Argun Saylam

Pulmonary Hydatid Disease: Report of 100 Patients

One hundred patients with pulmonary hydatid disease underwent thoractomy and operative removal of the cysts. Of the 60 men and 40 women, most were between 3 and 19 years old. Cough, fever, dyspnea, and chest pain were the prominent symptoms in the majority of cases. Intact hydatid cysts were found in 67 patients and infected or ruptured cysts in 33. The Casoni skin test, Weinberg reaction, and eosinophilia were found to be unreliable diagnostic criteria and therefore were not used routinely in our patients. Roentgenological examination was the most valuable diagnostic aid. A single lobe was affected in 72 patients. Unilateral multiple foci were present in 15 patients and bilateral multiple foci in 13. Cystectomy and capitonnage were the preferred operative procedures in most cases. Pulmonary resection was necessary to only a limited number of patients. We conclude that conservative surgical methods such as cystectomy (with or without capitonnage) are preferable, especially for children, whose residual lung parenchyma has great capacity for expansion. The mortality rate among our 100 patients was 2%; both died of cardiac arrest during operation.

Aorto—Right Ventricular Tunnel: A New Concept in Congenital Cardiac Malformations

Abstract A case of congenital aorto–right ventricular tunnel diagnosed preoperatively as ruptured sinus of Valsalva is presented. Careful search of the literature pertaining to this subject has revealed an extremely limited number of patients with the lesion, which differs from ruptured sinus of Valsalva by the presence of an intact aortic sinus and cusps displaying normal configuration. The entity has not yet been described in classic textbooks. Successful repair of this abnormal communication is possible with the help of extracorporeal circulation and anoxic arrest.

Pulmonary artery sling.

A case of pulmonary artery sling in a 1-year-old boy, treated by resection of the left pulmonary artery (LPA) at its origin from the right pulmonary artery (RPA) and reanastomosis of the LPA to the main pulmonary artery (MPA), is reported. In this patient the LPA-MPA anastomosis was demonstrated to be patent in a follow-up pulmonary angiogram six months after the operation. Pulmonary artery sling should be kept in mine when assessing respiratory distesss syndrome in children.

Foreign Body in the Right Atrium: a Complication of Pudenz Ventriculo-Atrial Shunt: A Case Report

A dislodged Pudenz ventriculo-atrial shunting catheter in a 1.5 year old girl, removed from the right heart by right atriotomy, is presented. The diagnosis, complications and treatment of this unusual complication of the Pudenz shunt are discussed.

The Effect of Extracorporeal Circulation on Serotonin Metabolism

Abstract Serotonin metabolism during extracorporeal circulation was investigated in 11 patients who had undergone open-heart operations by detection of 5-hydroxyindoleacetic acid (5-HIAA) in the urine. The amount of 5-HIAA excreted was found to be significantly higher during operation as compared with preoperative control values. In the postoperative period no significant rise in 5-HIAA excretion was observed. The role of serotonin as a mediator in postoperative complications is discussed.

Postoperative arrhythmias in open-heart surgery, A study on fifty cases.

50 consecutive patients undergone open heart surgery were analyzed regarding postoperative arrhythmias in the first postoperative 3 days. Disturbances of rhythm occurred in each case of our group, serious or not serious (100%). Ventricular premature beats were the most frequent type of arrhythmia in the first and second postoperative days (80%). Two cases expired postoperatively. In one of them complete atrioventricular block developed after double valvular replacements (mitral and tricuspid). The other died of low cardiac output syndrome. Etiology of the arrhythmias after open heart surgery is not clear in the absence of electrolyte and metabolic disturbances, digitalis intoxication and surgical trauma to the conduction system and coronary arteries. Low cardiac output syndrome, hypotension and hypoxia can also be blamed in the formation of these arrhythmias. Other factors such as the prolongation of anoxic arrest, irritation of the ventricular septum by valvular prostheses, cardiac irritation by thoracic tubes, psychologic trauma, halothane anesthesia and coronary arterial disease in the old age group may be the possible predisposing factors in these patients.

Cor Triatriatum Sinistrum Case Report and Review of Current Concepts

A case of classic cor triatriatum sinistrum in an adolescent, correctly diagnosed preoperatively and operated on successfully is presented. Current concepts regarding this rare cardiovascular malformation are reviewed and the possibility of misdiagnosis of this lesion as rheumatic mitral valve disease is emphasized, especially in countries where rheumatic fever is still the predominant cause of valvular heart diseases.

The Effect of extracorporeal Circulation on Magnesium Metabolism

A great number of investigations have been done in various diseases since analytic detection of serum magnesium became clinically available. In later years SHEINMAN et al. (4, 5) have called attention to variations of magnesium metabolism during extracorporeal circulation. In this report, the effect of extracorporeal circulation on magnesium metabolism was investigated and the results were analyzed accordingly.