MyMedR

Fulltext Large fusiform posterior cerebral artery aneurysm (P2 segment): successful trapping and excision via subtemporal approach

Ramzisham ARM, Azizi AB, Zurin AAR

Med J Malaysia, 2004 Oct;59(4):530-2.

PMID: 15779587

A 62-year-old man presented with a 2-month history of right occipito-parietal headache and worsening ipsilateral ptosis. CT scan and cerebral angiography revealed a large fusiform aneurysm of the P2 segment of the right posterior cerebral artery (PCA). The aneurysm was successfully trapped and subsequently excised via sub temporal approach leaving no additional neurological deficits to our patient.

Matched MeSH terms: Intracranial Aneurysm/surgery*

Fulltext Idiopathic cystic medionecrosis and aneurysms of the ascending aorta

Anuar M, Singham KT

Med J Malaysia, 1983 Mar;38(1):35-8.

PMID: 6633332

Two patients with ascending aortic aneurysms due to cystic medical necrosis are described. One of them was phenotypically normal while the other had features of Marfan's syndrome. Both were disabled by dyspnoea and angina which required corrective surgery.

Matched MeSH terms: Aortic Aneurysm/surgery

Unruptured anterior communicating artery aneurysm in a 2-year-old child

Syahrilfazli AJ, Nursharmizam MB, Azizi AB, Zurin AA

Pediatr Neurosurg, 2005 Sep-Oct;41(5):283-4.

PMID: 16195685

Matched MeSH terms: Intracranial Aneurysm/surgery

Fulltext Solitary focal coronary artery aneurysm in a middle aged male with atypical chest pain

Yeo CK, Khalid Y

Med J Malaysia, 1999 Mar;54(1):114-6.

PMID: 10972014

A 52 year old hypertensive Malay man, a smoker who presented with a one month history of mild chest discomfort not related to exertion and had a positive stress test with ST segment depression in the lateral leads. Coronary angiography showed stenosis in the right coronary artery and a coronary aneurysm in the proximal segment of his left anterior descending. The aneurysm was situated just distal to a stenotic lesion. The aneurysm is most likely related to atherosclerotic coronary artery disease. The patient was treated with oral nitrates, aspirin, angiotensin converting enzyme inhibitor and warfarin to prevent thromboembolism related to the coronary aneurysm. He remains asymptomatic one year after diagnosis.

Matched MeSH terms: Heart Aneurysm/surgery

Fulltext Primary repair with in-situ interposition graft for infrarenal mycotic aortic pseudoaneurysm

Adeeb SJSM, Yusha AW, Samad SA

Med J Malaysia, 1997 Jun;52(2):178-80.

PMID: 10968079

This is a case report of a pseudoaneurysm due to Salmonella aortitis in a 52 year old man. The condition is rare and represents one of the few cases reported in Malaysia. The diagnosis was made preoperatively by ultrasonography and computed tomography. This was confirmed at surgery where there was a 3 cm defect at the posterior wall of the aorta at L2/3 level. The aneurysmal sac extended to the retrocrural space at the 12th vertebra level cranially on the right side to the lower border of the 3rd lumbar vertebra caudally. It had a smooth fibrous wall and contained a mixture of organised haematoma and pus. At operation the aneurysm was excised, the affected region was carefully debrided and the aorta grafted with an in-situ in-lay graft. Antibiotic therapy was instituted until clinical response was evident, leukocytosis was reduced and blood culture was negative. However 4 months after surgery, the patient returned in irreversible shock and succumbed to disseminated intravascular coagulation secondary to massive upper gastrointestinal haemorrhage from an aortoduodenal fistula.

Matched MeSH terms: Aortic Aneurysm/surgery*

Fulltext Ruptured aneurysms of the sinus of Valsalva

Jeyamalar R, Kannan P

Med J Malaysia, 1991 Dec;46(4):371-5.

PMID: 1840448

Aneurysms of the sinus of Valsalva are uncommon disorders and are usually congenital in origin. When these aneurysms rupture into an intracardiac chamber, they may be silent initially but later give rise to progressive heart failure due to left or right shunting and aortic regurgitation. The mortality and morbidity in untreated cases is high. We report 13 patients with ruptured aneurysms of the sinus of Valsalva who underwent surgical repair. There were seven males and six females with a mean age of 24.5 years. Three patients were asymptomatic and five were in congestive cardiac failure. The majority of patients (61.5%) had insidious onset of symptoms, only 2 cases presenting acutely. The connection was between the right aortic sinus and the right ventricle in 11 cases and the non coronary sinus and the right ventricle in 2 cases. Associated cardiac anomalies included a ventricular septal defect (8 patients) and aortic regurgitation (6 patients). There was 1 post operative death and 1 patient required re-operation three months later for a recurrence of the fistula. All 6 patients with aortic regurgitation required aortic valve replacement. All patients remained well and asymptomatic during follow up ranging from 2 to 19 years.

Matched MeSH terms: Aortic Aneurysm/surgery*

Microsuture repair of intra-operative ruptures of cerebral aneurysms of the internal carotid artery

Vashu R, Tan S, Wong AS

J Clin Neurosci, 2009 Jul;16(7):960-2.

PMID: 19346131 DOI: 10.1016/j.jocn.2008.09.013

We report on two patients with intra-operative rupture of cerebral aneurysms that were managed by microsuturing. This is one of only a few reports of successful direct repair using suturing. We found that stitching remains an option to repair a tear of a saccular part of an aneurysm and a torn neck of a blister-like aneurysm, and thus this technique can be considered before sacrificing the artery.

Matched MeSH terms: Intracranial Aneurysm/surgery

Post-traumatic pericallosal artery aneurysm presenting with subdural haematoma without subarachnoid haemorrhage

Suhara S, Wong AS, Wong JO

Br J Neurosurg, 2008 Apr;22(2):295-7.

PMID: 18348031 DOI: 10.1080/02688690701687678

A 27-year-old patient presented with severe headache and seizures about a month after the initial head trauma. Computed tomography (CT) brain scan revealed acute subdural bleed continuous into the interhemispheric region, with no subarachnoid haemorrhage. This was due to rupture of a traumatic pericallosal artery aneurysm. This represents a rare case of traumatic pericallosal artery aneurysm presenting with subdural haematoma without subarachnoid haemorrhage.

Matched MeSH terms: Intracranial Aneurysm/surgery

Fulltext Noninvasive cardiac risk evaluation before elective abdominal aortic aneurysm surgery--clinical value of the Goldman index and echocardiography

Quek DK, Pung LY

Med J Malaysia, 1990 Sep;45(3):208-19.

PMID: 2152082

Cardiac complications comprise as much as 50% of perioperative vascular surgical morbidity and mortality. Using the Goldman multifactorial index for evaluating cardiac risk pre-operatively, 53 consecutive patients who underwent abdominal aortic aneurysm surgery were prospectively studied. Forty patients (75.5%) were also evaluated with echocardiography for assessment of left ventricular function. There were 14 (23.7%) peri-operative events, of which nine (17.0%) were acute myocardial infarctions--two of whom died (3.8%). The minor complications included three with hypovolaemic renal failure, and one each with acute respiratory failure and cerebrovascular accident. Patients with Goldman cardiac risk index (CRI) classes III and IV were associated with significantly higher risks of peri-operative complications (p less than 0.001), i.e. 77.8% and 66.7% respectively, compared with class II (22.7%) and class I (nil). Echocardiographic left ventricular shortening fraction (LVFS) of less than 28% helped identify high risk groups in all classes, although its positive predictive value was low (42.3%). Combining LVFS less than 28% with Goldman CRI categories II to IV improved the sensitivity to 91.7% and the positive predictive value to 61.1%. Careful pre-operative assessment using the simple Goldman index and echocardiography is helpful in identifying higher risk patients who would benefit from pre-operative stabilisation and more rigorous perioperative hemodynamic monitoring preferably including intensive care (ICU) management, so as to reduce cardiac complications.

Matched MeSH terms: Aortic Aneurysm/surgery*

Single stage treatment of complex aortic pathology (mega-aortic syndrome) using frozen elephant trunk technique

Krishna Moorthy PS, Saat SA, Sakijan AS

Med J Malaysia, 2019 02;74(1):94-96.

PMID: 30846673

This is a case report of single-stage total thoracic aortic repair by the frozen elephant trunk technique for a 75-yearold female with a complex aortic pathology of mega-aorta extending from the ascending aorta to the descending aorta. We used a Thora flex™ Hybrid device, a frozen elephant trunk device with four branched grafts and the distal stent graft. The distal stent graft was inserted into the downstream descending aorta via an aortic arch and positioned 15 cm beyond the left subclavian artery after total arch replacement had been performed using a four-branch graft. The postoperative course was unremarkable with no complications. A post procedural computed tomography scan demonstrated complete exclusion of the descending thoracic aneurysm without endoleak. Therefore, fixing the whole mega-aorta in a single stage using the frozen elephant trunk was effective and safe.

Matched MeSH terms: Aortic Aneurysm/surgery*

Current status in decision making to treat acute type A dissection: limited versus extended repair

Velayudhan BV, Idhrees M, Matalanis G, Park KH, Tang D, Sfeir PM, et al.

J Cardiovasc Surg (Torino), 2020 Jun;61(3):285-291.

PMID: 32337940 DOI: 10.23736/S0021-9509.20.11397-1

Acute type A aortic dissection remains one of the most challenging conditions in aortic surgery. Despite the advancements in the field, the mortality rate still remains high. Though there is a general consensus that the ascending aorta should be replaced, the distal extension of the surgery still remains a controversy. Few surgeons argue for a conservative approach to reduce operative and postoperative morbidity while others considering the problems associated with "downstream problems" support an aggressive approach including a frozen elephant trunk. The cohort in the Indian subcontinent and APAC is far different from the western world. Many factors determine the decision for surgery apart from the pathology of the disease. Economy, availability of the suitable prosthesis, the experience of the surgeon, ease of access to the medical facility all contribute to the decision making to treat acute type A dissection.

Matched MeSH terms: Aortic Aneurysm/surgery*

Fulltext Solitary focal coronary artery aneurysm in a middle aged male with atypical chest pain (letter)

Wong PS, Chong CL

Med J Malaysia, 1999 Dec;54(4):535-6.

PMID: 11072479

Comment on: Yeo CK, Khalid Y. Solitary focal coronary artery aneurysm in a middle aged
male with atypical chest pain. Med J Malaysia. 1999 Mar;54(1):114-6

Matched MeSH terms: Heart Aneurysm/surgery

Fulltext Bilateral persistent sciatic arteries with unilateral complicating aneurysm

Aziz ME, Yusof NR, Abdullah MS, Yusof AH, Yusof MI

Singapore Med J, 2005 Aug;46(8):426-8.

PMID: 16049615

Persistent sciatic artery is a very uncommon embryological vascular variant. This case report highlights this rare vascular anomaly, diagnostic difficulty, complication and subsequent treatment in a 43-year-old man who presented with sudden onset of right leg pain for a few hours. He was unable to walk because of pain and numbness. Emergency right lower limb angiogram showed a large aneurysm that was initially thought to arise from the right common femoral artery, associated with thrombus formation within the right popliteal artery. A below knee amputation was performed due to worsening ischaemia of the right leg. The persistent right sciatic artery was later obliterated using percutaneous stenting and endovascular grafting, with deployment of two wallstents.

Matched MeSH terms: Aneurysm/surgery*

Fulltext Re-do sternotomy for complex aortic surgery under deep hypothermic circulatory arrest: left ventricular vent--an invaluable adjunct

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 Apr;12(4):608.

PMID: 21429884 DOI: 10.1510/icvts.2010.262378A

Matched MeSH terms: Aortic Aneurysm/surgery*

Melioidosis and the vascular surgeon: Hospital Kuala Lumpur experience

Azizi ZA, Yahya M, Lee SK

Asian J Surg, 2005 Oct;28(4):309-11.

PMID: 16234087

Bacterial arteritis is relatively uncommon and management of this condition, which carries high morbidity and mortality, is difficult and time-consuming. Common organisms implicated include Salmonella and Staphylococcus. Arteritis as a result of infection by Burkholderia pseudomallei (formerly Pseudomonas pseudomallei) has been rarely reported in the English literature. This organism, which is endemic in our part of the world, is well known to cause a wide spectrum of septic conditions. A review of cases managed at Hospital Kuala Lumpur revealed that bacterial arteritis due to melioidosis is not such a rare entity. We share our experience in the management of this condition using three cases as examples.

Matched MeSH terms: Aortic Aneurysm/surgery

Fulltext Abdominal aortic aneurysm--a plea for early elective excision (aneurysmectomy)

Leong YP

Med J Malaysia, 1991 Mar;46(1):51-8.

PMID: 1836038

Though peripheral arterial disease is not as common as in the Western countries, abdominal aorit aneurysm (AAA) is the most frequent arterial problem in Malaysia. A prospective study was made of 100 consecutive patients who presented with AAA to the author between January 1986 to September 1988 (31 months' period). There were 88 males and 12 females. The age range was 47-90 years, mean = 68.7. All the major ethnic rates were equally affected. The sizes of the AAA were documented by ultrasonography and the diameters ranged from 3-10 centimetres, mean = 5.8. Aneurysmectomy was performed on 58 patients, 17 of which were emergencies for ruptured AAA. The operative mortality for elective surgery was 2 percent, but that for emergency surgery was 47 percent. Ten patients refused surgery and 28 were not offered an operation. The true incidence of AAA is likely to be much higher than the number of patients referred for treatment. Many cases are not diagnosed or referred for treatment. Many cases of ruptured AAA died at home or in peripheral hospitals without a diagnosis being made. It is estimated that an AAA is present in 17,000 persons in Peninsular Malaysia. The risk of elective surgery is significantly lower than that of emergency. The overall mortality for ruptured AAA is even higher at about 99 percent. Furthermore, AAA is a benign disease and after surgery the patients return to their normal life expectancy. It is recommended that patients with AAA of five centimetres or more should be advised surgery if premature death is to be avoided.

Matched MeSH terms: Aortic Aneurysm/surgery*

Bailouts During Neurointervention; Novel Techniques in Tackling Coil Migration and Premature Intravascular Detachment of Microcatheter Tip

Ambrosanio G, Arthimulam G, Leone G, Guarnieri G, Muto M, Muto M

World Neurosurg, 2020 10;142:167-170.

PMID: 32615295 DOI: 10.1016/j.wneu.2020.06.190

BACKGROUND: Intracranial vascular malformations are increasingly being treated via the endovascular route. Though generally safe, a multitude of intraprocedural complications that potentially lead to disastrous clinical outcomes may arise. It is crucial for the operators to be well versed with the various techniques that are available to overcome any procedure-specific complications.

METHODS: We present 2 cases in which we encountered premature intravascular detachment of the microcatheter tip and coil migration while treating a dural arteriovenous fistula and aneurysm, respectively. We used a stentriever to remove the detached microcatheter tip and suction using the reperfusion catheter to remove the migrated coil, both techniques that have not been reported in the literature thus far.

RESULTS: Detached microcatheter tip and migrated coil were successfully retrieved using a stentriever and aspiration catheter.

CONCLUSIONS: These novel techniques could potentially reduce mortality and morbidity associated with neurointervention.

Matched MeSH terms: Intracranial Aneurysm/surgery*

Fulltext Pulmonary artery aneurysm associated with severe degenerative aortic stenosis

Ling PK

Singapore Med J, 2009 Oct;50(10):e350-2.

PMID: 19907873

We report a pulmonary artery (PA) aneurysm associated with severe aortic stenosis and an aortic root dilatation occurring in a 59-year-old woman who presented with dyspnoea and chest pain. PA aneurysms are rare, and there are no definitive guidelines on its management. There are contentious opinions on whether such aneurysms should be managed conservatively or surgically. Our patient had associated aortic stenosis and underwent a successful aortic valve replacement and PA aneurysm repair. This case illustrates that concomitant PA repair with other cardiothoracic surgery can be performed safely, even in patients with moderate surgical risks. We also discuss the natural history, prognosis and management of PA aneurysms.

Matched MeSH terms: Aneurysm/surgery

Aneurysmal dilatation without distal obstruction: a rare complication of valved bovine jugular vein conduit

Qureshi AU, Abbaker AE, Sivalingam S, Latiff HA

World J Pediatr Congenit Heart Surg, 2014 Apr;5(2):348-51.

PMID: 24668992 DOI: 10.1177/2150135113509819

Valved bovine jugular vein (Contegra) conduit is considered a suitable choice for pediatric population with congenital heart defect requiring right ventricle to main pulmonary artery connection. Intermediate follow-up studies have shown the propensity of developing distal conduit stenosis and valve thrombosis. We present a rare case of aneurysmal dilatation of the conduit leading to valve failure requiring conduit explantation.

Matched MeSH terms: Aneurysm/surgery

Intracranial aneurysms in Sarawak General Hospital over a 30-month period

Wong JS, Ng KH, Wong SH

J Clin Neurosci, 2004 Apr;11(3):254-8.

PMID: 14975412

This is a prospective study conducted from February 2000 to July 2002 in a single neurosurgeon neurosurgical service in the state of Sarawak, Malaysia. There were 66 cases of subarachnoid hemorrhage or intracranial aneurysm presenting to this hospital over the study period. Fifty cases had their aneurysms clipped. Eighty percent of our patients were operated within 48 h of presentation. Forty-four percent presented with poor WFNS grades of 4 and 5. We had a 20% operative mortality and 29% total management mortality. Twenty-nine (58%) of the operated cases had a favorable outcome with a mean follow-up of 32 weeks. Multiple aneurysms were less common. The diagnosis of aneuysmal subarachnoid hemorrhage and clipping of aneurysms have increased dramatically over the previous two and half years indicating an increased awareness of the diagnosis and treatment. This series supports the previously reported beliefs that the lower rate of aneurymal subarachnoid hemorrhage in developing countries is likely due to both underdiagnosis and undertreatment. Good results can be achieved in developing countries with early diagnosis and intensive management.

Matched MeSH terms: Intracranial Aneurysm/surgery

Displaying publications 1 - 20 of 21 in total