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Background: Cardiac tamponade after heart surgery is of great concern. It increases perioperative mortality and morbidity. Late tamponade might be easily missed and difficult to be diagnosed clinically. It is thought that posterior pericardial window decreases the incidence of postoperative tamponade. Aim of the work: The aim of the study to evaluate the prophylactic role of posterior pericardial window (PPW) in preventing pericardial tamponade after heart valve surgery. Methods: Our prospective randomized comparative study included 640 patients collected by simple random sampling. All patients were admitted in cardiothoracic surgery department-Zagazig University hospitals-Egypt, from January 2020 to May 2022. They were divided into PPW group and non-PPW group and each group contains 320 patients. Results: There is statistical significant difference as regrading occurrence of late tamponade between both groups and also less developed new onset atrial fibrillation in PPW group. Conclusions: Pericardial window is easily to be performed technically. We recommend that procedure to prevent late pericardial effusion and tamponade as it provides a good drainage pathway between pericardial and pleural cavities. We consider that technique is valuable for patients with coagulation disorders. [ABSTRACT FROM AUTHOR]

Background: Management of an early empyema is an important problem in thoracic surgery. As an alternative to surgical treatment empyema is in patients who developed early empyema, intra-pleural fibrinolysis has been used with favorable results. This modality of treatment may reduce known morbidities secondary to surgical procedures and may result in significant medical cost savings. Our study aim is to test the efficacy and safety of tissue plasminogen activator and Streptokinase for management of early empyema. Methods: Our study included 48 patients presented with complicated parapneumonic effusion and early empyema. Patients were divided into two groups each contains 24 patients. First group treated with intra-pleural Alteplase (tissue plasminogen activator) and the second group treated with streptokinase, both were instilled via an intercostal chest tube. Clinical and radiologic (chest radiographs (CXR) and chest computed tomography (CT) data used for evaluation of efficacy of both protocols. Results: Tissue plasminogen activator give excellent results in early empyema, it showed success rate 100%, dramatic improvement in both chest tube drain and pleural thickness with no need for further surgical intervention, Streptokinase showed success rate 83.4% in comparison to TPA. Conclusion: Intrapleural tissue plasminogen activator is safe and more efficient than Streptokinase as a chemical modality in treating patients presented with complicated pleural effusion and early empyema. [ABSTRACT FROM AUTHOR]

Background: There is a high danger of foreign body aspiration (F.B.A.) since children put everything they find in their mouths. Children's tiny airways and undeveloped defensive mechanisms likely contribute to their higher rates of morbidity and deaths. Objective: Improving outcomes of patients with history of inhaled foreign body (F.B). Patients and Methods: We conducted a prospective cohort study on 90 cases suffered from foreign body inhalation (early or late management) in Cardio-thoracic Surgery Department, Zagazig University Hospitals. Results: We found 76.7 % of cases between age one and three years, 13.3 % of cases with age between three and ten years and 10% of the study sample had age more than ten years. 67.8% of the cases were males and 32.2% of them were females. As regard residence we reported that 65.6 % of cases were living in rural areas and 34.4% of them were living in urban areas. Conclusion: The timing of management of inhaled foreign bodies in children, whether early or late, can impact the clinical features and outcomes. Early management of inhaled foreign bodies tend to present acutely with choking and respiratory distress, while late management of inhaled foreign bodies may have more subtle and chronic respiratory symptoms. Prompt diagnosis and management are crucial in both cases to prevent complications and achieve favorable outcomes. [ABSTRACT FROM AUTHOR]