Khalil Ahmad

Fixation of sternal fracture using absorbable plating system, three years follow-up.

Sternal fractures occur due to severe chest wall trauma in a small number of patients. They are often conservatively treated. The surgical intervention, although controversial, is indicated in case of deformity, severe pain, and ventilatory complications. We report the first case where absorbable plate has been used to fix a traumatic fracture in a 42-year-old female. After 3 years, the patient is still free of symptoms and CT scanning reveals intact sternal bone structure.

Transcatheter aortic valve implantation in a young heart transplant recipient crossing the traditional boundaries.

Transcatheter aortic valve implantation (TAVI) is an established therapeutic alternative to surgical aortic valve replacement (SAVR) in high-risk or inoperable patients with symptomatic aortic valve stenosis. Hitherto, TAVI is not recommended in young and low-intermediate risk patients. However, TAVI may also serve as an alternative to SAVR in selected young patients, e.g., patients who have previously undergone multiple cardiac surgery procedures. We report a case of trans-femoral TAVI in a 25-year-old heart transplant (HTx) recipient with prior surgery for congenital heart disease.

Aortic aneurysms and trans-apical endovascular repair in high risk heart transplant recipient, one year follow up

Aortic aneurysms cause major morbidities and mortalities. Operative intervention in ascending aneurysms and dissections is the treatment of choice although there is the risk of major complications because of technical difficulties, late diagnoses, affected hemodynamic and organ mal perfusion. Improved survival of heart transplant (HTx) recipients, acceptance of older donors with co morbidities and advances in HTx give rise to new pathological challenges in the cardiovascular field. Only a few articles have been reported about cardiac and aorta surgery in HTx recipients. Endovascular treatment for aortic pathology in zone 0 is an emerging treatment option. We report the first trans-apical endovascular ascending aorta repair (EVAR) in a 26-year-old HTx recipient, with the history of mediastinitis and lack of femoral access. She had an uneventful operative and post-operative EVAR course.

Mediastino-hepato-renal cystic lymphangiomas—diagnostic and surgical considerations

Cystic lymphangiomas or hygromas are rare benign vascular tumours, caused by congenital malformation of the lymphatic vessels. It appears as a progressive swelling in the head or neck of children during 2-5 years of life, yet rarely seen in the mediastinum or abdomen. Symptomatic mediastinal cystic lymphangiomas provide symptoms such as chest pain, breathlessness, cough, and dysphagia, making it difficult to differentiate from other mediastinal tumours. The tumour can become larger due to infections, inflammations, obstructions and bleedings. Chest X-ray, ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) provide helpful information but the diagnosis appears merely after surgical resection and histological examination. Only a few cases have been reported. Hence, we report the first case of a mediastinal and asymptomatic renal and multiple hepatic cystic lymphangiomas in a 71-year-old male with respiratory symptoms and sever reduction in lung capacity. The symptoms regressed fully after surgical excision and lung diffusions capacity increased significantly.