Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoi... more Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoing cardiac operations. Successful outcome of coronary artery bypass grafting (CABG) in some patients with CRF has been reported, but remains controversial. Forty-four patients with CRF who underwent CABG were examined. Two groups were analyzed. Group I consisted of 13 patients with end-stage renal disease on hemodialysis. Group II consisted of 31 patients with a creatinine > or = 1.6 gm/dL for a minimum of 6 months, but were not on dialysis. There were 36 male and 8 female patients, with a mean age of 71 years. The hospital mortality was 10 patients (23%) with 4 (31%) hospital deaths in Group I, and 6 (19%) in Group II. There was major morbidity in 35 (80%) patients. In Group II there were 8 (26%) patients who required permanent postoperative dialysis. A control group of 547 patients 70 years of age who underwent CABG had 30 hospital mortalities (5%) and 75 morbidities (13%). The average length of stay was 27 days. Fifteen patients died at a mean of 34 months after being discharged from the hospital. Nineteen of the original 44 patients remain alive at a mean of 32 months. The total mortality at 6 years and 4 months was 57%. Older and sicker patients with CRF who undergo CABG are at an exceptionally high risk for mortality and morbidity. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of permanent postoperative dialysis. Long-term follow-up shows survival to be well below their non-CRF counterparts.
Bidirectional Glenn procedure is a staged palliative procedure for patients with the univentricul... more Bidirectional Glenn procedure is a staged palliative procedure for patients with the univentricular hearts or complex congenital heart disease. We in our study, attempted to evaluate the preoperative characteristics, operative data and the early postoperative outcomes in the patients who underwent Bidirectional Glenn procedure at our center.
Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoi... more Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoing cardiac operations. Successful outcome of coronary artery bypass grafting (CABG) in some patients with CRF has been reported, but remains controversial. Forty-four patients with CRF who underwent CABG were examined. Two groups were analyzed. Group I consisted of 13 patients with end-stage renal disease on hemodialysis. Group II consisted of 31 patients with a creatinine > or = 1.6 gm/dL for a minimum of 6 months, but were not on dialysis. There were 36 male and 8 female patients, with a mean age of 71 years. The hospital mortality was 10 patients (23%) with 4 (31%) hospital deaths in Group I, and 6 (19%) in Group II. There was major morbidity in 35 (80%) patients. In Group II there were 8 (26%) patients who required permanent postoperative dialysis. A control group of 547 patients 70 years of age who underwent CABG had 30 hospital mortalities (5%) and 75 morbidities (13%). The average length of stay was 27 days. Fifteen patients died at a mean of 34 months after being discharged from the hospital. Nineteen of the original 44 patients remain alive at a mean of 32 months. The total mortality at 6 years and 4 months was 57%. Older and sicker patients with CRF who undergo CABG are at an exceptionally high risk for mortality and morbidity. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of permanent postoperative dialysis. Long-term follow-up shows survival to be well below their non-CRF counterparts.
Metastatic testicular tumors extending from the abdomen into the inferior vena cava (IVC) and rig... more Metastatic testicular tumors extending from the abdomen into the inferior vena cava (IVC) and right atrium (RA) are relatively rare.1-3 The tumors reported to have such an extension are renal carcinoma,4-6 adrenocortical carcinoma,7 melanoma,8 hepatoblastoma,9 and, in women, leiomyomatosis. 10 The germ cell tumors of the testes are chemosensitive, and there is a risk of tumor embolization from the necrotic tumor in the TVC and RA during chemotherapy. In this case the main aim of surgery was to prepare the patient for chemotherapy so as to prevent this embolization.
Absorbable pulmonary artery banding may be a useful method of avoiding further operation or angio... more Absorbable pulmonary artery banding may be a useful method of avoiding further operation or angioplasty in patients whose underlying lesion has a natural history of resolution. We report 2 cases of absorbable pulmonary artery banding using braided Dexon. In both cases the bands functioned well initially and were completely resorbed after 2 years and 6 months, respectively.
A 23-year-old girl of Ghanan origin was referred to us for mitral regurgitation suspected to be o... more A 23-year-old girl of Ghanan origin was referred to us for mitral regurgitation suspected to be of rheumatic origin. She was admitted in an acute condition with pulmonary edema, and an urgent mitral valve replacement with a 29 mm St. Jude Medical prosthesis (St. Jude Medical, Inc., ...
We read with great interest the recent article by Hannan and associates [1], which represented st... more We read with great interest the recent article by Hannan and associates [1], which represented studies at an academic medical center in New York State with an extremely large experience with valvular heart surgery. Although the model created for predicting mortality in valvular ...
The Journal of Thoracic and Cardiovascular Surgery
Although patients with severe ventricular dysfunction have improved long-term survival times afte... more Although patients with severe ventricular dysfunction have improved long-term survival times after coronary bypass procedures, operative morbidity and mortality rates remain high. This study was designed to identify the ...
Although intracranial metastases from malignant pleural mesothelioma are rare, their presence sho... more Although intracranial metastases from malignant pleural mesothelioma are rare, their presence should be suspected in cases of high-grade mesothelioma and should possibly be included in routine preoperative evaluation. An unusual case of cerebral metastases from pleural mesothelioma is presented and the literature is reviewed.
Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoi... more Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoing cardiac operations. Successful outcome of coronary artery bypass grafting (CABG) in some patients with CRF has been reported, but remains controversial. Forty-four patients with CRF who underwent CABG were examined. Two groups were analyzed. Group I consisted of 13 patients with end-stage renal disease on hemodialysis. Group II consisted of 31 patients with a creatinine > or = 1.6 gm/dL for a minimum of 6 months, but were not on dialysis. There were 36 male and 8 female patients, with a mean age of 71 years. The hospital mortality was 10 patients (23%) with 4 (31%) hospital deaths in Group I, and 6 (19%) in Group II. There was major morbidity in 35 (80%) patients. In Group II there were 8 (26%) patients who required permanent postoperative dialysis. A control group of 547 patients 70 years of age who underwent CABG had 30 hospital mortalities (5%) and 75 morbidities (13%). The average length of stay was 27 days. Fifteen patients died at a mean of 34 months after being discharged from the hospital. Nineteen of the original 44 patients remain alive at a mean of 32 months. The total mortality at 6 years and 4 months was 57%. Older and sicker patients with CRF who undergo CABG are at an exceptionally high risk for mortality and morbidity. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of permanent postoperative dialysis. Long-term follow-up shows survival to be well below their non-CRF counterparts.
Bidirectional Glenn procedure is a staged palliative procedure for patients with the univentricul... more Bidirectional Glenn procedure is a staged palliative procedure for patients with the univentricular hearts or complex congenital heart disease. We in our study, attempted to evaluate the preoperative characteristics, operative data and the early postoperative outcomes in the patients who underwent Bidirectional Glenn procedure at our center.
Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoi... more Chronic renal failure (CRF) is known to increase the morbidity and mortality in patients undergoing cardiac operations. Successful outcome of coronary artery bypass grafting (CABG) in some patients with CRF has been reported, but remains controversial. Forty-four patients with CRF who underwent CABG were examined. Two groups were analyzed. Group I consisted of 13 patients with end-stage renal disease on hemodialysis. Group II consisted of 31 patients with a creatinine > or = 1.6 gm/dL for a minimum of 6 months, but were not on dialysis. There were 36 male and 8 female patients, with a mean age of 71 years. The hospital mortality was 10 patients (23%) with 4 (31%) hospital deaths in Group I, and 6 (19%) in Group II. There was major morbidity in 35 (80%) patients. In Group II there were 8 (26%) patients who required permanent postoperative dialysis. A control group of 547 patients 70 years of age who underwent CABG had 30 hospital mortalities (5%) and 75 morbidities (13%). The average length of stay was 27 days. Fifteen patients died at a mean of 34 months after being discharged from the hospital. Nineteen of the original 44 patients remain alive at a mean of 32 months. The total mortality at 6 years and 4 months was 57%. Older and sicker patients with CRF who undergo CABG are at an exceptionally high risk for mortality and morbidity. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of permanent postoperative dialysis. Long-term follow-up shows survival to be well below their non-CRF counterparts.
Metastatic testicular tumors extending from the abdomen into the inferior vena cava (IVC) and rig... more Metastatic testicular tumors extending from the abdomen into the inferior vena cava (IVC) and right atrium (RA) are relatively rare.1-3 The tumors reported to have such an extension are renal carcinoma,4-6 adrenocortical carcinoma,7 melanoma,8 hepatoblastoma,9 and, in women, leiomyomatosis. 10 The germ cell tumors of the testes are chemosensitive, and there is a risk of tumor embolization from the necrotic tumor in the TVC and RA during chemotherapy. In this case the main aim of surgery was to prepare the patient for chemotherapy so as to prevent this embolization.
Absorbable pulmonary artery banding may be a useful method of avoiding further operation or angio... more Absorbable pulmonary artery banding may be a useful method of avoiding further operation or angioplasty in patients whose underlying lesion has a natural history of resolution. We report 2 cases of absorbable pulmonary artery banding using braided Dexon. In both cases the bands functioned well initially and were completely resorbed after 2 years and 6 months, respectively.
A 23-year-old girl of Ghanan origin was referred to us for mitral regurgitation suspected to be o... more A 23-year-old girl of Ghanan origin was referred to us for mitral regurgitation suspected to be of rheumatic origin. She was admitted in an acute condition with pulmonary edema, and an urgent mitral valve replacement with a 29 mm St. Jude Medical prosthesis (St. Jude Medical, Inc., ...
We read with great interest the recent article by Hannan and associates [1], which represented st... more We read with great interest the recent article by Hannan and associates [1], which represented studies at an academic medical center in New York State with an extremely large experience with valvular heart surgery. Although the model created for predicting mortality in valvular ...
The Journal of Thoracic and Cardiovascular Surgery
Although patients with severe ventricular dysfunction have improved long-term survival times afte... more Although patients with severe ventricular dysfunction have improved long-term survival times after coronary bypass procedures, operative morbidity and mortality rates remain high. This study was designed to identify the ...
Although intracranial metastases from malignant pleural mesothelioma are rare, their presence sho... more Although intracranial metastases from malignant pleural mesothelioma are rare, their presence should be suspected in cases of high-grade mesothelioma and should possibly be included in routine preoperative evaluation. An unusual case of cerebral metastases from pleural mesothelioma is presented and the literature is reviewed.
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Papers by Saify Arsiwala