Purpose:To assess vancomycin paste effect on poststernotomy healing in high-risk coronary artery bypass grafting (CABG) patients compared to bone wax using the 6-point computed tomography (CT) score. Additionally assessed the reliability of this score and its relationship to the occurrence of infection. Patients and Methods: A prospective comparative analysis included 126 high-risk CABG patients. The patients were randomly assigned into bone wax or vancomycin paste for sternal haemostasis. All patients were submitted to CT examinations 6-months postoperative. Two radiologists independently reviewed all CT scans to assess sternal healing using the 6-point CT score. The CT healing score of the two groups was compared. The kappa statistics were used to calculate the inter-reader agreement (IRA) of the 6-point CT score. Results: The final analysis included 61 patients in each group. The main CT score for sternal healing was 3.9±0.4 in the vancomycin group and 3.3±0.8 in the bone wax group. Patients in the vancomycin group had a higher statistically significant improvement in CT healing score than those in the bone wax group (p<0.001). There was no statistically significant relationship (p = 0.79) between the occurrence of infection and the 6-point CT score in the vancomycin group. The overall IRA of the 6-point CT score was good in two groups (κ = 0.79 in the vancomycin group and = 0.78 in the bone wax group). Conclusion: Vancomycin paste had a better CT healing score and can be used as a sternal haemostatic material instead of bone wax. The 6-point CT healing score is a reliable diagnostic tool for evaluating sternal healing.

Background: For decades, the traditional median sternotomy has been the access of choice in aortic valve surgery; however, numerous researchers have worked to develop less invasive procedures, and the partial upper ministernotomy is the most prevalent minimally invasive procedure. Objective: To compare outcomes, in patients who undergo mini-sternotomy, and patients who undergo standard sternotomy, in aortic valve replacement operations. Patients and Methods: This randomized controlled clinical trial study included fifty patients who were admitted to the Zagazig University Hospital, Cardiothoracic Surgery Department in the period between January 2021 to August 2021, Patients were split into two groups, each with 25 patients: Group "A" had aortic valve surgery by ministernotomy, while Group "B" got aortic valve surgery via traditional surgery. Aortic valve surgery was performed via a conventional median sternotomy in Group "B." An ECG was performed to see whether there was any ischemia present, as well as laboratory tests and a chest x-ray. Results: In the present research, there was a significant difference in postoperative outcomes between the mini-sternotomy and complete sternotomy groups in terms of mechanical ventilation and hospital stay. Inotropic support and reopening were not substantially different across groups; however, infection and blood transfusion were strongly linked with the complete group, and neither group had any mortality. Conclusions: Minimally invasive aortic valve replacement, is a safe and eff ective procedure and is performed with comparable morbidity and mortality to conventional aortic valve replacement (AVR). Minimally invasive aortic valve replacement (MIAVR) results in improved ventilator function, fewer wound infections, shorter hospital stays, and a higher percentage of patients released home early.

Background: The presence of malignant cells in pleural fluid or pleural tissue is called malignant pleural effusion (MPE). Lung cancer, breast, ovary, and lymphoma are responsible for malignant pleural effusion by more than 75%. Pleurodesis is a common method for managing malignant pleural effusion to generate a symphysis between parietal and visceral pleura. Aim and objectives: The aim of this study is to evaluate the safety, efficacy and the success rate of 10% povidone-iodine in pleurodesis procedure through thoracostomy by conducting the objectives which were assessment of radiological outcome after using of povidone-iodinee as a chemical pleurodesis, assessment the adverse event and clinical outcome after using of povidoneiodinee as a chemical pleurodesis and evaluation the effect of povidone-iodine on thyroid function test. patients and methods: this is randomized clinical trial, was carried out on 24 cases at Cardiothoracic Surgery Department, Zagazig and Tripoli University Hospitals, all patients, who underwent pleural drainage and received bedside pleurodesis with 10% povidone-iodine, Pleurodesis efficacy was defined in three response levels, 1)symptomatic improvement of dyspnea with complete radiographic resolution of the pleural effusion till the end of follow up as "complete response"2) symptomatic improvement with recurrent pleural effusion that did not need additional thoracentesis as "partial response" ,and 3) recurrent pleural effusion that needs further thoracentesis as "treatment failure" . Results The results revealed that Early response was 70.8% complete response, partial response in 25%, and failure 4.2%, the major complication was need of analgesia, regarding follow up successes (complete and partial) 87.5% and failure 12.5%. Conclusions: Povidone-iodine is shown to be a safe and effective agent with few adverse effects in pleurodesis of patients with malignant pleural effusion can be used as a low cost and accessible alternative to other chemical sclerosing agents.