ORCID Profile
0000-0002-7772-2269
Current Organisation
James Cook University
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Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.HLC.2006.10.010
Abstract: Herein we describe a patient with an unusually large bronchogenic cyst. The removal of the cyst was performed through a mini-thoracotomy and facilitated by video-assisted thoracic surgery (VATS).
Publisher: Hindawi Limited
Date: 31-03-2008
DOI: 10.1111/J.1540-8191.2007.00549.X
Abstract: Use of side-biting cl s in patients with coronary artery disease and atheromatous disease of ascending aorta, undergoing coronary artery surgery can lead to major postoperative neurological events. We describe the use of a simple device to avoid use of side-biting cl on aorta for proximal aortocoronary anastomosis.
Publisher: Elsevier BV
Date: 07-2016
Publisher: Medknow
Date: 2007
Publisher: Elsevier BV
Date: 10-2005
DOI: 10.1016/J.ATHORACSUR.2004.04.018
Abstract: A young woman presented with a presumptive diagnosis of tricuspid valve tumor in a structurally normal heart. She was recently started on oral progesterone for menorrhagia related to uterine fibroids. She underwent an excision of the mass attached to the tricuspid valve, which was found to be an organized thrombus. We suggest a clinical approach to this problem.
Publisher: Elsevier BV
Date: 05-2006
Publisher: Elsevier BV
Date: 03-2006
Publisher: Elsevier BV
Date: 05-2007
Publisher: Elsevier BV
Date: 02-2007
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.ATHORACSUR.2003.10.096
Abstract: Injection of pressurized normal saline into the retrosternal tissue has been used in redo sternotomies. This technique has been labeled as hydrodissection. It is a simple but effective technique to help minimize the trauma and risk of complications in redo sternotomies. My colleagues and I present a series of 6 consecutive patients in whom hydrodissection was performed. There was no injury to the heart or any vessel on reentry.
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.HLC.2007.01.008
Abstract: Iatrogenic oesophageal injury is a common cause of oesophageal perforation. This complication carries a poor prognosis in the setting of malignancy of oesophagus. We discuss the role of stents in the management of a case in this clinical scenario.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.HLC.2007.03.019
Abstract: Infective endocarditis is a life threatening condition with high morbidity and mortality. We present a case report of a young female who had a rare complication of infective endocarditis in the form of mitral valve leaflet abscess. Patient underwent successful surgical treatment with valve replacement.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.JSS.2009.12.020
Abstract: Kallikrein-kinin system (KKS) plays an important role in inflammation, ischemia-reperfusion (IR) injury, and development of neoplasia. There is evidence to suggest that KKS plays an important role in organ protection during preconditioning. Aprotinin is a nonspecific serine protease inhibitor, which has been extensively used in cardiac surgery for the control of post operative bleeding. The anti-inflammatory effects of aproprotin are due to its inhibitory effect on the kallikrein-kinin system (KKS). We herein review KKS and its role as applied to the practice of surgery.
Publisher: SAGE Publications
Date: 06-2010
Abstract: We describe a modified extended 3-patch surgical procedure to relieve supravalvular aortic stenosis. This simple technique provides effective and lasting enlargement of the ascending aorta in patients with severe congenital supravalvular aortic stenosis.
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.JSS.2009.11.011
Abstract: Remote ischemic preconditioning (RIPC) has been shown to reduce ischemic-reperfusion injury and is induced by brief forearm ischemia. Kinins are known to be involved in RIPC and act via the G protein coupled B1 and B2 receptors. Interaction of the kinins with their respective receptors causes receptor internalization, thereby reducing the potential for further activation. This may be critical for the protective effect of RIPC and if so, we hypothesized, would significantly decrease the expression of kinin receptors on the surface of neutrophils. The study was performed on five healthy human volunteers. The left forearm was rendered ischemic for three 5-min periods, each separated by 5 min of reperfusion. Three venous blood s les were taken from the right arm, one before and two after RIPC. Neutrophil isolation, immunofluorescence labeling, and confocal microscopy were performed. Mean pixel intensity data were generated using a fixed circular area of interest (AOI, 40×40 μm). For every image, the AOI was placed over a cell and the mean pixel intensity was recorded. The mean intensity was expressed as pixel×10(2)/μm(2) and presented as mean±SEM. Immunofluorescence at the different time points was compared by one way analysis of variance with Bonferroni's post-hoc test. A P value<0.05 was considered significant. The mean pixel intensity for kinin B1 receptors was decreased at 24 h after RIPC compared with both baseline and 15 min after RIPC (P<0.001). Similarly, the intensity for B2 receptor labeling on neutrophils was significantly decreased 24 h after RIPC compared with the baseline value (P<0.001). RIPC decreases expression of kinin receptors on circulating human neutrophils. Reduction in kinin surface receptors suggests internalization of receptors and is consistent with the concepts of kinin receptor activation and their role in RIPC.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.HLC.2007.04.015
Abstract: Redo cardiac surgery is commonly performed in the current era. We describe a clinical scenario in a patient with a patent left internal thoracic artery to left anterior descending artery graft, requiring replacement of ascending aortic aneurysm with previous coronary artery bypass operation complicated by mediastinitis. A pre-operative 64 slice computed tomographic scan helped us plan and perform replacement of ascending aorta safely.
Publisher: Elsevier BV
Date: 11-2007
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.ATHORACSUR.2006.03.022
Abstract: Giant bullae can be complicated by respiratory tract infection in the setting of emphysema. Herein we describe a technique of palliative decompression of the bullae that gives time to treat acute pulmonary infection prior to definitive surgical treatment.
Publisher: Elsevier BV
Date: 02-2010
Publisher: Elsevier BV
Date: 08-2004
Publisher: Elsevier BV
Date: 11-2007
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.ATHORACSUR.2008.08.030
Abstract: Primary pulmonary artery sarcoma is a rare tumor that can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. This article reports a patient with a preoperative diagnosis of pulmonary embolism who was found to have an extensive pulmonary artery tumor. Surgical resection of the primary pulmonary artery sarcoma and reconstruction of the central pulmonary arteries, followed by adjuvant chemoradiotherapy, provided significant improvement in his clinical symptoms.
Publisher: Hindawi Limited
Date: 09-2009
DOI: 10.1111/J.1540-8191.2008.00800.X
Abstract: Sternal dehiscence following midline sternotomy is associated with significant morbidity and mortality in high-risk patients. A novel simple technique of sternal stabilization after midline sternotomy by interlocking wires was introduced in high-risk patients with morbid obesity, diabetes, osteoporosis, chronic obstructive pulmonary disease, bilateral internal thoracic artery harvesting, or various combinations of the above. A sternal stabilization by interlocking wires was performed in 25 consecutive high-risk patients. Stable sternum was achieved in all patients despite multiple risk factors. We describe a simple technique of interlocking wires that provides excellent stabilization of the sternum after midline stenotomy in high-risk patients. This technique utilizes the benefit of figure-eight wires, provides the continuity of the weave and effectively prevents cutting of the wires through the sternum without compromising its blood supply.
Publisher: Elsevier BV
Date: 03-2007
Publisher: American Thoracic Society
Date: 03-2013
Publisher: Elsevier BV
Date: 06-2007
Publisher: Elsevier BV
Date: 2013
Publisher: Elsevier BV
Date: 07-2009
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.ATHORACSUR.2008.05.004
Abstract: Necrotizing fasciitis of the chest wall is rare and associated with high mortality. Herein we present a patient with necrotizing fasciitis who was managed successfully with aggressive surgical debridement combined with an aeration system that provided effective aeration and drainage of the infected tissues.
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1016/J.HLC.2008.03.081
Abstract: Inflammatory aneurysms of thoracic aorta are rare. Of all the aneurysms, only 5-10% are inflammatory in nature and are almost exclusively confined to the infrarenal segment of the aorta. We hereby present a patient with a large inflammatory aneurysm involving the thoracic aorta in association with mediastinal fibrosis and idiopathic retroperitoneal fibrosis.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.HLC.2008.04.005
Abstract: Deep hypothermia leading to cardiac arrest requires aggressive management for resuscitation. Various methods are available to rewarm the patient. We hereby present a case report where active resuscitation was carried out using cardiopulmonary bypass in a young female who was found unconscious with a core temperature of 26 degrees C. The relevant literature is also reviewed.
Publisher: Elsevier BV
Date: 09-2010
Publisher: Oxford University Press (OUP)
Date: 12-2006
Publisher: SAGE Publications
Date: 04-2011
Abstract: Immature mediastinal teratomas refractory to chemotherapy are very rare and require management by an aggressive surgical approach. We describe resection of a large mediastinal teratoma in a 23-year-old man, with a satisfactory early result.
Publisher: Wiley
Date: 05-2007
Publisher: Elsevier BV
Date: 2014
Publisher: Hindawi Limited
Date: 12-10-2011
DOI: 10.1111/J.1540-8191.2011.01330.X
Abstract: Coronary artery bypass graft (CABG) surgery is associated with a low risk of paraplegia. Spinal cord ischemia causing paraplegia following off-pump coronary artery bypass (OPCAB) surgery has not been described previously. We now describe a patient who developed paraplegia following OPCAB and review the literature on spinal cord ischemia following CABG surgery.
Publisher: SAGE Publications
Date: 05-2009
Abstract: Objective: To determine if remote ischemic preconditioning (RIPC) induced by transient limb ischemia is protective against delayed hippoc al neuronal death in rats undergoing transient global cerebral ischemia (GCI). Method: Animals were randomized into 3 groups: Group I (Control, n = 5) underwent sham procedure, namely, general anesthesia x 2, without cerebral ischemia Group II (RIPC + GCI, n = 5) was subjected to RIPC, induced by transient left hind limb ischemia under general anesthesia prior to GCI Group III (GCI only, n = 5) underwent sham procedure under general anesthesia prior to GCI. Twenty-four hours after the RIPC or sham procedure, a transient GCI was induced for 8 minutes in Groups II and III by means of bilateral common carotid artery occlusion and hypotension. Hippoc al CA1 neurons were histologically examined at 7 days after ischemia. Results: There was no significant difference between the RIPC group and the ischemia only group. The number of neurons in the RIPC group were 0.90 (95% CI 0.20, 4.08) times the number in the ischemia group (p=0.89). The number of neurons in the RIPC group were 0.03 (95% CI 0.01, 0.10) times the number in the Control group (p=0.0001). Conclusion: Second window of the RIPC does not prevent hippoc al CA1 neuronal death at 7 days after transient global cerebral ischemia.
Publisher: Hindawi Limited
Date: 2010
DOI: 10.1111/J.1540-8191.2009.00820.X
Abstract: Remote ischemic conditioning is a novel concept of protection against ischemia-reperfusion injury. Brief controlled episodes of intermittent ischemia of the arm or leg may confer a powerful systemic protection against prolonged ischemia in a distant organ. This conditioning phenomenon is clinically applicable and can be performed before--preconditioning, during--perconditioning, or after--postconditioning prolonged distant organ ischemia. The remote ischemic conditioning may have an immense impact on clinical practice in the near future.
Publisher: Hindawi Limited
Date: 07-2008
Publisher: SAGE Publications
Date: 10-2011
Abstract: A 40-year-old man presented with left lower lobe pneumonia that failed to resolve on antibiotic therapy. Computed tomography revealed intralobar sequestration of the left lower lobe supplied by a large artery from the descending aorta. The aberrant artery was embolized using polyvinyl alcohol particles. The sequestered tissue was resected 3 weeks later. Identification and control of the aberrant artery is essential to avoid inadvertent injury and massive hemorrhage.
Publisher: Hindawi Limited
Date: 17-04-2012
DOI: 10.1111/J.1540-8191.2012.01437.X
Abstract: A combination of cardiac surgery and thyroidectomy as a single stage operation has rarely been reported in the literature. We report on the management of a 64-year-old female undergoing a combined aortic valve replacement and excision of a primary (ectopic) intrathoracic goiter. The literature on combined cardiac surgery and thyroidectomy is also reviewed.
Publisher: Elsevier BV
Date: 2009
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.ATHORACSUR.2009.05.080
Abstract: Children undergoing an extensive tracheoplasty, particularly those with associated cardiovascular anomalies, may require long cardiopulmonary bypass, prolonged ventilatory support, subsequent tracheostomy, and multiple reinterventions on the trachea. Thus, these rare patients are at risk of mediastinitis. With tracheal erosion into the adjacent vessels and tracheal perforation during subsequent bronchoscopic interventions. Herein we describe a simple technique of interposition pericardial flap that provides an effective seal and isolation of the tracheoplasty site.
Publisher: Elsevier BV
Date: 12-2007
DOI: 10.1016/J.HLC.2006.08.010
Abstract: Thymomas are common mediastinal tumours. We report a rare case of thymoma invasion into the superior vena cava with resultant venous obstruction. The tumour was resected. The superior vena cava and left brachiochephalic vein were reconstructed with autologous pericardial patch.
Publisher: Elsevier BV
Date: 05-2006
Publisher: Hindawi Limited
Date: 11-2011
DOI: 10.1111/J.1540-8191.2011.01346.X
Abstract: Type A aortic dissection (TAAD) can be complicated by myocardial ischemia due to extension of the dissection into coronary artery or by extrinsic compression of a coronary artery by the false lumen. We present the successful surgical management of a hemodynamically unstable patient with acute aortic dissection with ongoing myocardial ischemia by stenting the left main system prior to the surgical repair of TAAD.
Publisher: Elsevier BV
Date: 02-2009
Publisher: Elsevier BV
Date: 2006
Publisher: Elsevier BV
Date: 04-2009
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.ATHORACSUR.2011.11.069
Abstract: We describe an efficient, safe, and effective method for constructing a satisfactory composite venous conduit from 2 portions of saphenous vein, which by themselves would be inadequate in length to function as independent conduits.
Publisher: SAGE Publications
Date: 12-2010
Abstract: The true incidence of coronary artery anomalies in the general population is unknown. Rarely, atherosclerotic coronary artery disease can be associated with single coronary artery. We describe coronary artery bypass surgery in a 57-year-old man with this association.
Publisher: Elsevier BV
Date: 12-2005
DOI: 10.1016/J.ATHORACSUR.2004.07.023
Abstract: This report describes an unusual etiology of coronary artery disease. A 60-year-old male presented with angina. He was treated with methysergide for migraine. It was determined that the patient possessed an extremely thick-walled ascending aorta that caused the coronary ostial narrowing. He underwent replacement of the ascending aorta and proximal aortic arch. Double vessel coronary artery bypass grafting was performed using saphenous vein. Microscopic examination indicated the pathology to be sclerosing mediastinis.
Publisher: Elsevier BV
Date: 07-2005
DOI: 10.1016/J.ATHORACSUR.2004.02.004
Abstract: Use of internal thoracic arteries in coronary artery bypass surgery has become universal. Skeletonized internal thoracic artery is useful in coronary artery surgery for sequential anastomosis as it also provides a long length of graft. Skeletonizing the conduit is technically more difficult than harvesting it as a pedicle graft. We describe a technique of harvesting the internal thoracic artery in which 10 to 20 mL of normal saline is injected into the fascial plane of the left side of chest wall along the course of artery to develop a plane of dissection.
Publisher: Elsevier BV
Date: 04-2009
Publisher: Oxford University Press (OUP)
Date: 07-2001
DOI: 10.1016/S1010-7940(01)00685-6
Abstract: Pulmonary tuberculosis and bronchiectasis are the major causes of massive hemoptysis in developing countries. Lung resection remains the surgical treatment of choice. This may not always be possible and may even be hazardous in some patients due to fibrosis and dense vascular adhesions between the lung and the chest wall. This leads to marked blood loss and control of hilar vessels becomes dangerous. A series of 20 cases is described here. Nineteen presented with massive hemoptysis where control of bleeding was obtained by physiological lung exclusion. One patient had traumatic left main bronchus transection not suitable for repair or resection. Physiological lung exclusion was performed by surgical interruption of the bronchus and pulmonary artery of the involved lobe or lung, keeping pulmonary veins intact. Hemoptysis could be controlled in all these patients without any significant morbidity. There was no mortality. There was no postoperative empyema and recurrence of hemoptysis on long-term follow-up. No patient required anatomical lung resection later on. Physiological lung exclusion is a safe and effective method for control of massive hemoptysis in cases where lung resection is technically hazardous or difficult. This should be kept as an alternative or adjunct to anatomical lung resection.
Publisher: Elsevier BV
Date: 10-2013
Publisher: Wiley
Date: 04-12-2018
DOI: 10.1111/ANS.14953
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.ATHORACSUR.2009.03.056
Abstract: Isolated subclavial artery is a rare congenital anomaly. Herein we discuss a patient with isolated left subclavian artery and bilateral patent arterial ducts who underwent successful repair. We also describe the detailed anatomy of both recurrent nerves in this condition and embryology of the anomaly.
Publisher: Elsevier BV
Date: 06-2008
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.HLC.2006.10.016
Abstract: Papillary fibroelastoma (PFE) is a rare and benign cardiac tumour that mainly affects the valves. This tumour has the potential to cause serious life threatening thromboembolic complications. Herein, we describe successful excision of an aortic valve papillary fibroelastoma. The importance of valve sparing tumour resection is emphasised.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.JSS.2008.08.010
Abstract: Preconditioning of cells or organs by transient sublethal ischemia-reperfusion (IR), termed ischemic preconditioning (IPC), protects the cell or organ from a subsequent prolonged ischemic insult. The mechanisms of this effect remain to be fully elucidated. We have recently reported that IPC of a forearm results in alterations in gene expression profiles of circulating polymorphonuclear leukocytes. The goal of the current study was to determine if the observed changes in gene expression lead to functional changes in neutrophils. We examined the effect of repetitive transient human forearm ischemia (three cycles of 5 min ischemia, followed by 5 min of reperfusion) on the function of circulating neutrophils. Neutrophil functions were examined before, after 1 d, and after 10 d of daily transient forearm ischemia. To modulate IR-induced inflammation the neutrophils were stimulated with N-formyl-methionyl-leucyl phenylalanine (FMLP) and lipopolysaccharide (LPS). Neutrophil adhesion was significantly decreased on day 1 and remained low on day 10 (P = 0.0149) without significant change in CD11b expression. Phagocytosis was significantly suppressed on day 10 compared with day 0 (P < 0.0001). Extracellular cytokine levels were low in the absence of an exogenous stimulus but stimulation with LPS induced significant changes on day 10. We observed a trend in reduction of apoptosis on day 1 and day 10 that did not reach statistical significance (P < 0.08). This study indicates that repetitive IPC of the forearm results in substantial alterations in neutrophil function, including reduced adhesion, exocytosis, phagocytosis, and modified cytokine secretion.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.HLC.2007.02.095
Abstract: Subscapular abscess is a rare clinical problem. Herein we describe a young male patient who presented with a subscapular abscess and was managed successfully with surgical drainage and debridement of the cavity.
No related grants have been discovered for Pankaj Saxena.