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179 results on '"Makey, Ian A."'

10. The Outcomes of Surgical Pulmonary Embolectomy for Pulmonary Embolism: A Meta-Analysis.

Author

Rahouma, Mohamed, Al-Thani, Shaikha, Salem, Haitham, Mahmoud, Alzahraa, Khairallah, Sherif, Shenouda, David, Sultan, Batool, Khalil, Laila, Alomari, Mohammad, Ali, Mostafa, Makey, Ian A., Haney, John C., Mick, Stephanie, and El-Sayed Ahmed, Magdy M.

Subjects
LITERATURE reviews, HOSPITAL mortality, GASTROINTESTINAL hemorrhage, DEATH rate, CARDIAC arrest
Abstract

Objectives: The purpose of this study is to assess the efficacy, short- and long-term cardiovascular and non-cardiovascular mortalities and postoperative morbidities of surgical pulmonary embolectomy (SPE) for patients with massive or submassive pulmonary embolism. Methods: A comprehensive literature review was performed to identify articles reporting SPE for pulmonary embolism. The outcomes included in-hospital and long-term mortality in addition to postoperative morbidities. The random effect inverse variance method was used. Cumulative meta-analysis, leave-one-out sensitivity analysis, subgroup analysis and meta-regression were performed. Results: Among the 1949 searched studies in our systematic literature search, 78 studies met our inclusion criteria, including 6859 cases. The mean age ranged from 42 to 65 years. The percentage of males ranged from 25.6% to 86.7%. The median rate of preoperative cardiac arrest was 27.6%. The percentage of contraindications to preoperative systemic thrombolysis was 30.4%. The preoperative systemic thrombolysis use was 11.5%. The in-hospital mortality was estimated to be 21.96% (95% CI: 19.21–24.98); in-hospital mortality from direct cardiovascular causes was estimated to be 16.05% (95% CI: 12.95–19.73). With a weighted median follow-up of 3.05 years, the late cardiovascular and non-cardiovascular mortality incidence rates were 0.39 and 0.90 per person-year, respectively. The incidence of pulmonary bleeding, gastrointestinal bleeding, surgical site bleeding, non-surgical site bleeding and wound complications was 0.62%, 4.70%, 4.84%, 5.80% and 7.2%, respectively. Cumulative meta-analysis showed a decline in hospital mortality for SPE from 42.86% in 1965 to 20.56% in 2024. Meta-regression revealed that the publication year and male sex were associated with lower in-hospital mortality, while preoperative cardiac arrest, the need for inotropes or vasopressors and preoperative mechanical ventilation were associated with higher in-hospital mortality. Conclusions: This study demonstrates acceptable perioperative mortality rates and late cardiovascular and non-cardiovascular mortality in patients who undergo SPE for massive or submassive pulmonary embolism. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Extending donor criteria: successful lung transplantation post ex vivo back table donor pulmonary artery thrombolysis.

Author

Jacob, Samuel, Garg, Pankaj, Ahmed, Magdy El-Sayed, and Makey, Ian A

Subjects
PULMONARY artery, LUNG transplantation, THROMBOLYTIC therapy, LUNG diseases, PULMONARY embolism
Abstract

Pulmonary embolization in donor lungs is a common finding and found in up to 38% of cases. To expand the pool of organs, transplant centers now utilize lungs, from increased risk donors, that may have pulmonary embolic disease. Modalities of clearing pulmonary artery embolisms are critical to reduce the prevalence of primary graft dysfunction post transplantation. There have been anecdotal cases of pulmonary embolectomy pre and post organ procurement or in vivo and ex vivo thrombolytic therapy performed in donors with massive pulmonary emboli. We report for the first time therapeutic ex vivo thrombolysis on the back table without Ex Vivo Lung Perfusion (EVLP), followed by successful transplantation. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Visual Abstract - Supplemental material for The Radial Stapler Facilitates Lung-Conserving Wedge Resections

Author

Makey, Ian A., Magdy M. El-Sayed Ahmed, and Jacob, Samuel

Subjects
FOS: Clinical medicine, 110323 Surgery
Abstract

Supplemental material, Visual Abstract, for The Radial Stapler Facilitates Lung-Conserving Wedge Resections by Ian A. Makey, Magdy M. El-Sayed Ahmed and Samuel Jacob in Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery

Published
2020
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29. Pulmonary Langerhans Cell Histiocytosis Presenting as a Solitary Pulmonary Nodule on a Lung Cancer Screening CT

Author

Baig, Hassan, Sonavane, Sushilkumar, Makey, Ian, Mallea, Jorge, and Khoor, Andras

Subjects
Article Subject
Abstract

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare inflammatory condition that mostly affects lungs in smokers. On imaging, it usually presents as multiple, upper lobe predominant, solid, and cavitary nodules, but presentation as solitary pulmonary nodule (SPN) is rare. We describe a case of SPN seen on low-dose lung cancer screening CT (LDCT) that was FDG avid on PET/CT. Given concern for malignancy, lobectomy was planned if intraoperative frozen section was consistent with malignancy. Lobectomy was performed based on frozen section; however, on formal pathology review, the nodule was ultimately found to be PLCH. This case illustrates an atypical presentation of PLCH as a solitary nodule. Furthermore, it helps demonstrate how rare etiologies (like PLCH) may be more frequently encountered and should be considered in the differential diagnosis for solitary lung nodules, especially in the era of lung cancer screening.

Published
2020
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41. Postoperative Opioid Consumption in Thoracic Surgery Patients: How Much Is Actually Used?

Author

Holst, Kimberly A., primary, Thiels, Cornelius A., additional, Ubl, Daniel S., additional, Blackmon, Shanda H., additional, Cassivi, Stephen D., additional, Nichols, Francis C., additional, Shen, K. Robert, additional, Wigle, Dennis A., additional, Thomas, Mathew, additional, Makey, Ian A., additional, Beamer, Staci E., additional, Jaroszewski, Dawn E., additional, Allen, Mark S., additional, and Habermann, Elizabeth B., additional

Published
2020
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42. Kidney transplantation on extracorporeal life support for primary cardiac allograft dysfunction

Author

Pham, Anthony N., primary, Patel, Parag C., additional, Landolfo, Kevin, additional, Burns, Justin M., additional, Yip, Daniel S., additional, Leoni Moreno, Juan C., additional, Goswami, Rohan M., additional, Jacob, Samuel, additional, El‐Sayed Ahmed, Magdy M., additional, Makey, Ian A., additional, Thomas, Mathew, additional, Mai, Martin L., additional, Taner, C. Burcin, additional, and Pham, Si M., additional

Published
2020
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45. Incidence, Management, and Outcomes of Chylothorax after Lung Transplantation: A Single-center Experience

Author

Jacob, Samuel, Meneses, Axel, Landolfo, Kevin, El-Sayed Ahmed, Magdy, Makey, Ian A, Pham, Si M, and Thomas, Mathew

Subjects
Transplantation, Medical Education, complications, chylothorax, Cardiac/Thoracic/Vascular Surgery, lung transplantation, management
Abstract

Background The objective of this study was to determine the incidence and outcomes of chylothorax after lung transplantation. Methods We conducted a retrospective review of our institutional lung transplant registry of 504 adult transplantations done from 2001 to 2015 and identified seven patients (1.38%) with chylothorax. Electronic health records were then analyzed to determine demographics, indications for surgery, management, and outcomes. Survival curves were plotted using the Kaplan-Meier method. Results Chylothorax presented in the first week in four (62.5%) patients, and approximately one month later in the remaining three. Nonsurgical management was initially attempted in all patients and succeeded in three (42.9%). Elective surgical ligation of the thoracic duct (LTD) was successful in two (66.7%) out of three patients in whom it was performed. One patient required emergent reoperation for clamshell thoracotomy dehiscence from severe chylothorax. Thoracic duct embolization was attempted but unsuccessful in two patients. Subsequently, one of these patients received a peritoneal-venous shunt and the other underwent LTD. Chylothorax permanently resolved in six patients (85.7%). There were no mortalities directly related to chylothorax. The median time to resolution was 11 days (range: 7-60). The mean survival in months for chylothorax patients was 29.2 (SE 3.1) and 78.2 (SE 2.9) for the remaining patients (p = 0.37). The median survival was not reached for the chylothorax group and was 71.8 months (95% CI: 58.0-83.9) for the rest. Conclusion Chylothorax is rare after lung transplantation but can lead to major comorbidities and prolonged hospital stay. In our experience, nonsurgical management was successful in up to 40% of patients. LTD should be considered in those who fail conservative management.

Published
2019

47. Agitation Techniques to Enhance Drainage of Retained Hemothorax.

Author

Makey, Ian A., Das, Nitin A., Jacob, Samuel, El-Sayed Ahmed, Magdy M., Makey, Colleen M., Johnson, Scott B., and Thomas, Mathew

Abstract

Background. Retained hemothorax (RH) is a common problem in cardiothoracic and trauma surgery. We aimed to determine the optimum agitation technique to enhance thrombus dissolution and drainage and to apply the technique to a porcine-retained hemothorax. Methods. Three agitation techniques were tested: flush irrigation, ultrasound, and vibration. We used the techniques in a benchtop model with tissue plasminogen activator (tPA) and pig hemothorax with tPA. We used the most promising technique vibration in a pig hemothorax without tPA. Statistics. We used 2-sample t tests for each comparison and Cohen d tests to calculate effect size (ES). Results. In the benchtop model, mean drainages in the agitation group and control group and the ES were flush irrigation, 42%, 28%, and 2.91 (P =.10); ultrasound, 35%, 27%, and.76 (P =.30); and vibration, 28%, 19%, and 1.14 (P =.04). In the pig hemothorax with tPA, mean drainages and the ES of each agitation technique compared with control (58%) were flush irrigation, 80% and 1.14 (P =.37); ultrasound, 80% and 2.11 (P =.17); and vibration, 95% and 3.98 (P =.06). In the pig hemothorax model without tPA, mean drainages of the vibration technique and control group were 50% and 43% (ES =.29; P =.65). Discussion. In vitro studies suggested flush irrigation had the greatest effect, whereas only vibration was significantly different vs the respective controls. In vivo with tPA, vibration showed promising but not statistically significant results. Results of in vivo experiments without tPA were negative. Conclusion. Agitation techniques, in combination with tPA, may enhance drainage of hemothorax. [ABSTRACT FROM AUTHOR]

Published
2021
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