Background & Objectives:�Aortic coarctation occurs in 6 to 8% of patients with congenital heart disease. It is the fourth most prevalent heart disease which requires catheterization and surgical involvement in the early years of life. If surgical repair is not conducted on-time, it can lead to heart failure (HF) and death. That is why we decided to study this disease in shahid Madani hospital, Tabriz.

Methods:�53 patients with aortic coarctation who underwent surgery from early 1999 to late 2003 in Tabriz Shahid Madani Research and Health center were studied retrospectively. 

Results: 88% of the cases were diagnosed during routine examinations. The most frequent complaints of the patients were palpitation (45%) and exertional dyspnea (41%), and the most important signs were systolic ejection murmur in 96%, weakness of lower limbs pulses in 86% and hypertension in 45%. In ECG, 96% of the patients had LVH and in CXR, 45% had cardiomegaly. In angiography, 100% of the patients had apparent aortic coarctation, which in 14 this was associated with Patent Ductus Arteriosus (PDA) In other 15 cases, PDA was not reported in angiography but was discovered during operation. The most common surgeries were resection, end-to-end anastomosis (43%) and Dacron patch angioplasty (39%). In both methods the pressure graradient decreased to under 10 mmHg in the site of anastomosis and the late complications in the patch method was more than the other one.

Conclusion:�The diagnosis of this disease had been delayed in these patients because of imprecise examination of all four limbs' pulses at the first examination of the patients, the patients' own ignorance, misdiagnosis, mismanagement and symptomatic therapy. In spite of PDA and low blood pressure in coarc region, these patients did not have severe pulmonary hypertension. Resection and end-to-end anastomosis is associated with less common late complications and if conducted in early ages, it can lead to complete recovery.

Ulnar nerve involvement is the second most common local mononeuropathy. The ulnar nerve consists of motor and sensory fibers that arise in C₈-T₁ roots and extends to the lower trunk and medial cord of brachial plexus. Manifestations of this nerve involvement range from elbow pain and intermittent hand paresthesia to marked sensory loss, wasting and weakness  of hand muscles and a claw hand. Ulnar nerve lesion in the elbow region commonly follows surgery in which general anesthesia is used (particularly in patients with coronary artery bypass graft surgery). The patient presented in this article was a 56-year-old male who was involved in left ulnar nerve lesion after undergoing coronary artery bypass graft. In electrodiagnostic study we noticed diffused demyelination lesion of the ulnar nerve with dominancy in elbow region along with secondary axonal degeneration. Therefore, suitable positioning of elbow is recommended to avoid the  nervous complications of these operations.

  Background & Objectives: Neurofibromatosis is a congenital disorder with different kinds of disabling manifestations. There are several types of operations for these manifestations with relative improvement. This study set out to determine age, sex, clinical manifestations and evaluate methods of treatment of these patients.

  Methods: This descriptive, cross-sectional study was conducted through studying the hospital records of patients who had previously undergone surgery. 45 patients with neurofibromatosis who were hospitalized and operated in surgical ward of Firoozgar and orthopedic ward of Shafa hospital from 1995 to 1998 were studied in terms of clinical manifestations and treatment methods. Patients with central nervous system involvement were excluded from the study.

  Results: 55% of the subjects were male and the rest of them were female. Most of the patients were in the second decade of their life. Skeletal abnormalities were seen in 35 patients (77.77%) and 16 patients (35.55%) were suffering from scoliosis which was the most common complication of this disease. With respect to the progression of the disease, brace was used in 2 patients, which led to their improvement. In 13 patients Horington Rod implantation was used, three cases of which developed scoliosis, who underwent surgical vertebral fusion. Pseudoarthrosis was seen in 8 patients (17/77%). Bone graft and plate were used in their operation. In five cases with pseudoarthrosis in lower limbs no ::union:: occurred. Two patients died with malignant shwanoma.

  Conclusion: scoliosis is the most common manifestation of neurofibromatosis which can improve in early stages with surgical treatment but pseudoarthrosis in lower limbs has not improved with bone graft and plate. Operation with pediculated fibula resulted in the improvement of this complication. Surgical intervention would be more effective in the early stages of the disease. 2 of thses 5 cases were reoperated with pediculated fibula graft and 3 others were amputated.