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OBJECTIVE: The association between pre-operative carotid intima-media thickness (CIMT) and early postoperative acute kidney injury (AKI) following isolated coronary artery bypass grafting (CABG) was investigated. METHODS: Data were sought retrospectively of 237 patients (166 male, 71 female; mean age 61.4 ± 8.1 years; range: 32-74), operated on for isolated CABG with cardiopulmonary bypass (CPB) in a single centre between June 2014 and December 2020, with a serum creatinine level < 1.5 mg/dl and normal carotid arteries on Doppler ultrasonography. AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes 2012 Acute Kidney Injury Guideline. Patients were grouped as group 1 with AKI in the early postoperative period (n = 63) and group 2 without AKI ( n = 174). Univariate analyses were done to determine significant clinical factors, and subsequent multiple logistic regression analysis was done to determine independent predictors of AKI. RESULTS: AKI occurred in 63 (26.6%) patients. Pre-operative CIMT was significantly higher in the AKI group (p = 0.0001). Multivariate logistic regression analysis revealed that elevated pre-operative CIMT ( p = 0.005), C-reactive protein ( p = 0.001), erythrocyte sedimentation rate ( p = 0.005), neutrophil-lymphocyte ratio ( p = 0.0001) and platelet-lymphocyte ratio ( p = 0.0001) increased on the postoperative seventh day. C-reactive protein ( p = 0.04), postoperative first day platelet- lymphocyte ratio ( p = 0.0001), postoperative seventh day erythrocyte sedimentation rate ( p = 0.02) and intubation time ( p = 0.02) were independent predictors of early postoperative AKI following isolated CABG. CONCLUSIONS: Pre-operative CIMT was found to be an independent predictor of AKI in the early postoperative period of isolated CABG.
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Lesión Renal Aguda , Grosor Intima-Media Carotídeo , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Proteína C-Reactiva , Estudios Retrospectivos , Factores de Riesgo , Puente de Arteria Coronaria/efectos adversos , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Puente Cardiopulmonar/efectos adversosRESUMEN
BACKGROUND: Cardiac involvement of hydatid cyst disease (HCD) is a rare presentation but may lead to life-threatening complications such as cyst rupture and should be treated surgically. METHODS: A 10-year-old male patient with cranial and complicated cardiac HCD lesions that caused lower extremity peripheral arterial occlusion and aneurysmatic dilatation in the left ventricular apex is presented. RESULTS: Although the patient was in the pediatric age group, the Dor procedure was successfully applied to preserve the ventricular geometry. The Dor procedure for a ventricular aneurysm caused by a cardiac hydatid cyst (CHC) was rarely applied in the pediatric age group. CONCLUSION: In conclusion, this case differs from other CHCs previously reported in the literature due to the advanced stage of the disease, atypical clinical presentation, and rare complications despite the young age of the case. The surgical method used in treating the patient makes the subject more interesting.
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Equinococosis , Aneurisma Cardíaco , Masculino , Humanos , Niño , Equinococosis/complicaciones , Equinococosis/diagnóstico por imagen , Equinococosis/cirugía , Aneurisma Cardíaco/complicaciones , Aneurisma Cardíaco/diagnóstico por imagen , Aneurisma Cardíaco/cirugía , Ventrículos Cardíacos/cirugía , Miocardio , CorazónRESUMEN
Aim: The aim of the article was to study the role of the time between cardiac catheterization and cardiac surgery in the development of early postoperative acute kidney injury in patients who underwent isolated coronary artery bypass grafting was investigated. Material and methods: A total of 1196 patients (832 males, 364 females; mean age 60.8 ±8.2 years; range: 32-74 years) operated between November 2006 and June 2014 at the same centre and by the same team for isolated coronary artery bypass grafting with cardiopulmonary bypass, whose preoperative serum creatinine level was < 1.5 mg/dl, were enrolled in the study. Patients were divided into group 1 - with acute kidney injury in the early postoperative period (n = 207) and group 2 - without (n = 989). Univariate analyses were done to determine significant clinical factors, and subsequent multiple logistic regression analysis was performed to determine independent predictors of acute kidney injury. Results: A total of 207 (17.3%) patients developed acute kidney injury during 72 h postoperatively. Regarding the time interval between coronary angiography and coronary artery bypass grafting, there was a statistically highly significant difference between the patients with and without acute kidney injury (7.8 and 11.9 days, respectively; p = 0.0001). Postoperative C-reactive protein (p = 0.0001) and erythrocyte sedimentation rate (p = 0.0001) were significantly increased in group 1. Multivariate logistic regression analysis revealed the time between cardiac catheterization and surgery (p = 0.0001), increased postoperative C-reactive protein (p = 0.007 and p = 0.0001, respectively), and erythrocyte sedimentation rate (p = 0.0001) as independent predictors of early postoperative acute kidney injury in patients undergone isolated coronary artery bypass grafting. Conclusions: If patients to be operated on are stable from a cardiac aspect, limitation of surgery in the early period following catheterization results in reduction of the incidence of postoperative acute kidney injury.
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Coronary artery bypass grafting (CABG) often causes physiological changes in patients. Although functional changes, such as lung function and exercise capacity changes, are observed in patients, there are no detailed studies examining this. The aim was to compare preoperative and postoperative pulmonary function and exercise capacity in patients undergoing on-pump CABG with a multidimensional index (BODE index). Demographic and surgical characteristics of patients were recorded. Pulmonary function test, six-minute walk test (6MWT), and modified Medical Research Council (mMRC) dyspnea score were assessed and BODE index were calculated in preoperative and at six months postoperatively. A total of 75 patients were included with a mean ± standard deviation age of 59.8±10.0 years. The male to female ratio was 57/18. There was a statistically significant decrease in the forced expiratory flow at 25-75% (FEF25-75%) value after CABG. Other pulmonary function test values were also lower in the postoperative period compared to the preoperative period, but these changes were not significant. The mean distance achieved in the 6MWT (p=0.02) and the mMRC dyspnea score (p=0.001) were significantly better postoperatively. The BODE index, which combines these parameters, had increased in the postoperative period. Age (OR 1.09; 95% CI: 1.008-1.181) and postoperative FEF25-75% (OR -0.96; 95% CI: 0.938-0.988) were the independent predictors of BODE score ≥3 in multivariate analysis. Despite the decrease in pulmonary function in patients undergoing CABG, there was an improvement in exercise capacity and dyspnea score.
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Puente de Arteria Coronaria/métodos , Enfermedad Coronaria/fisiopatología , Enfermedad Coronaria/cirugía , Tolerancia al Ejercicio/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Disnea/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Pruebas de Función Respiratoria , Índice de Severidad de la Enfermedad , Prueba de PasoRESUMEN
The presence of critical coronary artery disease and concomitant critical limb ischemia represents a clinical challenge. Single-stage operations for cardiac and peripheral revascularization can be an option in such cases. The "Süzer technique" provides a more physiological extra-anatomical vascular reconstruction by using the descending thoracic aorta as the inflow source. This is an alternative to the more widely used technique of ascending aorta to bifemoral bypass and concomitant coronary revascularization. We report a case of critical limb ischemia with juxtrarenal aortic occlusion and left main coronary artery stenosis treated with concomitant coronary artery bypass grafting and descending thoracic aorto-bi-iliac bypass using a modification of the Süzer technique.
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Aorta Torácica , Arteriopatías Oclusivas , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Puente de Arteria Coronaria , Arteria Femoral , Humanos , Procedimientos Quirúrgicos VascularesRESUMEN
INTRODUCTION:: Elevated hemoglobin A1c levels in patients with diabetes mellitus have been known as a risk factor for acute kidney injury after coronary artery bypass grafting. However, the relationship between hemoglobin A1c levels in non-diabetics and acute kidney injury is under debate. We aimed to investigate the association of preoperative hemoglobin A1c levels with acute kidney injury in non-diabetic patients undergoing isolated coronary artery bypass grafting. METHODS:: 202 non-diabetic patients with normal renal function (serum creatinine <1.4 mg/dl) who underwent isolated coronary bypass were analyzed. Hemoglobin A1c level was measured at the baseline examination. Patients were separated into two groups according to preoperative Hemoglobin A1c level. Group 1 consisted of patients with preoperative HbA1c levels of < 5.6% and Group 2 consisted of patients with preoperative HbA1c levels of ≥ 5.6%. Acute kidney injury diagnosis was made by comparing baseline and postoperative serum creatinine to determine the presence of predefined significant change based on the Kidney Disease Improving Global Outcomes (KDIGO) definition. RESULTS:: Acute kidney injury occurred in 19 (10.5%) patients after surgery. The incidence of acute kidney injury was 3.6% in Group 1 and 16.7% in Group 2. Elevated baseline hemoglobin A1c level was found to be associated with acute kidney injury (P=0.0001). None of the patients became hemodialysis dependent. The cut off value for acute kidney injury in our group of patients was 5.75%. CONCLUSION:: Our findings suggest that, in non-diabetics, elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. Prospective randomized studies in larger groups are needed to confirm these results.
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Lesión Renal Aguda/etiología , Puente de Arteria Coronaria/efectos adversos , Hemoglobina Glucada/análisis , Complicaciones Posoperatorias/etiología , Lesión Renal Aguda/sangre , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Creatinina/sangre , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
Abstract INTRODUCTION: Elevated hemoglobin A1c levels in patients with diabetes mellitus have been known as a risk factor for acute kidney injury after coronary artery bypass grafting. However, the relationship between hemoglobin A1c levels in non-diabetics and acute kidney injury is under debate. We aimed to investigate the association of preoperative hemoglobin A1c levels with acute kidney injury in non-diabetic patients undergoing isolated coronary artery bypass grafting. METHODS: 202 non-diabetic patients with normal renal function (serum creatinine <1.4 mg/dl) who underwent isolated coronary bypass were analyzed. Hemoglobin A1c level was measured at the baseline examination. Patients were separated into two groups according to preoperative Hemoglobin A1c level. Group 1 consisted of patients with preoperative HbA1c levels of < 5.6% and Group 2 consisted of patients with preoperative HbA1c levels of ≥ 5.6%. Acute kidney injury diagnosis was made by comparing baseline and postoperative serum creatinine to determine the presence of predefined significant change based on the Kidney Disease Improving Global Outcomes (KDIGO) definition. RESULTS: Acute kidney injury occurred in 19 (10.5%) patients after surgery. The incidence of acute kidney injury was 3.6% in Group 1 and 16.7% in Group 2. Elevated baseline hemoglobin A1c level was found to be associated with acute kidney injury (P=0.0001). None of the patients became hemodialysis dependent. The cut off value for acute kidney injury in our group of patients was 5.75%. CONCLUSION: Our findings suggest that, in non-diabetics, elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. Prospective randomized studies in larger groups are needed to confirm these results.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Complicaciones Posoperatorias/etiología , Hemoglobina Glucada/análisis , Puente de Arteria Coronaria/efectos adversos , Lesión Renal Aguda/etiología , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/epidemiología , Biomarcadores/sangre , Incidencia , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y Especificidad , Creatinina/sangre , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/sangre , Lesión Renal Aguda/epidemiologíaRESUMEN
Background The aim of the present study was to investigate the role of inflammatory markers to predict amputation following embolectomy in acute arterial occlusion. Methods A total of 123 patients operated for arterial thromboembolectomy due to acute embolism were included in the study. The patients without an extremity amputation following thromboembolectomy were classified as Group 1 ( n = 91) and the rest were classified as Group 2 ( n = 32). These groups were compared in terms of clinical and demographic characteristics, C-reactive protein, complete blood count parameters, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red cell distribution width. Results The average age was 68.0 ± 11.7 years. The most common thromboembolism localization was femoral artery. When preoperative mean C-reactive protein ( p = 0.0001), mean platelet volume ( p = 0.0001), platelet-lymphocyte ratio ( p = 0.0001), neutrophil-lymphocyte ratio ( p = 0.0001) and red cell distribution width ( p = 0.0001) were compared, a statistically significant difference was observed between groups. In univariate and multivariate regression analysis, higher levels of preoperative C-reactive protein ( p = 0.009) and mean platelet volume ( p = 0.04) were detected as independent risk factors of early extremity amputation. Conclusion We observed that preoperative mean platelet volume and C-reactive protein were predictors of amputation after thromboembolectomy in acute arterial occlusion.
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Amputación Quirúrgica , Arteriopatías Oclusivas/cirugía , Proteína C-Reactiva/análisis , Embolectomía/efectos adversos , Mediadores de Inflamación/sangre , Volúmen Plaquetario Medio , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Arteriopatías Oclusivas/sangre , Arteriopatías Oclusivas/diagnóstico por imagen , Biomarcadores/sangre , Índices de Eritrocitos , Femenino , Humanos , Recuperación del Miembro , Modelos Logísticos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neutrófilos , Oportunidad Relativa , Recuento de Plaquetas , Valor Predictivo de las Pruebas , Curva ROC , Reoperación , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del TratamientoRESUMEN
INTRODUCTION: Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) operation is associated with increased risk of prolonged hospitalisation, health expenses and adverse clinical outcomes. AIM: To investigate the relationship of atrial fibrillation after an isolated coronary artery bypass operation with levels of mean platelet volume and C-reactive protein. MATERIAL AND METHODS: Among 1240 patients who underwent operations for isolated coronary artery bypass grafting with cardiopulmonary bypass between January 2007 and May 2014, 1138 (91.8%) patients with preoperative normal sinusal rhythm were enrolled in the study. Patients were assigned to group 1 (n = 294) comprising patients who developed atrial fibrillation in the first 72 postoperative hours or group 2 (n = 844) comprising patients who remained in normal sinusal rhythm in the postoperative period. RESULTS: The incidence of postoperative atrial fibrillation was 25.8%. The preoperative mean platelet volume (fl) and C-reactive protein (mg/dl) values in group 1 were 9.1 ±0.5 and 1.1 ±0.9 respectively, while these values were 8.3 ±0.6 and 0.5 ±0.3 respectively in group 2, which was statistically significant (p = 0.0001). Length of stay in the hospital (p = 0.0001) was higher in group 1. The values of mean platelet volume (fl) and mean C-reactive protein (mg/dl) were 9.9 ±0.9 and 30.9 ±3.4 respectively in group 1, while the values of mean platelet volume (fl) and mean C-reactive protein (mg/dl) were 8.8 ±0.6 and 24.9 ±4.8 respectively in group 2 (p = 0.0001 for mean platelet volume, p = 0.0001 for C-reactive protein). The difference between the groups was statistically significant in terms of postoperative neurologic events (p = 0.0001) and hospital mortality (p = 0.001). Increased C-reactive protein and mean platelet volume levels were found to be independent predictors of postoperative atrial fibrillation. CONCLUSIONS: In our study, elevated preoperative mean platelet volume and C-reactive protein levels were associated with development of postoperative atrial fibrillation.
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BACKGROUND: Metabolic syndrome (MetS) is defined as a cluster of systemic abnormalities: hyperglycemia, dyslipidemia, abdominal obesity, and hypertension. Acute kidney injury (AKI) is one of the devastating complications after cardiac surgery. Age, DM, preexisting renal dysfunction, hypertension, impaired left ventricular function, and severe arteriosclerosis of the aorta are the major risk factors for the development of AKI. The purpose of the current study was to analyze the influence of MetS on AKI occurring after coronary artery bypass grafting (CABG). METHODS: We retrospectively reviewed the prospectively collected data of 500 adult patients who underwent isolated CABG surgery with normal renal function (baseline serum creatinine value <1.4 mg/dL) from January 2011 to January 2015. The patients were divided into two groups either having the diagnosis of MetS (Group I) or not (Group II). MetS was diagnosed based on International Diabetes Federation definition. Kidney injury was interpreted according to RIFLE classification. The effect of MetS on AKI after CABG was determined using logistic regression analysis and the results were expressed as odds ratio (OR) with a 95% confidence interval (CI). A P value <.05 was considered statistically significant. RESULTS: Metabolic syndrome was diagnosed in 16.4% of all patients. Postoperative AKI occurred in 26 patients (31.7%) in Group I whereas there were 53 patients (12.7%) in Group II. On logistic regression analysis, the presence of MetS was shown to be associated with increased incidence of postoperative AKI (OR, 3.197; 95% CI, 1.850-5.526; P = .000). CONCLUSION: The presence of MetS seems to be associated with increased incidence of AKI after cardiac surgery. MetS is a modifiable issue; if its components are well controlled its dreadful effects after cardiac surgery might be controlled as well.
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Lesión Renal Aguda/etiología , Puente de Arteria Coronaria/efectos adversos , Síndrome Metabólico/complicaciones , Complicaciones Posoperatorias/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
In this report, our aim is to present a case of renal artery occlusion due to type-3 acute aortic dissection following blunt trauma. A twenty-four-year-old male patient was admitted to the emergency department of our hospital with pain in his abdomen and on his back 3 hours after a blunt abdominal trauma due to an industrial injury. After consultation with the urology department, the patient was taken to operation to be evaluated for an intervention for aortic dissection and nephrectomy.
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Traumatismos Abdominales/complicaciones , Aneurisma de la Aorta Abdominal/complicaciones , Disección Aórtica/complicaciones , Obstrucción de la Arteria Renal/etiología , Procedimientos Quirúrgicos Vasculares/métodos , Heridas no Penetrantes/complicaciones , Traumatismos Abdominales/diagnóstico , Disección Aórtica/diagnóstico , Disección Aórtica/cirugía , Aneurisma de la Aorta Abdominal/diagnóstico , Aneurisma de la Aorta Abdominal/cirugía , Humanos , Laparotomía , Masculino , Obstrucción de la Arteria Renal/diagnóstico , Obstrucción de la Arteria Renal/cirugía , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnóstico , Adulto JovenRESUMEN
OBJECTIVE: This study evaluated the relationship between the amount of urinary output during cardiopulmonary bypass and acute kidney injury in the postoperative period of coronary artery bypass grafting. METHODS: Two hundred patients with normal preoperative serum creatinine levels, operated on with isolated CABG between 2012-2014 were investigated retrospectively. The RIFLE (Risk, injury, failure, loss of function, and end-stage renal disease) risk scores were calculated for each patient in the third postoperative day. Patients were distributed into two groups in relation to the presence of acute kidney injury or not and these two groups were compared. RESULTS: The urinary output (mL/kg/hour) during cardiopulmonary bypass in the acute kidney injury negative group was significantly higher than in the acute kidney injury positive group (P = .022). In case of a urinary output value 3.70 and lower to predict acute kidney injury positivity, sensitivity was detected as 71.43%. Results of the analysis for urinary output predict positivity of acute kidney injury. CONCLUSION: We suggest that urine output during cardiopulmonary bypass is a significant criteria that could predict acute kidney injury following coronary artery bypass grafting with cardiopulmonary bypass. Attempts to increase the urine output during cardiopulmonary bypass could help to maintain the renal functions during and after surgery.
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Lesión Renal Aguda/orina , Puente Cardiopulmonar/efectos adversos , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/cirugía , Complicaciones Posoperatorias , Medición de Riesgo/métodos , Micción/fisiología , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Anciano , Enfermedad de la Arteria Coronaria/metabolismo , Femenino , Estudios de Seguimiento , Tasa de Filtración Glomerular , Humanos , Incidencia , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Turquía/epidemiologíaRESUMEN
BACKGROUND: Treatment method in patients with coronary artery disease undergoing coronary bypass surgery with accompanying carotid artery disease is still a hot topic among clinicians. This study is designed to investigate if there is an effect on myocardial infarction, cerebrovascular events and mortality during postoperative period of simultaneous carotid endarterectomy with coronary bypass surgery compared to staged carotid artery stenting before coronary bypass surgery. METHODS: 102 patients (79 male, 23 female) who underwent simultaneous carotid endarterectomy with coronary bypass surgery or staged carotid artery stenting with coronary bypass surgery in the same center with the same surgical team were divided into 2 groups and retrospectively reviewed. Group 1 (n = 71) had coronary artery bypass surgery under general anesthesia with carotid endarterectomy followed by cardiopulmonary bypass with heart team decision. Again with heart team decision, Group 2 (n=31), patients at high-risk for carotid endarterectomy (serious cardiac disease, severe chronic obstructive pulmonary disease, superiorly located lesions), received carotid artery stents in the interventional radiology department and a month later, coronary bypass surgery was performed with cardiopulmonary bypass under elective conditions. RESULTS: Median of patient age was 67.5 (45-83) years. Twenty-two patients (31%) in Group 1 and 19 patients (56.3%) in Group 2 had neurological symptoms, which was statistically significant (P = .004). During the early postoperative term, three patients (4.2%) in Group 1 and two patients (6.5%) in Group 2 died (P = .64). Five patients (7.0%) in Group 1 and two patients (6.5%) in Group 2 developed neurological symptoms during the early postoperative term (P > .05). Likewise, two patients (2.8%) in Group 1 and five patients (16.1%) in Group 2 developed myocardial infarction following carotid intervention (P = .03). CONCLUSIONS: In patients with significant carotid artery stenosis undergoing coronary bypass surgery with cardiopulmonary bypass, in comparison to simultaneous carotid endarterectomy with coronary bypass technique and carotid artery stenting followed with coronary bypass technique showed no difference in combined endpoint (postoperative myocardial infarction, neurological events, and mortality). With proper tools and according to the decisions made by heart teams, both management strategies can be safely performed.
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Estenosis Carotídea/mortalidad , Estenosis Carotídea/cirugía , Puente de Arteria Coronaria/mortalidad , Enfermedad de la Arteria Coronaria/mortalidad , Enfermedad de la Arteria Coronaria/cirugía , Endarterectomía Carotidea/mortalidad , Stents/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Terapia Combinada/mortalidad , Comorbilidad , Endarterectomía Carotidea/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Prevalencia , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento , Turquía/epidemiologíaRESUMEN
A 62-year-old man presented to the cardiology clinic with symptoms of fatigue, shortness of breath and swelling in the abdomen and legs. A pedunculated mobile mass with a short stalk in the right atrium was found to originate from the inferior vena caval opening and prolapse into the right ventricle through a tricuspid valve during diastole in echocardiography. The patient was referred to our department and surgery was planned for right atrial myxomas diagnosis. The mass with surrounding tissue was surgically removed using the cardiopulmonary bypass method. No postoperative complications were seen in the currently asymptomatic patient who is still under our follow-up schedule.
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Atrios Cardíacos/patología , Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Puente Cardiopulmonar , Diagnóstico Diferencial , Atrios Cardíacos/cirugía , Neoplasias Cardíacas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Mixoma/cirugía , Estenosis de la Válvula Tricúspide/patologíaRESUMEN
Pulmonary agenesis is associated with the absence of pulmonary vessels, bronchi, or parenchyma. This condition usually occurs between the 4th and 5th week of gestation during the embryonic phase. Etiopathogenic factors associated with pulmonary agenesis are not fully understood. In the literature, genetic and teratogenic factors, viral infections, and vitamin-A deficiency are shown to be associated with pulmonary agenesis [Malcon 2012]. This condition may be seen unilaterally or bilaterally. Although the precise rate of incidence is unknown, it is estimated to occur in one of every 10,000 to 12,000 live births [Yetim 2011]. There is a 1.3:1 female predominance with unilateral agenesis [Halilbasic 2013].
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Implantación de Prótesis de Válvulas Cardíacas , Enfermedades Pulmonares/complicaciones , Pulmón/anomalías , Insuficiencia de la Válvula Mitral/cirugía , Válvula Mitral/cirugía , Anomalías Múltiples , Humanos , Masculino , Insuficiencia de la Válvula Mitral/complicaciones , Adulto JovenRESUMEN
OBJECTIVE: Recent studies have demonstrated that preoperative statin therapy reduces the incidence of postoperative atrial fibrillation (AF). The objective of this study was to assess the efficacy of statin therapy started in the early postoperative period for the prevention from new-onset AF after isolated coronary artery bypass grafting (CABG). METHODS: This prospective and randomized study consisted of 60 consecutive patients who underwent elective isolated CABG. Patients were divided into two groups to examine the influence of statins: those with postoperative statin therapy (statin group, n=30) and those without it (non-statin group, n=30). Patient data were collected and analyzed prospectively. In the statin group, each extubated patient was given 40 mg of atorvastatin per day, starting from an average of 6 hours after the operation. RESULTS: The overall incidence of postoperative AF was 30%. Postoperative AF occurred in 5 patients (16.7%) in the statin group. This was significantly lower compared with 13 patients (43.3%) in the non-statin group (p=0.049). According to the multivariate analysis, postoperative atorvastatin reduced the risk of postoperative AF by 49% [odds ratio (OR) 0.512, 95% confidence interval (CI) 0.005 to 0.517, p=0.012]. Also, age was an independent predictor of postoperative AF (OR 1.299, 95% CI 1.115 to 1.514, p=0.001). CONCLUSION: Postoperative statin therapy seems to reduce new-onset AF after isolated CABG in our study.
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Atorvastatina/uso terapéutico , Fibrilación Atrial/prevención & control , Puente de Arteria Coronaria , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Complicaciones Posoperatorias/prevención & control , Anciano , Atorvastatina/administración & dosificación , Ecocardiografía , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Persona de Mediana Edad , Posmenopausia , Estudios Prospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate the association of platelet to lymphocyte ratio to mortality and morbidity after coronary artery bypass grafting operation. METHODS: We evaluated records of 916 patients who underwent coronary artery bypass grafting operation between January 2009 and May 2014 retrospectively. Patients were grouped as Group 1 (n = 604) if the platelet to lymphocyte ratio was above 142 and Group 2 (n = 312) if platelet to lymphocyte ratio was below 142. RESULTS: The number of patients who developed a neurologic event during the hospital stay and in the first postoperative month was 7 (1.2%) in Group 1 and 12 (3.8%) in Group 2 for which the difference was statistically significant (P = .007). Early term mortality occurred in 3 patients (0.5%) in Group 1 and in 10 patients (3.2%) in Group 2 for which the difference was statistically highly significant (P = .001). In univariate and multivariate regression analysis, the preoperative platelet to lymphocyte ratio was determined as an independent risk factor for occurrence of atrial fibrillation in the early postoperative period, reoperation for sternum dehiscence, occurrence of a neurologic event, prolonged stay in the hospital and mortality. CONCLUSION: In this study, elevated levels of platelet to lymphocyte ratio were associated with mortality and morbidity after coronary artery bypass grafting operation.
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Puente de Arteria Coronaria/efectos adversos , Puente de Arteria Coronaria/mortalidad , Recuento de Linfocitos , Recuento de Plaquetas , Adulto , Anciano , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Periodo Preoperatorio , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Foreign body is among complications of surgery. But as a complication of varicose vein surgery it was reported extremely rarely and, to our knowledge, there is only one paper in the literature. A case with retained sponge which was detected five months after varicose vein surgery was presented.
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BACKGROUND AND OBJECTIVE: Evaluation of graft patency is an important component of coronary bypass surgery. In the present study, intraoperative cineangiography was performed in a cardiovascular hybrid operating room to evaluate anastomosis quality and patency of coronary venous grafts. METHOD: This prospective study evaluated coronary bypass grafts in 34 patients between January 2012 and June 2012. Radiopaque material was administered into the grafts through a vessel cannula before the proximal anastomosis. Then, cineangiographic images were obtained using a mobile C-arm cineangiography system. The myocardial perfusion scintigraphy (MPS) of the patients was compared between preoperative and first month postoperative periods to assess graft function. RESULTS: The localization of the grafts in the target vessel, structural status of the grafts, anastomosis line, and availability of the target vessel were easily evaluated. Angiographic defects were detected in two grafts (3%, n = 60) in two patients (6%, n = 34). Staining was observed in the distal myocardial segments of the saphenous vein grafts following the administration of radiopaque material. The procedure took eight minutes, on average (range, 5-14 minutes), and a mean of 15 mL (range, 10-35 mL) of opaque material was used. None of the patients developed intraoperative myocardial infarction, postoperative complications, or contrast material-induced renal failure. No mortality was observed. The distal myocardial segments of saphenous vein grafts were detected to be perfused 92% normally, 5% reversibly defective, and 3% irreversibly defective with postoperative MPS controls. CONCLUSION: Cineangiographic graft evaluation in a hybrid operating room is a practical, safe, noninvasive, easily available, and easily applicable method.
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Cineangiografía , Angiografía Coronaria , Puente de Arteria Coronaria , Enfermedad Coronaria/cirugía , Oclusión de Injerto Vascular/diagnóstico por imagen , Complicaciones Intraoperatorias/diagnóstico por imagen , Grado de Desobstrucción Vascular/fisiología , Venas/trasplante , Adulto , Anciano , Enfermedad Coronaria/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Estudios ProspectivosRESUMEN
A 48-year-old hiatus hernia patient with a history of an occasional epigastric burning sensation for the last 10 years presented with a new onset of chest pain in addition to the persistence of his other symptoms. An apical left ventricular aneurism was found on 64-slice computed tomographic angiography. Coronary angiography confirmed the diagnosis. No coronary lesion was found and the apical region of the left ventricle was avascular. He was operated on under the suspected preoperative possible diagnoses of left ventricular apical aneurysm, a pseudoaneurysm, or a diverticulum. Macroscopically, a subepicardial whitish aneurysmal region with a weakened wall was seen at the apical part of the left ventricle. The size of the lesion was 3 x 3 cm. The aneurysm did not have an extracardiac neck. When the aneurysm site was opened, a sclerotic aneurysm wall and a narrow neck below the incised sac was found; and the neck was communicating with the left ventricular cavity. The aneurysm site was resected and closed with a linear closure technique by using pledget-supported sutures. The termination of cardiopulmonary bypass was uneventful. The patient left the intensive care unit on the first postoperative day and was discharged from hospital on the 4th postoperative day. A subepicardial left ventricular aneurysm should therefore also be considered in the differential diagnosis of atypical chest pain.