Ertan Yücel

Primary Muscular Hydatid Cyst Causing Arterial Insufficiency: Case Report and Literature Review

Hydatid disease, though known to occur in most organs and areas of the body, is extremely rare in skeletal muscle. In this article the authors present a case of a primary muscular hydatid cyst, originating from the adductor muscle group, causing obstruction of the femoral artery and vein.

Use of an ultrasonic scalpel in the open-heart reoperation of a patient with pacemaker.

Electrocautery has a potential risk of serious pacemaker dysfunction in patients with implanted pacemaker. Here we present the safe and efficient use of ultrasonic scalpel (Harmonic scalpel) for the first time in a patient with implanted pacemaker undergoing open-heart reoperation.

Consequences of PTFE membrane used for prevention of re-entry injuries in rheumatic valve disease

BACKGROUND The value of polytetrafluoroethylene (PTFE) surgical membrane as a pericardium substitute in patients who undergo reoperation for rheumatic valve disease is reported in this observational study. METHODS PTFE was used for pericardial closure in 56 rheumatic valve patients. During reoperation of seven cases, adhesions were classified as none, minimal, moderate to severe and scored in the sections of heart. Data found at reoperations were collected prospectively in all patients. RESULTS Seven of 56 patients reoperated mean period of 67.1+/-23.4 (SD) months later. No infection, complication and operative or late death attributable to the membrane were observed. There were two right ventricular, three minimal right atrial and one innominate vein lacerations during resternotomy and all of them were controlled. During histological examination, a microscopically significant foreign body reaction was found. CONCLUSION PTFE membrane produced an undesirable fibrous membrane that obscured the epicardial anatomy and hardened the dissection in patients with rheumatic heart disease.

Thromboangiitis obliterans (Buerger's disease) in women (a reevaluation).

Thromboangiitis obliterans (TAO) is an occlusive vascular disease tradition ally known to be almost exclusive to young male smokers. The disease was con sidered to be extremely rare in women, seen only as isolated, novel case reports in the literature. In the past decade, however, a dramatic increase in the inci dence of female TAO has been observed. In this paper the authors report 7 cases of clinically and angiographically verified female TAO. The world literature in regard to the diagnostic criteria, changing incidence, and etiology is reviewed. They conclude that the increased use of tobacco among young women in the past two to three decades is responsi ble for this dramatic change.

Ectopic Thyroid Gland on the Ascending Aorta with a Partial Pericardial Defect: Report of a Case

Intrathoracic ectopic goiters are rare. To our knowledge, only two reports of thyroid tissue on the aorta have been reported in the English literature. A 42-year-old woman was found to have a right paracardiac mass. Sternotomy revealed a firm and encapsulated tumor attached to the anterolateral surface of the ascending aorta and a defect in the right superior part of the pericardium. The mass was completely excised and histopathologic examination confirmed a multinodular goiter. We discuss the features of this rare tumor.

Subclinical Injury to Forearm Nerves During Radial Harvesting: Electrophysiologic Study

Abstract  Background and Aim: There are few reports about injury to forearm nerves and its potential mechanisms during radial artery (RA) harvesting. We studied electrophysiologic changes in these nerves not sought until now. Methods: Among 152 consecutive patients who underwent coronary artery bypass surgery between February 2002 and August 2002, 20 were randomized for RA harvesting and formed the study group and 20 were randomized as control group. Neurologic examination and electrophysiologic studies were performed for sensory and motor impairment of the nerves in both groups pre‐ and postoperatively. Results: There was no change on neurologic examinations before and after surgery. Electromyography (EMG) revealed significant reduction in sensory and motor conduction amplitudes of median, ulnar, and radial nerves and motor conduction velocities of median and ulnar nerves at the level of forearm in the study group. In the control group, ulnar nerve was mostly affected. When two groups are compared, sensory and motor amplitude drops of median and radial nerves and motor velocity impairment of median nerve in the study group are significant. Ulnar nerve impairments are identical in both groups. Conclusions: Handling of tissues, minor hematoma or edema along with chest retraction best explains these impairments. Patients were asymptomatic after surgery showing that EMG is highly sensitive and is not predictive of clinical impairment.

Primary cardiac angiosarcoma: a case report

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. We describe a 29-year-old man with primary cardiac angiosarcoma with multiple site metastases. The therapeutic approach includes surgery, chemotherapy and radiotherapy alone or in combination. New techniques of radiotherapy and combined chemotherapeutic agents may relieve symptoms and prolong a patients life. We discuss the diagnosis and treatment of cardiac angiosarcoma in the light of a case report.

Elastofibroma dorsi: report of a case with diagnostic features.

Elastofibroma dorsi, named for its characteristic location, is a rarely seen benign soft tissue tumor mostly detected at the infrascapular region between the thoracic wall, the serratus anterior muscle, and the latissimus dorsi muscle. 1,2 The other locations of elastofibroma are the greater trochanter, deltoid muscle, ischial tuberosity, breast, foot, stomach, mediastinum, orbita, cornea, and oral mucosa. 3 The anatomic location, clinical symptoms, and typical radiologic features of elastofibroma dorsi may not easily distinguish this rare benign tumor from malignant soft tissue tumors. 4-6 Here we report preoperative diagnostic methods and surgical treatment of elastofibroma dorsi presenting with severe thoracic pain.

Ruptured Abdominal Aortic Aneurysm Due to Behçet's Disease—A Case Report

Behçets disease, originally described as a triad of orogenital ulcerations and uveitis, is a chronic, multisystem disorder involving the skin, mucous mem branes, gastrointestinal tract, eyes, joints, central nervous system, and blood vessels. Vascular manifestations of Behçets disease (vasculo-Behçets disease) consists of venous and arterial forms. The arterial form is rare but carries a grave prognosis. The authors present a case of Behçets disease that manifested itself with a rupture of an abdominal aortic aneurysm. The outcome, although successful in this case, poses a prognostic dilemma for the surgical team in volved. The world literature in respect to complications and prognosis of vascu lar reconstruction in Behçets disease is reviewed and discussed.

Aortocaval Fistula Due to Stabbing Injury: A Case Report

Traumatic aortocaval fistula due to stabbing injury by knife is a rare entity. The authors present a case of aortocaval fistula due to stabbing injury and its successful surgical treatment by bifurcated Dacron graft interposition between the aorta and both common iliac arteries. No complication occurred in the post operative course.