Pub Date : 2024-07-23eCollection Date: 2024-07-01DOI: 10.5606/tgkdc.dergisi.2024.26103
İsa Civelek, Ayla Ece Çelikten, Hamdi Mehmet Özbek, Bekir Boğaçhan Akkaya, Anıl Özen, Ertekin Utku Unal, Cemal Levent Birincioğlu
Background: This study aims to investigate the incidence, prognosis, and etiology of diaphragmatic elevation following cardiac surgery.
Methods: Between February 2019 and December 2019, a total of 888 patients (631 males, 257 females; mean age: 58.4±12.1 years; range, 19 to 84 years) who underwent cardiac surgery were retrospectively analyzed. A series of chest X-rays taken before and after surgery were analyzed to detect diaphragmatic elevation. The patients were divided into two groups: those without diaphragmatic elevation (Group 1, n=789) and those with diaphragmatic elevation (Group 2, n=99).
Results: Diaphragmatic elevation occurred in 11.14% of patients. Of these patients, 85% recovered within a year. Patients with concomitant chronic obstructive pulmonary disease and diaphragmatic elevation exhibited prolonged mechanical ventilation compared to chronic obstructive pulmonary disease patients without elevation. The incidence of diaphragmatic elevation was higher in coronary artery bypass grafting patients compared to others (p<0.001). A secondary analysis utilizing propensity score matching revealed topical cold slush as an independent risk factor for diaphragmatic elevation. Incidence and hospitalization duration were higher among patients exposed to topical cold slush (p=0.011 and p=0.002, respectively). Left internal mammary artery harvesting and diabetes mellitus were associated with increased incidence of diaphragmatic elevation.
Conclusion: Diaphragmatic elevation is frequent following cardiac surgery, particularly in coronary artery bypass grafting patients with diabetes mellitus. Among chronic obstructive pulmonary disease patients, diaphragmatic elevation can lead to unfavorable clinical outcomes. Minimizing the use of topical cold slush and considering beating heart surgery may be prudent in high-risk groups to reduce diaphragmatic elevation incidence.
背景:本研究旨在探讨心脏手术后膈肌抬高的发生率、预后和病因:本研究旨在探讨心脏手术后膈肌抬高的发生率、预后和病因:回顾性分析2019年2月至2019年12月期间接受心脏手术的888例患者(男631例,女257例;平均年龄:58.4±12.1岁;范围:19至84岁)。分析了手术前后拍摄的一系列胸部 X 光片,以检测膈肌是否隆起。患者被分为两组:无膈肌抬高组(第1组,人数=789)和有膈肌抬高组(第2组,人数=99):结果:11.14%的患者出现膈肌抬高。结果:11.14%的患者出现膈肌抬高,其中85%的患者在一年内痊愈。与没有膈肌抬高的慢性阻塞性肺病患者相比,同时患有慢性阻塞性肺病和膈肌抬高的患者机械通气时间更长。与其他患者相比,冠状动脉旁路移植术患者的膈肌抬高发生率更高(p结论:膈肌抬高在心脏手术后很常见,尤其是在冠状动脉旁路移植术患者和糖尿病患者中。在慢性阻塞性肺病患者中,膈肌抬高可导致不利的临床结果。在高危人群中,尽量减少使用局部冷敷液和考虑心脏跳动手术可能是降低膈肌抬高发生率的明智之举。
{"title":"Diaphragmatic elevations following cardiac surgery.","authors":"İsa Civelek, Ayla Ece Çelikten, Hamdi Mehmet Özbek, Bekir Boğaçhan Akkaya, Anıl Özen, Ertekin Utku Unal, Cemal Levent Birincioğlu","doi":"10.5606/tgkdc.dergisi.2024.26103","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26103","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the incidence, prognosis, and etiology of diaphragmatic elevation following cardiac surgery.</p><p><strong>Methods: </strong>Between February 2019 and December 2019, a total of 888 patients (631 males, 257 females; mean age: 58.4±12.1 years; range, 19 to 84 years) who underwent cardiac surgery were retrospectively analyzed. A series of chest X-rays taken before and after surgery were analyzed to detect diaphragmatic elevation. The patients were divided into two groups: those without diaphragmatic elevation (Group 1, n=789) and those with diaphragmatic elevation (Group 2, n=99).</p><p><strong>Results: </strong>Diaphragmatic elevation occurred in 11.14% of patients. Of these patients, 85% recovered within a year. Patients with concomitant chronic obstructive pulmonary disease and diaphragmatic elevation exhibited prolonged mechanical ventilation compared to chronic obstructive pulmonary disease patients without elevation. The incidence of diaphragmatic elevation was higher in coronary artery bypass grafting patients compared to others (p<0.001). A secondary analysis utilizing propensity score matching revealed topical cold slush as an independent risk factor for diaphragmatic elevation. Incidence and hospitalization duration were higher among patients exposed to topical cold slush (p=0.011 and p=0.002, respectively). Left internal mammary artery harvesting and diabetes mellitus were associated with increased incidence of diaphragmatic elevation.</p><p><strong>Conclusion: </strong>Diaphragmatic elevation is frequent following cardiac surgery, particularly in coronary artery bypass grafting patients with diabetes mellitus. Among chronic obstructive pulmonary disease patients, diaphragmatic elevation can lead to unfavorable clinical outcomes. Minimizing the use of topical cold slush and considering beating heart surgery may be prudent in high-risk groups to reduce diaphragmatic elevation incidence.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"271-279"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23eCollection Date: 2024-07-01DOI: 10.5606/tgkdc.dergisi.2024.26340
Ignazio Condello
Background: This study aimed to explore the evolution and impact of smart cannulas in enhancing outcomes and expanding the scope of minimally invasive cardiac surgery.
Methods: In this study, a comprehensive review of the relevant literature was conducted, focusing on articles detailing the development, implementation, and outcomes associated with smart cannulas in cardiac surgery. PubMed, MEDLINE, and Google Scholar databases were searched until January 2024 using specific search terms related to smart cannulas and cardiac surgery. The review identified six studies, of which five met the inclusion criteria after screening titles and abstracts.
Results: Key findings included improved venous drainage, reduced complications, and enhanced surgical precision. From early prototypes to contemporary designs, smart cannulas demonstrated improved access, enhanced perfusion, and reduced complications compared to traditional cannulation methods. Additionally, advancements in technology-enabled remote access perfusion and facilitated complex procedures in pediatric and adult populations.
Conclusion: Smart cannulas represent a significant advancement in cardiac surgery, offering safer and more efficient alternatives to conventional cannulation techniques. The versatility and effectiveness of smart cannulas have paved the way for expanding the applications of minimally invasive cardiac surgery, ultimately benefiting patients through better improved outcomes and reduced morbidity. Continued research and innovation in smart cannula technology promise further enhancements in the field of cardiac surgery.
背景本研究旨在探讨智能插管在提高微创心脏手术效果和扩大微创心脏手术范围方面的演变和影响:本研究对相关文献进行了全面综述,重点是详细介绍心脏手术中智能插管的开发、实施和相关结果的文章。使用与智能插管和心脏手术相关的特定检索词对 PubMed、MEDLINE 和 Google Scholar 数据库进行了检索,直至 2024 年 1 月。综述确定了六项研究,经筛选标题和摘要后,其中五项符合纳入标准:主要发现包括改善静脉引流、减少并发症和提高手术精确度。与传统插管方法相比,从早期原型到现代设计,智能插管都能改善通路、加强灌注并减少并发症。此外,技术的进步还实现了远程入路灌注,为儿童和成人的复杂手术提供了便利:智能插管代表了心脏手术的一大进步,为传统插管技术提供了更安全、更高效的替代方案。智能插管的多功能性和有效性为扩大微创心脏手术的应用范围铺平了道路,最终通过更好地改善预后和降低发病率使患者受益。智能插管技术的持续研究和创新有望进一步提升心脏外科领域的水平。
{"title":"A narrative review on the evolution and impact of smart cannulas in minimally invasive procedures.","authors":"Ignazio Condello","doi":"10.5606/tgkdc.dergisi.2024.26340","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26340","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the evolution and impact of smart cannulas in enhancing outcomes and expanding the scope of minimally invasive cardiac surgery.</p><p><strong>Methods: </strong>In this study, a comprehensive review of the relevant literature was conducted, focusing on articles detailing the development, implementation, and outcomes associated with smart cannulas in cardiac surgery. PubMed, MEDLINE, and Google Scholar databases were searched until January 2024 using specific search terms related to smart cannulas and cardiac surgery. The review identified six studies, of which five met the inclusion criteria after screening titles and abstracts.</p><p><strong>Results: </strong>Key findings included improved venous drainage, reduced complications, and enhanced surgical precision. From early prototypes to contemporary designs, smart cannulas demonstrated improved access, enhanced perfusion, and reduced complications compared to traditional cannulation methods. Additionally, advancements in technology-enabled remote access perfusion and facilitated complex procedures in pediatric and adult populations.</p><p><strong>Conclusion: </strong>Smart cannulas represent a significant advancement in cardiac surgery, offering safer and more efficient alternatives to conventional cannulation techniques. The versatility and effectiveness of smart cannulas have paved the way for expanding the applications of minimally invasive cardiac surgery, ultimately benefiting patients through better improved outcomes and reduced morbidity. Continued research and innovation in smart cannula technology promise further enhancements in the field of cardiac surgery.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"350-353"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25891
Koray Aydoğdu, Mehmet Çetin, Emre Yılmaz, Şevki Mustafa Demiröz, İlteriş Türk, Funda İncekara, Ali Alagöz, Göktürk Fındık
Background: This study aimed to analyze our video-assisted thoracic surgery (VATS) experience in the surgical treatment of bronchiectasis and the reasons limiting VATS application.
Methods: Two hundred one patients (106 males, 95 females; mean age: 39.7±14.1 years; range, 12 to 68 years) who underwent surgical treatment for bronchiectasis between January 2012 and October 2021 were included in the retrospective study. Three groups were created based on the surgical technique used: VATS, thoracotomy, and patients who were converted from VATS to thoracotomy.
Results: The most significant presenting symptoms were cough (43%) and excessive sputum expectoration (40%). Surgical intervention was applied to the left side of 60% of the patients, and the most common resection performed in all three groups was left lower lobectomy. The rate of conversion from VATS to thoracotomy was 28.8%, and it was found that dense pleural adhesions were the most common reason. Revision surgery was performed on a total of 11 (5.47%) patients. The frequency of revision surgery did not differ significantly among the three groups (p=0.943). The most common postoperative complication was prolonged air leakage. There was no statistically significant difference in postoperative complication rates among the groups (p=0.417). The rate of surgical treatment of bronchiectasis with VATS was observed to have increased from 11.1% to 77.7% in our clinic.
Conclusion: In experienced hands, VATS can be safely applied in the surgical treatment of bronchiectasis.
{"title":"Analysis of bronchiectasis patients who underwent video-assisted thoracoscopic surgery in a tertiary thoracic surgery center: Ten years of experience.","authors":"Koray Aydoğdu, Mehmet Çetin, Emre Yılmaz, Şevki Mustafa Demiröz, İlteriş Türk, Funda İncekara, Ali Alagöz, Göktürk Fındık","doi":"10.5606/tgkdc.dergisi.2024.25891","DOIUrl":"10.5606/tgkdc.dergisi.2024.25891","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze our video-assisted thoracic surgery (VATS) experience in the surgical treatment of bronchiectasis and the reasons limiting VATS application.</p><p><strong>Methods: </strong>Two hundred one patients (106 males, 95 females; mean age: 39.7±14.1 years; range, 12 to 68 years) who underwent surgical treatment for bronchiectasis between January 2012 and October 2021 were included in the retrospective study. Three groups were created based on the surgical technique used: VATS, thoracotomy, and patients who were converted from VATS to thoracotomy.</p><p><strong>Results: </strong>The most significant presenting symptoms were cough (43%) and excessive sputum expectoration (40%). Surgical intervention was applied to the left side of 60% of the patients, and the most common resection performed in all three groups was left lower lobectomy. The rate of conversion from VATS to thoracotomy was 28.8%, and it was found that dense pleural adhesions were the most common reason. Revision surgery was performed on a total of 11 (5.47%) patients. The frequency of revision surgery did not differ significantly among the three groups (p=0.943). The most common postoperative complication was prolonged air leakage. There was no statistically significant difference in postoperative complication rates among the groups (p=0.417). The rate of surgical treatment of bronchiectasis with VATS was observed to have increased from 11.1% to 77.7% in our clinic.</p><p><strong>Conclusion: </strong>In experienced hands, VATS can be safely applied in the surgical treatment of bronchiectasis.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"202-211"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25700
Busra Tok Cekmecelioglu, Peter Legeza, Pooja Tekula, Martin Giesecke, Charudatta S Bavare, Zsolt Garami, Alan Lumsden
Background: This study aimed to assess intraoperative cerebral hemodynamic responses and embolic events during transcarotid artery revascularization via transcranial Doppler, near-infrared spectroscopy, and bispectral index monitoring.
Methods: Twelve patients (7 males, 5 females; mean age: 72.8±9.0 years; range, 63 to 91 years) undergoing transcarotid artery revascularization with simultaneous transcranial Doppler, near-infrared spectroscopy, and bispectral index monitoring were analyzed in this retrospective study between September 2017 and December 2019. The mean flow velocity and pulsatility index of the middle cerebral artery, alongside near-infrared spectroscopy and bispectral index values, before flow reversal, during flow reversal, and after flow reversal phases were investigated. The presence and frequency of high-intensity transient signals were recorded to evaluate embolic incidents.
Results: Significant reductions in middle cerebral artery mean flow velocity were noted during flow reversal (40.58±10.57 cm/sec to 20.58±14.34 cm/sec, p=0.0004), which subsequently returned to and exceeded baseline values after flow reversal cessation (53.33±17.69 cm/sec, p=0.0005). Near-infrared spectroscopy (71±4.4% to 66±6.2%) and bispectral index (45.71±8.5 to 40.14±8.1) values mirrored these hemodynamic changes, with notable decreases during flow reversal, and recoveries after flow reversal. The highest concentration of high-intensity transient signals was observed during stent deployment, signifying a critical embolic phase. No perioperative neurological complications or other significant adverse events were documented.
Conclusion: Transcranial Doppler, near-infrared spectroscopy, and bispectral index effectively monitor cerebral hemodynamics and embolic potential during transcarotid artery revascularization, providing real-time data crucial for optimizing perioperative management. These findings underscore the clinical value of multimodal monitoring in improving patient outcomes in transcarotid artery revascularization procedures.
{"title":"The intracranial effects of flow reversal during transcarotid artery revascularization.","authors":"Busra Tok Cekmecelioglu, Peter Legeza, Pooja Tekula, Martin Giesecke, Charudatta S Bavare, Zsolt Garami, Alan Lumsden","doi":"10.5606/tgkdc.dergisi.2024.25700","DOIUrl":"10.5606/tgkdc.dergisi.2024.25700","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess intraoperative cerebral hemodynamic responses and embolic events during transcarotid artery revascularization via transcranial Doppler, near-infrared spectroscopy, and bispectral index monitoring.</p><p><strong>Methods: </strong>Twelve patients (7 males, 5 females; mean age: 72.8±9.0 years; range, 63 to 91 years) undergoing transcarotid artery revascularization with simultaneous transcranial Doppler, near-infrared spectroscopy, and bispectral index monitoring were analyzed in this retrospective study between September 2017 and December 2019. The mean flow velocity and pulsatility index of the middle cerebral artery, alongside near-infrared spectroscopy and bispectral index values, before flow reversal, during flow reversal, and after flow reversal phases were investigated. The presence and frequency of high-intensity transient signals were recorded to evaluate embolic incidents.</p><p><strong>Results: </strong>Significant reductions in middle cerebral artery mean flow velocity were noted during flow reversal (40.58±10.57 cm/sec to 20.58±14.34 cm/sec, p=0.0004), which subsequently returned to and exceeded baseline values after flow reversal cessation (53.33±17.69 cm/sec, p=0.0005). Near-infrared spectroscopy (71±4.4% to 66±6.2%) and bispectral index (45.71±8.5 to 40.14±8.1) values mirrored these hemodynamic changes, with notable decreases during flow reversal, and recoveries after flow reversal. The highest concentration of high-intensity transient signals was observed during stent deployment, signifying a critical embolic phase. No perioperative neurological complications or other significant adverse events were documented.</p><p><strong>Conclusion: </strong>Transcranial Doppler, near-infrared spectroscopy, and bispectral index effectively monitor cerebral hemodynamics and embolic potential during transcarotid artery revascularization, providing real-time data crucial for optimizing perioperative management. These findings underscore the clinical value of multimodal monitoring in improving patient outcomes in transcarotid artery revascularization procedures.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"123-131"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25724
Omer Topaloglu, Kubra Nur Kılıc, Sami Karapolat, Yener Aydın, Atila Turkyilmaz, Aysen Taslak Sengul, Atilla Eroglu, Ahmet Basoglu
Background: This study aims to assess the outcomes and prognosis of surgical interventions aimed at removing esophageal foreign bodies in patients with mental retardation.
Methods: Between January 2010 and January 2021, a total of 30 consecutive patients (20 males, 10 females; median age: 29.5 years; range, 2 to 57 years) with mental retardation who were diagnosed with esophageal foreign bodies and underwent surgical treatment were retrospectively analyzed. Age and sex of the patients, symptoms, type of the foreign body, esophageal stricture level, methods used for preoperative diagnosis, type of surgical procedure, postoperative complications, and length of hospital stay were recorded.
Results: Seventeen (56.6%) patients had a foreign body in the first narrowing, 12 (40%) in the second narrowing, and one (3.3%) in the third narrowing. A rigid esophagoscopy was performed in all cases. However, successful removal was not achieved in two (6.6%) cases, and foreign bodies were removed through cervical esophagotomy in one (3.3%) patient and through esophagotomy with right thoracotomy in one (3.3%) patient. Postoperative complications included esophagitis in seven patients (23.3%) and wound infection and pneumonia in two patients (6.6%). The median length of hospital stay after treatment was 1.09 days in patients without complications and 3.3 days in patients with complications. There was a significant correlation between the occurrence of complications and the length of hospital stay (p=0.002). The foreign body was successfully removed in all patients, and no mortality was observed.
Conclusion: Early diagnosis and emergency intervention can reduce complications, particularly considering the possibility of non-food and sharp-edged foreign bodies that pose a higher risk of damaging the digestive system, in patients with mental retardation than those without such conditions.
{"title":"Diagnosis, treatment, and management of esophageal foreign bodies in patients with mental retardation: A retrospective study from three centers.","authors":"Omer Topaloglu, Kubra Nur Kılıc, Sami Karapolat, Yener Aydın, Atila Turkyilmaz, Aysen Taslak Sengul, Atilla Eroglu, Ahmet Basoglu","doi":"10.5606/tgkdc.dergisi.2024.25724","DOIUrl":"10.5606/tgkdc.dergisi.2024.25724","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the outcomes and prognosis of surgical interventions aimed at removing esophageal foreign bodies in patients with mental retardation.</p><p><strong>Methods: </strong>Between January 2010 and January 2021, a total of 30 consecutive patients (20 males, 10 females; median age: 29.5 years; range, 2 to 57 years) with mental retardation who were diagnosed with esophageal foreign bodies and underwent surgical treatment were retrospectively analyzed. Age and sex of the patients, symptoms, type of the foreign body, esophageal stricture level, methods used for preoperative diagnosis, type of surgical procedure, postoperative complications, and length of hospital stay were recorded.</p><p><strong>Results: </strong>Seventeen (56.6%) patients had a foreign body in the first narrowing, 12 (40%) in the second narrowing, and one (3.3%) in the third narrowing. A rigid esophagoscopy was performed in all cases. However, successful removal was not achieved in two (6.6%) cases, and foreign bodies were removed through cervical esophagotomy in one (3.3%) patient and through esophagotomy with right thoracotomy in one (3.3%) patient. Postoperative complications included esophagitis in seven patients (23.3%) and wound infection and pneumonia in two patients (6.6%). The median length of hospital stay after treatment was 1.09 days in patients without complications and 3.3 days in patients with complications. There was a significant correlation between the occurrence of complications and the length of hospital stay (p=0.002). The foreign body was successfully removed in all patients, and no mortality was observed.</p><p><strong>Conclusion: </strong>Early diagnosis and emergency intervention can reduce complications, particularly considering the possibility of non-food and sharp-edged foreign bodies that pose a higher risk of damaging the digestive system, in patients with mental retardation than those without such conditions.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"179-184"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25961
Khaled Alebrahim
{"title":"Primary repair is the ideal strategy for the closure of a complete sternal cleft.","authors":"Khaled Alebrahim","doi":"10.5606/tgkdc.dergisi.2024.25961","DOIUrl":"10.5606/tgkdc.dergisi.2024.25961","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"243"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study aimed to compare patients in whom wide chest wall resection and reconstruction or primary closure was performed.
Methods: A total of 63 patients who underwent chest wall resection and reconstruction between January 2018 and December 2022 were included in the retrospective study. The patients were divided into two groups: the first group, which included 31 patients (14 males, 17 females; mean age: 44.6±16.4 years; range, 16 to 71 years) who were closed primarily, and the second group, constituting 32 patients (25 males, 7 females; mean age: 54.6±17.2 years; range, 9 to 80 years) who underwent reconstruction with plates and meshes.
Results: There was no significant difference between the two groups in terms of smoking and diabetes. Primary chest wall or metastatic tumor was determined in 33 patients; benign tumor and trauma were determined in 30 patients. The difference between the two groups in mean defect diameter (p=0.009), mean number of plates used (p<0.001), and mean hospital stay (p<0.001) was statistically significant. However, there was no significant difference in terms of complications (p=0.426).
Conclusion: Wide chest wall resection and reconstruction is a safe and feasible surgical procedure when compared with primary closure.
{"title":"Should wide chest wall resections and reconstruction intimidate thoracic surgeons?","authors":"Kuthan Kavaklı, Hakan Işık, Merve Şengül İnan, Ersin Sapmaz, Musab Yeniköy, Ufuk Ünsal, Denizhan Kılınç, Hasan Çaylak","doi":"10.5606/tgkdc.dergisi.2024.25804","DOIUrl":"10.5606/tgkdc.dergisi.2024.25804","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare patients in whom wide chest wall resection and reconstruction or primary closure was performed.</p><p><strong>Methods: </strong>A total of 63 patients who underwent chest wall resection and reconstruction between January 2018 and December 2022 were included in the retrospective study. The patients were divided into two groups: the first group, which included 31 patients (14 males, 17 females; mean age: 44.6±16.4 years; range, 16 to 71 years) who were closed primarily, and the second group, constituting 32 patients (25 males, 7 females; mean age: 54.6±17.2 years; range, 9 to 80 years) who underwent reconstruction with plates and meshes.</p><p><strong>Results: </strong>There was no significant difference between the two groups in terms of smoking and diabetes. Primary chest wall or metastatic tumor was determined in 33 patients; benign tumor and trauma were determined in 30 patients. The difference between the two groups in mean defect diameter (p=0.009), mean number of plates used (p<0.001), and mean hospital stay (p<0.001) was statistically significant. However, there was no significant difference in terms of complications (p=0.426).</p><p><strong>Conclusion: </strong>Wide chest wall resection and reconstruction is a safe and feasible surgical procedure when compared with primary closure.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"195-201"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25931
İbrahim Halil Demir, Murat Kardas, İlker Kemal Yucel, Rukiye İrem Yekeler, Mustafa Orhan Bulut, Emine Hekim Yılmaz, Murat Sürücü, Serdar Epçaçan, Ahmet Celebi
Background: This study aimed to investigate the safety and efficacy of transverse aortic arch stenting and evaluate the course of hypertension and the act of arch stenting on systemic hypertension.
Methods: The transverse aortic arch stenting procedures between January 2007 and May 2023 were retrospectively analyzed. Detailed procedure information, technical aspects, pressure measurements, angiographic data, balloons and stents used, complications, and immediate results were examined. Early and mid-term results were assessed.
Results: Eighteen patients (10 males and 8 females; mean age: 14.5±5.3 years; range, 4 to 23 years) were included in the study, all of whom were hypertensive before the procedure. The mean weight was 56.8±19.6 kg. In seven patients, the stent struts had to be dilated due to the stent causing jailing at the entrance of nearby arch vessels. After stenting, there was a significant increase in arch diameter and a decrease in ascending aorta pressure and the pressure gradient across the aorta. There were no early mortality or major complications. Late migration of the stent was observed in one patient. Three patients became normotensive immediately after the intervention, and five became drug-free during the follow-up. The requirement for dual antihypertensive therapy was significantly reduced.
Conclusion: Residual transverse arch lesions may contribute to the persistence of systemic hypertension after coarctation treatment. Transverse arch stent implantation can be performed safely with favorable outcomes, facilitating better blood pressure control. However, it should be noted that these patients remain at risk for lifelong hypertension and should be closely monitored in this regard.
{"title":"Transverse arch stenting and its effect on systemic hypertension.","authors":"İbrahim Halil Demir, Murat Kardas, İlker Kemal Yucel, Rukiye İrem Yekeler, Mustafa Orhan Bulut, Emine Hekim Yılmaz, Murat Sürücü, Serdar Epçaçan, Ahmet Celebi","doi":"10.5606/tgkdc.dergisi.2024.25931","DOIUrl":"10.5606/tgkdc.dergisi.2024.25931","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the safety and efficacy of transverse aortic arch stenting and evaluate the course of hypertension and the act of arch stenting on systemic hypertension.</p><p><strong>Methods: </strong>The transverse aortic arch stenting procedures between January 2007 and May 2023 were retrospectively analyzed. Detailed procedure information, technical aspects, pressure measurements, angiographic data, balloons and stents used, complications, and immediate results were examined. Early and mid-term results were assessed.</p><p><strong>Results: </strong>Eighteen patients (10 males and 8 females; mean age: 14.5±5.3 years; range, 4 to 23 years) were included in the study, all of whom were hypertensive before the procedure. The mean weight was 56.8±19.6 kg. In seven patients, the stent struts had to be dilated due to the stent causing jailing at the entrance of nearby arch vessels. After stenting, there was a significant increase in arch diameter and a decrease in ascending aorta pressure and the pressure gradient across the aorta. There were no early mortality or major complications. Late migration of the stent was observed in one patient. Three patients became normotensive immediately after the intervention, and five became drug-free during the follow-up. The requirement for dual antihypertensive therapy was significantly reduced.</p><p><strong>Conclusion: </strong>Residual transverse arch lesions may contribute to the persistence of systemic hypertension after coarctation treatment. Transverse arch stent implantation can be performed safely with favorable outcomes, facilitating better blood pressure control. However, it should be noted that these patients remain at risk for lifelong hypertension and should be closely monitored in this regard.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"151-161"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.24507
Igor Zivkovic, Petar Milacic, Zoran Tabakovic, Slobodan Micovic, Miroslav Milicic
Acute aortic root thrombosis is a potentially lethal condition due to the possibility of thrombosis into the ascending aorta branches, resulting in various clinical manifestations. A 29-year-old male patient was admitted to our center with hyperacute left main thrombosis after elective Bentall procedure. Due to massive left ventricular infarction, the patient was supported by extracorporeal membrane oxygenation, but without success to recovery. The patient's blood analyses revealed a high level of the Factor VIII. In conclusion, Factor VIII levels in the blood are elevated by genetic abnormalities, infectious diseases such as severe acute respiratory syndrome-coronavirus 2 infection, and vascular inflammation. This pathological condition may be a reason for hyperacute thrombosis.
急性主动脉根部血栓是一种潜在的致命疾病,因为血栓可能会进入升主动脉分支,从而导致各种临床表现。一名 29 岁的男性患者在接受本托尔(Bentall)择期手术后因超急性左主干血栓形成而入住本中心。由于左心室大面积梗死,患者接受了体外膜氧合,但未能成功康复。患者的血液分析显示因子 VIII 含量很高。总之,基因异常、感染性疾病(如严重急性呼吸系统综合征-冠状病毒 2 感染)和血管炎症会导致血液中因子 VIII 水平升高。这种病理情况可能是导致急性血栓形成的原因之一。
{"title":"Fatal hyperacute left main thrombosis after aortic root surgery.","authors":"Igor Zivkovic, Petar Milacic, Zoran Tabakovic, Slobodan Micovic, Miroslav Milicic","doi":"10.5606/tgkdc.dergisi.2024.24507","DOIUrl":"10.5606/tgkdc.dergisi.2024.24507","url":null,"abstract":"<p><p>Acute aortic root thrombosis is a potentially lethal condition due to the possibility of thrombosis into the ascending aorta branches, resulting in various clinical manifestations. A 29-year-old male patient was admitted to our center with hyperacute left main thrombosis after elective Bentall procedure. Due to massive left ventricular infarction, the patient was supported by extracorporeal membrane oxygenation, but without success to recovery. The patient's blood analyses revealed a high level of the Factor VIII. In conclusion, Factor VIII levels in the blood are elevated by genetic abnormalities, infectious diseases such as severe acute respiratory syndrome-coronavirus 2 infection, and vascular inflammation. This pathological condition may be a reason for hyperacute thrombosis.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"222-224"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30eCollection Date: 2024-04-01DOI: 10.5606/tgkdc.dergisi.2024.25584
Mustafa Mert Ozgur, Mehmet Aksut, Tanıl Ozer, Barış Gurel, İsmail Yerli, Mine Şimşek, Sabit Sarikaya, Kaan Kırali
Background: In this study, we shared our experience with the minimal invasive extracorporeal circulation system for coronary artery bypass grafting patients.
Methods: A total of 163 patients were included in the retrospective study, with 83 patients (63 males, 20 females; mean age: 61.9±8.9 years; range, 35 to 81 years) undergoing coronary artery bypass grafting with minimal invasive extracorporeal circulation and 80 patients (65 males, 15 females; mean age: 60.5±8.8 years; range, 43 to 82 years) undergoing coronary artery bypass grafting with conventional cardiopulmonary bypass between July 2021 and April 2023. Elective coronary bypass performed by same surgical team were included in the study. Mortality, major adverse cardiac and cerebrovascular event, hospital stays and transfusion requirements were evaluated.
Results: There were no significant differences in sex distribution, age, comorbidities, and blood values between the two groups. Intraoperatively, the minimal invasive extracorporeal circulation group had a slightly higher number of distal anastomoses and comparable times for aortic cross-clamp and cardiopulmonary bypass. Postoperative outcomes such as tamponade, bleeding, atrial fibrillation, left ventricular ejection fraction improvement or reduction, and postoperative drainage were similar between the two groups. However, the minimal invasive extracorporeal circulation group had fewer transfusions of packed red blood cells and fresh frozen plasma and a shorter length of stay in the intensive care unit.
Conclusion: The minimal invasive extracorporeal circulation system effectively preserves blood, works with lower activated clotting time values without additional complications in coronary artery bypass grafting, and could present a better option for patients with anemia or patients with a relatively high risk for high-dose heparinization.
{"title":"Comparison of minimal invasive extracorporeal circulation versus standard cardiopulmonary bypass systems on coronary artery bypass surgery.","authors":"Mustafa Mert Ozgur, Mehmet Aksut, Tanıl Ozer, Barış Gurel, İsmail Yerli, Mine Şimşek, Sabit Sarikaya, Kaan Kırali","doi":"10.5606/tgkdc.dergisi.2024.25584","DOIUrl":"10.5606/tgkdc.dergisi.2024.25584","url":null,"abstract":"<p><strong>Background: </strong>In this study, we shared our experience with the minimal invasive extracorporeal circulation system for coronary artery bypass grafting patients.</p><p><strong>Methods: </strong>A total of 163 patients were included in the retrospective study, with 83 patients (63 males, 20 females; mean age: 61.9±8.9 years; range, 35 to 81 years) undergoing coronary artery bypass grafting with minimal invasive extracorporeal circulation and 80 patients (65 males, 15 females; mean age: 60.5±8.8 years; range, 43 to 82 years) undergoing coronary artery bypass grafting with conventional cardiopulmonary bypass between July 2021 and April 2023. Elective coronary bypass performed by same surgical team were included in the study. Mortality, major adverse cardiac and cerebrovascular event, hospital stays and transfusion requirements were evaluated.</p><p><strong>Results: </strong>There were no significant differences in sex distribution, age, comorbidities, and blood values between the two groups. Intraoperatively, the minimal invasive extracorporeal circulation group had a slightly higher number of distal anastomoses and comparable times for aortic cross-clamp and cardiopulmonary bypass. Postoperative outcomes such as tamponade, bleeding, atrial fibrillation, left ventricular ejection fraction improvement or reduction, and postoperative drainage were similar between the two groups. However, the minimal invasive extracorporeal circulation group had fewer transfusions of packed red blood cells and fresh frozen plasma and a shorter length of stay in the intensive care unit.</p><p><strong>Conclusion: </strong>The minimal invasive extracorporeal circulation system effectively preserves blood, works with lower activated clotting time values without additional complications in coronary artery bypass grafting, and could present a better option for patients with anemia or patients with a relatively high risk for high-dose heparinization.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 2","pages":"141-150"},"PeriodicalIF":0.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11197417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}