1.Coronary artery bypass graft surgery in a young female with systemic lupus erythematosus and its operative challenges: A case report
Gurpreet Singh ; Simon Jerome Vendargon ; Syed Rasul Syed Hamid
The Medical Journal of Malaysia 2019;74(6):549-550
We understand that autoimmune disorders such as
Systemic Lupus Erythematosus increases the likelihood of
developing coronary heart disease. However, its
implications on patients undergoing cardiac surgery is not
well understood. Here we present a female patient with SLE
who developed coronary artery disease at a young age and
underwent coronary artery bypass graft surgery. As SLE is
associated with vasculitis, we wanted to understand
regarding the choice of conduit as well as its long term
patency. Also whether percutaneous angioplasty has a role
to play in patients with SLE.
2.Inadvertent Diaphragmatic Rent Following Thoracic Surgery for Empyema Thoracis Successfully Repaired With Mesh
Henry Tan Chor Lip ; Tan Jih Huei ; Simon Jerome Vendargon
Malaysian Journal of Medicine and Health Sciences 2020;16(No.3, September):322-324
Iatrogenic diaphragmatic entry following thoracic surgery is rare with only two cases reported till date. This case reports on a 46-year-old male with persistent pleural sepsis due to right empyema thoracis despite best medical efforts. Following a right thoracotomy and decortication, the right diaphragm was inadvertently incised due to dense adhesions between the diaphragm and thickened cortex. To our knowledge, this is the third case reported of iatrogenic diaphragmatic entry following thoracic surgery for empyema thoracis. The pearls from this case report is that any evidence of empyema thoracis involving the lower lobe on imaging should warn the surgeons to be aware of inadvertent entry into the peritoneal cavity, as the diaphragm can be adherent to the cortex trapping the lower lobe.