HighlightsLipoma is the most frequent soft tissue tumor in adults.Its occurrence in the retroperitoneal region is extremely rare.It presents with various clinical scenarios.We present a case of retroperitoneal lipoma with a brief literature review.

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Introduction: The combination of mitral valve replacement (MVR) with coronary artery bypass grafting (CABG) is generally thought to have a greater early and late mortality than either procedure alone. The aim of this study is to review single center experience for the concomitant MVR and CABG. Patients and methods: This is a single center, retrospective, single cohort study, composes of consecutive cases. It included all the cases of combined operation of MVR and CABG. The patients were followed up for a median duration of two years (six months to four years). The data were collected from hospital records and registers of hospital statistics. The followings were obtained; socio-demographic data, information regarding clinical courses, intraoperative findings, and post-operative follow up data. Result: The study included 72 cases, the mean age was 56 years, 38 of them (53%) were males and 34 (47%) were female. The most common comorbidity was hypertension which was found in 24 patients (33%). The mean preoperative ejection fraction was 59%. Twenty-two patients (30.6%) had single graft, 21 patients (29.2%) underwent 3-vessel grafting, 16 patients (22.2%) had 2-vessel grafting, and 13 cases (18.1%) underwent 4-vessel grafting. The CPB duration ranged from 108 to 280 min with a mean of 182 min and cross-clamp time ranged from 80 to 186 min with a mean of 122 min. The most common complication was plural effusion which occurred in 8 cases (11.1%) and managed by aspiration. Overall mortality was 8.3% (4 patients). Conclusion: CABG and chordal-sparing and posterior leaflet replacement has favorable outcome, as well as minimizes the need of redo surgery as in repair.one of the best options for CAD and sever MR. Highlights

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Introduction: Co-presentation with both coronary and valve diseases is increasing as the age of the individuals referred for coronary artery intervention rises. The study aims to report a single center experience in combined coronary artery bypass grafting and aortic valve replacement (CABG-AVR). Methods: This is a retrospective study from January 2014 till January 2019 in a single center. Inclusion criteria included those patients that underwent combined coronary and aortic valve procedure in a single operation. The data were collected from the hospital registry. All patients underwent preoperative coronary angiography, transthoracic echocardiography (TTE), Doppler study was performed for those patients with previous stroke and peripheral vascular diseases. The cases were followed up for a mean duration of 2 years. Result: The study included 62 patients, 38 of them were males, the mean age was 57 years. Prosthetic mechanical valves were inserted in all of the cases, left internal mammary artery (LIMA) was harvested in all the cases, 24 patients (38.7%) had single graft, 26 cases (41.9%) two grafts, and 12 (19.3) had three grafts. The mean cross clamp time was 148.9 min and mean cardiopulmonary bypass (CPB) time was 187 min. The overall mortality rate was 6.4% (4 patients). Conclusion: With maximum myocardial protection and minimum cross clamp and CPB time and meticulous technique, the outcome of combined CABG-AVR is comparable with isolated CABG or isolated AVR. Highlights: