of patients undergoing heart transplantation as a redo-operation and compare the results with those obtained in patients undergoing transplantation as their first cardiac surgical procedure. Methods: Between 1990 and 1997, 49 heart transplantation procedures were performed in patients who had undergone previous cardiac surgery (group A). This subgroup of patients was compared to 109 control patients who underwent cardiac transplantation as the primary cardiac procedure (group B). Patient groups were analysed regarding their preoperative, intra-operative, and postoperative variables in addition to survival. Results: Pre-operative events were comparable in both groups but the duration of the operation was longer for group A (311 ^ 68 min) compared to group B (202 ^ 34 min); Pa 0:02. Post-operative exploration for bleeding was 6/49 patients in group A compared to 2/107 patients in group B (Pa 0:02). Post-operative blood loss and intensive care stay were greater for group A (1302 ^ 360 ml and 6:1 ^ 3:1 days, respectively) compared to group B (763 ^ 126 ml and 4:1 ^ 1:9 days, respectively); Pa 0:02. There was no difference in hospital mortality (group A 12.5%, group B 13 % Pa 0:9) and the 5-year survival rates were 68 and 71% for group A and B, respectively (Pa 0:9). Conclusions: Heart transplantation after previous open cardiac surgery is entirely justified in terms of outcome and graft function even in time of profound organ scarcity. Long-term events in these recipients are similar to patients in whom transplantation is the primary procedure. q 2000 Elsevier Science B.V. All rights reserved.
21 citations
TL;DR: It was concluded that early decortication in the chronic stage of the disease is a safe and effective treatment modality.
Abstract: Empyema is a serious complication of bacterial pneumonia in children. Between July 1992 and July 1998, 53 children aged 7 months to 12 years (mean age, 5.5 years) were treated for empyema complicating pneumonia. After diagnostic thoracentesis, closed tube drainage was carried out with appropriate antibiotic therapy and other treatment strategies such as pleural lavage, intrapleural enzymatic debridement, decortication, or pulmonary resection, according to the effectiveness of drainage and clinical status. There was one death from toxic shock. It was concluded that early decortication in the chronic stage of the disease is a safe and effective treatment modality.
10 citations
TL;DR: Between 1996 and 1998, surgery was carried out in 4 patients with myocardial bridging who had angina refractory to medical therapy and one patient suffered a right ventricular perforation that was successfully repaired.
Abstract: Between 1996 and 1998, surgery was carried out in 4 patients with myocardial bridging who had angina refractory to medical therapy. Two patients were treated by supraarterial myotomy and 2 underwent coronary artery bypass grafting. One patient suffered a right ventricular perforation that was successfully repaired. Surgery is recommended for a grade-III myocardial bridge.
4 citations