- Email: [email protected]
Ave Sina was an Islamic physician
Ann Thorac Surg 2002;73:693–700
Double-Inlet Left Ventricle: Successfully Staged Ventricular Septation With 12.5 Years Follow-up To the Editor: It is with great interest that we read the case report of Naito and colleagues [1]. They described ventricular septation for doubleinlet left ventricle in early infancy with a follow-up of 9 years. They state, however, that no successful case of primary septation had been reported thus far, and overlooked a case report of a baby with identical cardiac anatomy who underwent staged septation [2]. Our patient has been operated on by Prof. Quaegebeur with a staged procedure in which he first inserted a perforated Dacron patch inside the large left ventricle with the double inlet and banded the pulmonary artery. The septation was completed at age 3 years with closure of the perforation in the patch between both newly created ventricles, debanding of the pulmonary artery, and enlargement of the ventricular defect between the newly formed left ventricle and the originally hypoplastic right ventricle giving rise to the aorta. Immediately after the completion of septation the right ventricular systolic pressure was 25 mm Hg with a systolic left ventricular pressure of 80 mm Hg. The boy has been followed as an outpatient for more than 12.5 years after completion of the septation, and is doing well. His heart size has decreased to normal, and he has a stable sinus rhythm. There is, however, slight to moderate regurgitation of the right atrioventricular valve connected to the newly formed right ventricle. At the moment he is almost 16 years of age, attending 3rd class of secondary school, and playing soccer, without medication and without limitations. His weight is 40 kg and his height 161 cm. We sincerely agree with Naito and colleagues that in these relatively infrequent forms of univentricular atrioventricular connection, ventricular septation should be seriously considered to prevent the well-known disadvantages of a Fontan circulation. Jaap Ottenkamp, MD, PhD Mark G. Hazekamp, MD, PhD Center for Congenital Heart Disease Amsterdam-Leiden s/c PO Box 9600 2300 RC Leiden The Netherlands e-mail: [email protected].
References 1. Naito Y, Fujiwara K, Komai H, Uemura S. Midterm results after ventricular septation for double-inlet left ventricle in early infancy. Ann Thorac Surg 2001;71:1344– 6. 2. Bogers AJJC, Quaegebeur JM, Ottenkamp J, Hess J, Bos E. A modification of staged septation for univentricular atrioventricular connection. J Thorac Cardiovasc Surg 1992;104:204 –5.
Ave Sina was an Islamic Physician To the Editor: I am writing in response to the article by Dr Batirel [1] concerning early Islamic physicians. I do not agree with Dr Batirel that Ave Sina was a Turkish physician. I am obliged to draw the readers’ attention to certain facts about this outstanding Iranian philosopher, scientist, doctor, and musician. Ave Sina (980 –1039) was born in Xarmaysan, near Bokhara, a © 2002 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
CORRESPONDENCE
699
city in Iran that was occupied by Russian forces in the war between Iran and Russia and became a part of the Soviet Union. Since the fall of the former Soviet Union, it is now part of Ozbakestan [2]. Ave Sina’s teacher in logic, philosophy, medicine, and mathematics was Abuabdollah Natelee. His success in treating Nooh, a king of Samanid, brought Ave Sina a nationwide reputation and allowed him to use the royal library and its resources [2]. He was then 22 years old when he went to Gorgan and wrote canon in medicine. Later he moved to Shahre-e-ray, Gazvin, and Hamadan. He died in Hamadan and was buried there. One of Ave Sina’s masterpieces, shafa (in law) is considered to be an enyclopedia of philosophy [3, 4]. He also wrote books in physics, astrology, personal hygiene, and child education. Most of Ave Sina’s 125 books are written in Arabic and only a few of them are written in Farsi. Ave Sina, like other Iranian scientists, wrote his books in Arabic simply because Arabic was the official language in Iran at that time. To avoid any misunderstanding to your readers, I would appreciate your publication of this letter. Feridoun Sabzi, MD Emam Ali Heart Center Kermanshah University of Medical Sciences Shahid Beheshti Ave Kermanshah, Iran
References 1. Batirel HF. Early Islamic physicians and thorax. Ann Thorac Surg 1999;67:578– 8. 2. Atkin M. Russian and Iran, 1st ed. University of Mimn Press, 1980:178 –1828. 3. Mosaheb GH. Dairatol-Maaref Farsi, 1st ed. Tehran, offset. 1996:32. 4. Gwinn RP. Encyclopedia Britanica, 1st edition. Chicago: Encyclopedia Britanica Inc, 1990:739.
Cardiac Hydatid Cysts To the Editor: We read with interest the recent article by Kaplan and colleagues [1] on cardiac hydatid cysts (HC) with intracavitary expansion. The authors reported their 10-year surgical experience with 8 cardiac HC patients; another 12 patients with pericardial HCs were excluded from this study of intracardiac hydatid cysts. Ninety-eight percent of pericardial HCs originate from myocardial HC rupture into the pericardium [2]. In a few patients, it may occur secondary to lung or liver echinococcosis with pericardial extension [3]. There have been so few reports of isolated pericardial involvement [2] that it would be of particular interest to know whether any of Kaplan and associates’ 12 patients had isolated pericardial disease, or whether their management was unique. We agree with the authors’ conclusion that the presence of viable Echinococcus is an indication for surgery, but preoperative diagnosis of live HCs remains problematic. Small, totally calcified, asymptomatic HCs in an elderly patient with negative serology for hydatid disease and no impedance of hemodynamics or cardiac blood supply has thus far been considered an indication for follow-up only [4]. Kaplan and colleagues’ patients were all symptomatic, making surgery the only option. To prevent contamination, the surrounding area was wrapped with compression gauze and the cystic fluid was aspirated. Soaking of 0003-4975/02/$22.00
Double-Inlet Left Ventricle: Successfully Staged Ventricular Septation With 12.5 Years Follow-up To the Editor: It is with great interest that we read the case report of Naito and colleagues [1]. They described ventricular septation for doubleinlet left ventricle in early infancy with a follow-up of 9 years. They state, however, that no successful case of primary septation had been reported thus far, and overlooked a case report of a baby with identical cardiac anatomy who underwent staged septation [2]. Our patient has been operated on by Prof. Quaegebeur with a staged procedure in which he first inserted a perforated Dacron patch inside the large left ventricle with the double inlet and banded the pulmonary artery. The septation was completed at age 3 years with closure of the perforation in the patch between both newly created ventricles, debanding of the pulmonary artery, and enlargement of the ventricular defect between the newly formed left ventricle and the originally hypoplastic right ventricle giving rise to the aorta. Immediately after the completion of septation the right ventricular systolic pressure was 25 mm Hg with a systolic left ventricular pressure of 80 mm Hg. The boy has been followed as an outpatient for more than 12.5 years after completion of the septation, and is doing well. His heart size has decreased to normal, and he has a stable sinus rhythm. There is, however, slight to moderate regurgitation of the right atrioventricular valve connected to the newly formed right ventricle. At the moment he is almost 16 years of age, attending 3rd class of secondary school, and playing soccer, without medication and without limitations. His weight is 40 kg and his height 161 cm. We sincerely agree with Naito and colleagues that in these relatively infrequent forms of univentricular atrioventricular connection, ventricular septation should be seriously considered to prevent the well-known disadvantages of a Fontan circulation. Jaap Ottenkamp, MD, PhD Mark G. Hazekamp, MD, PhD Center for Congenital Heart Disease Amsterdam-Leiden s/c PO Box 9600 2300 RC Leiden The Netherlands e-mail: [email protected].
References 1. Naito Y, Fujiwara K, Komai H, Uemura S. Midterm results after ventricular septation for double-inlet left ventricle in early infancy. Ann Thorac Surg 2001;71:1344– 6. 2. Bogers AJJC, Quaegebeur JM, Ottenkamp J, Hess J, Bos E. A modification of staged septation for univentricular atrioventricular connection. J Thorac Cardiovasc Surg 1992;104:204 –5.
Ave Sina was an Islamic Physician To the Editor: I am writing in response to the article by Dr Batirel [1] concerning early Islamic physicians. I do not agree with Dr Batirel that Ave Sina was a Turkish physician. I am obliged to draw the readers’ attention to certain facts about this outstanding Iranian philosopher, scientist, doctor, and musician. Ave Sina (980 –1039) was born in Xarmaysan, near Bokhara, a © 2002 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
CORRESPONDENCE
699
city in Iran that was occupied by Russian forces in the war between Iran and Russia and became a part of the Soviet Union. Since the fall of the former Soviet Union, it is now part of Ozbakestan [2]. Ave Sina’s teacher in logic, philosophy, medicine, and mathematics was Abuabdollah Natelee. His success in treating Nooh, a king of Samanid, brought Ave Sina a nationwide reputation and allowed him to use the royal library and its resources [2]. He was then 22 years old when he went to Gorgan and wrote canon in medicine. Later he moved to Shahre-e-ray, Gazvin, and Hamadan. He died in Hamadan and was buried there. One of Ave Sina’s masterpieces, shafa (in law) is considered to be an enyclopedia of philosophy [3, 4]. He also wrote books in physics, astrology, personal hygiene, and child education. Most of Ave Sina’s 125 books are written in Arabic and only a few of them are written in Farsi. Ave Sina, like other Iranian scientists, wrote his books in Arabic simply because Arabic was the official language in Iran at that time. To avoid any misunderstanding to your readers, I would appreciate your publication of this letter. Feridoun Sabzi, MD Emam Ali Heart Center Kermanshah University of Medical Sciences Shahid Beheshti Ave Kermanshah, Iran
References 1. Batirel HF. Early Islamic physicians and thorax. Ann Thorac Surg 1999;67:578– 8. 2. Atkin M. Russian and Iran, 1st ed. University of Mimn Press, 1980:178 –1828. 3. Mosaheb GH. Dairatol-Maaref Farsi, 1st ed. Tehran, offset. 1996:32. 4. Gwinn RP. Encyclopedia Britanica, 1st edition. Chicago: Encyclopedia Britanica Inc, 1990:739.
Cardiac Hydatid Cysts To the Editor: We read with interest the recent article by Kaplan and colleagues [1] on cardiac hydatid cysts (HC) with intracavitary expansion. The authors reported their 10-year surgical experience with 8 cardiac HC patients; another 12 patients with pericardial HCs were excluded from this study of intracardiac hydatid cysts. Ninety-eight percent of pericardial HCs originate from myocardial HC rupture into the pericardium [2]. In a few patients, it may occur secondary to lung or liver echinococcosis with pericardial extension [3]. There have been so few reports of isolated pericardial involvement [2] that it would be of particular interest to know whether any of Kaplan and associates’ 12 patients had isolated pericardial disease, or whether their management was unique. We agree with the authors’ conclusion that the presence of viable Echinococcus is an indication for surgery, but preoperative diagnosis of live HCs remains problematic. Small, totally calcified, asymptomatic HCs in an elderly patient with negative serology for hydatid disease and no impedance of hemodynamics or cardiac blood supply has thus far been considered an indication for follow-up only [4]. Kaplan and colleagues’ patients were all symptomatic, making surgery the only option. To prevent contamination, the surrounding area was wrapped with compression gauze and the cystic fluid was aspirated. Soaking of 0003-4975/02/$22.00