Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery最新文献

Background: This study aims to investigate the effects of Panax ginseng (P. ginseng) on intimal hyperplasia following intimal injury induced in the abdominal aortas of rats.

Methods: Twenty-four Wistar Albino rats were divided into four equal groups. Group A was designated as the control group and underwent laparotomy alone. In Group B, following laparotomy, the abdominal aorta was partially transected, and intimal injury was induced proximally using a 2F Fogarty catheter. Groups C and D received 20 mg/kg and 40 mg/kg of P. ginseng, respectively, and both groups underwent the same procedure as Group B. Two samples were collected from all rats with aortic injury: one from the primarily repaired aortic segment and another from the aortic segment with intimal injury caused by a Fogarty catheter. One sample was collected from the control group. The intima and media thicknesses of the collected aortic samples were histopathologically evaluated.

Results: No significant intimal hyperplasia was observed in the primarily repaired aortic segments, and P. ginseng did not have significant effect in these segments (p=0.394 and p=0.580, p=0.180, p>0.05). However, significant intimal hyperplasia developed in the aortic segments with injury induced by the Fogarty catheter (p=0.012, p<0.05). High-dose P. ginseng (40 mg/kg) significantly reduced intimal hyperplasia in these segments (p=0.036, p<0.05), while the low dose (20 mg/kg) did not show statistically significant effect (p=1.000, p>0.05).

Conclusion: Our study results showed that P. ginseng reduced intimal hyperplasia in a dose-dependent manner in rat abdominal aortas.

Background: This study aims to evaluate the long-term outcomes of patients undergoing right ventricle-to-pulmonary artery reconstruction with valved homografts.

Methods: A total of 106 patients (49 males, 57 females; median age: 5 years; range, 2 to 49 years) who underwent right ventricle-to-pulmonary artery reconstruction between January 2002 and January 2024 were retrospectively analyzed. The study utilized cryopreserved homografts and surgical procedures were conducted under moderate hypothermic conditions using cardiopulmonary bypass. Homograft failure was defined as the need for reintervention or replacement. The primary outcome measures were overall survival, freedom from conduit replacement rate, and freedom from any required reinterventions rate.

Results: The median follow-up was 7 years. The overall survival rate was 92.5%, with early mortality primarily due to low cardiac output. Freedom from reintervention rates were 90.8%, 84.8%, and 76.3% at three, five, and 10 years, respectively. Thirteen patients required conduit replacement, with pulmonary homografts showing improved durability. Risk factors for homograft failure included pulmonary valve regurgitation treatment, lower patient weight, younger age, and female sex.

Conclusion: This study highlights the excellent survival and durability of valved homografts in cardiac reconstruction, with implications for patient management and surgical decision-making in complex congenital heart disease procedures.

Retroperitoneal paragangliomas are neuroendocrine tumors originating from chromaffin cells in the sympathetic nerves. These tumors are commonly located around the abdominal aorta and inferior vena cava and can cause significant bleeding during surgery due to their hypervascular nature. In such cases, preoperative selective embolization can facilitate tumor resection and reduce both morbidity and mortality. This case report presented a 38-year-old male patient with a retroperitoneal paraganglioma who underwent surgery following preoperative embolization due to tumor hypervascularity.

Endovascular treatment methods are often preferred in suitable patients with complicated acute type B aortic dissection due to the high mortality and morbidity associated with the open surgical procedure. Retrograde aortic dissection is a rare complication of endovascular procedures. Herein, we reported surgical treatment of a retrograde aortic dissection that developed after thoracic endovascular aortic repair in a 53-year-old male patient with a history of liver transplantation two years ago and taking immunosuppressive medication.

Background: The aim of this study is to identify risk factors for recurrence of hemoptysis after bronchial artery embolization and to evaluate patient feedbacks on this intervention.

Methods: Between August 2013 and October 2022, a total of 122 patients (83 males, 39 females; mean age: 59.7±17.3 years; range, 13 to 91 years) who underwent bronchial artery embolization were retrospectively analyzed. The endpoint event was hemoptysis recurrence or death. Baseline data of the patients, technical and clinical success rates, complications, postoperative recovery time in hospital and patient satisfaction and re-acceptance rates were evaluated via a questionnaire.

Results: During follow-up, 24 patients died. A total of 50 patients experienced recurrence, and the overall recurrence rate was 40.98%. Patients with embolization of single culprit artery had a higher recurrence-free survival rate (p=0.049). Of 97 respondents, 81 were satisfied with the result of the procedure and 84 gave consent for re-intervention, if necessary.

Conclusion: Bronchial artery embolization is a safe and effective method of hemoptysis suppression, particularly for those with embolization of single culprit artery. Better suppression of hemoptysis and strengthening communication with patients in the perioperative period can improve the patient satisfaction.

Background: In this review, we discuss the risk factors of intraabdominal hypertension developing after cardiac surgery.

Methods: We used records from electronic databases (PubMed, Scopus, Web of Science and Ovid) between 1980 and 2025. All studies in which possible pre- and intraoperative risk factors (age, sex, hypertension, diabetes mellitus, lung disease, coronary artery bypass grafting, body mass index and, cardiopulmonary bypass duration) were recorded were included in the analysis. The results of the studies were evaluated with a random or fixed effect model depending on the presence of heterogeneity (I² >25%).

Results: A total of 4,286 articles were found from the database search. After analyzing the abstract and full texts, six articles which met the inclusion criteria and covered 696 patients were included in the analysis. The overall rate of intraabdominal hypertension was 44.68%. Age (standardized mean difference [SMD]: 0.303, 95% confidence interval [CI]: 0.123-0.484, p<0.001), hypertension (odds ratio [OR]=0.524, 95% CI: 0.087-0.960, p=0.019), body mass index (SMD: 0.532, 95% CI: 0.004-1.061, p=0.048), and cardiopulmonary bypass duration (SMD: 0.545, 95% CI: 0.184-0.907, p=0.003) were preoperative risk factors.

Conclusion: The patient's age, hypertension, body mass index, and duration of cardiopulmonary bypass are the risk factors for the development of intraabdominal hypertension after cardiac surgery. However, larger studies are needed to avoid heterogeneity of results.

An aortic pseudoaneurysm is a rare, but serious condition which can result in life-threatening complications. It is usually caused by previous cardiac surgery, trauma, or infection. Due to the high likelihood of rupture with primary surgical intervention, endovascular closure may be performed as the standard of care in eligible cases. In this article, we present a case of a huge aortic pseudoaneurysm with a wide neck which could safely be closed using an atrial septal occluder.

Background: This study aims to evaluate the mid-term outcomes of transcatheter ventricular septal defect closure with the Konar-MF™ device and to investigate the impact of an optimized device selection strategy using a retrograde approach.

Methods: Between January 2019 and November 2023, a total of 58 patients (32 males, 26 females; median age: 4.5 years; range, 8 months to 16 years) who underwent transcatheter closure of ventricular septal defects using the Konar-MF™ device were retrospectively analyzed. Patient demographics, procedural details, and follow-up data were recorded.

Results: Procedural success was achieved in 95% of cases, with a median procedure time of 60 min and fluoroscopy time of 12.6 min. Retrograde implantation was used in 79% of patients, significantly reducing procedural time and minimizing complications associated with an arteriovenous loop. Our refined strategy of selecting smaller devices when anatomically feasible played a crucial role in reducing interference with surrounding cardiac structures, substantially contributing to the absence of complete atrioventricular block in our cohort. Major complications included device embolization, moderate aortic regurgitation due to device dislocation, and right ventricular perforation (each in 1.8% of patients). The median follow-up was 34.5 months. Residual shunt rates were initially 42% on postoperative Day 1, reducing to 1.8% by the end of the follow-up period.

Conclusion: The Konar-MF™ occluder demonstrated high procedural success and acceptable complication rates for perimembranous ventricular septal defect closure. The use of a retrograde approach and a refined device selection strategy were key factors in achieving favorable outcomes, minimizing complications such as atrioventricular block and valve interference. The device offers significant advantages, making it a suitable alternative to surgical ventricular septal defect closure.