WITHDRAWN: Subsegmental Thrombus in COVID-19 Pneumonia: Immuno-Thrombosis or Pulmonary Embolism? Data Analysis of Hospitalized Patients with Coronavirus Disease.

This article has been withdrawn at the request of the author(s). The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

The preventive and curative effects of melatonin against abdominal aortic aneurysm in rats.

OBJECTIVE: Oxygen free radicals are important components involved in the histopathologic tissue alterations observed during abdominal aortic aneurysms (AAAs). This study examined whether melatonin has protective or therapeutic effects against AAAs. METHODS: Sprague-Dawley rats were divided into four groups. A CaCl2 model was used to induce AAA. Starting on the operation day (Mel+AAA+Mel group) or 4 weeks after the operation (AAA+Mel group), the rats received intraperitoneal melatonin (10 mg/kg/day) for 6 and 2 weeks, respectively. The control and AAA groups received vehicle for 2 weeks after the sham operation and AAA induction, respectively. Angiographic measurements were recorded at the beginning, week 4, and week 6 of the study. After decapitation, aorta tissues were taken for the measurement of malondialdehyde, 8-hydroxy-2'-deoxyguanosine, glutathione levels, and myeloperoxidase and caspase-3 activity. Matrix metalloproteinase (MMP)-2, MMP-9, tumor necrosis factor-α, and inducible nitric oxide synthase protein expressions were analyzed by Western blot technique. Aortic tissues were also examined by light microscopy. RESULTS: CaCl2 caused an inflammatory response and oxidative damage indicated by rises in malondialdehyde and 8-hydroxy-2'-deoxyguanosine levels. Myeloperoxidase and caspase-3 activities were increased, but glutathione levels were reduced. On the one hand, MMP-2, MMP-9, tumor necrosis factor-α, and inducible nitric oxide synthase protein expressions were increased in the vehicle-treated AAA group. On the other hand, melatonin treatment reversed all of these biochemical indices and histopathologic alterations. CONCLUSIONS: According to the data, although melatonin tended to reverse the biochemical parameters given on week 4, the preventive effect is more pronounced when given concomitantly with AAA induction because values were closer to the control levels.

The Perceval Sutureless Valve in Aortic Root Reoperation.

The case is reported of a 62-year-old man with severe aortic regurgitation that was related to failed prior valve-sparing ascending aortic aneurysm repair, and who was successfully treated with a Perceval Sutureless valve.

Correction of cortriatriatum sinister with classical Raghib's complex using an extracardiac conduit.

We present a 32-year-old patient with cortriatriatum sinister with Raghib's complex (a left persistent superior vena cava draining into the left atrium with an absent coronary sinus and an atrial septal defect [ASD]) who underwent successful surgical correction with excision of the cortriatriatum, closure of the ASD, and establishing the drainage of the persistent left superior vena cava to the right atrium via interposition of an extracardiac 13-mm ringed polytetrafluoroethylene conduit.

Direct transapical implantation of an endocardial pacing lead to the left ventricle: an alternate pacing site after tricuspid valve replacement.

In this paper, we report an alternative approach for implantation of ventricular pacing lead for complete atrioventricular block after tricuspid valve replacement.

Effects of myeloperoxidase -463 G/A gene polymorphism and plasma levels on coronary artery disease.

Myeloperoxidase is a lysosomal enzyme of polymorphonuclear leucocytes that contributes to inflammatory responses. In previous studies it was shown that MPO was synthesized in atherosclerotic lesions responsible of lipoprotein oxidations. We aimed to determine the MPO -463 G/A gene polymorphism distribution in Turkish population and evaluate the effects of it on myeloperoxidase levels. There were 100 myocardial infarct patients and 100 healthy control subjects in our study. MPO polymorphism was studied by using PCR-RFLP technique and MPO levels were measured by ELISA. It was shown that MPO levels were increasing in patients after myocardial infarct event but there were no effect of MPO -463 G/A polymorphism on MPO levels. It was also found that serum total cholesterol and LDL-cholesterol levels and smoking was contributing factors in increments of MPO enzymes. We observed that MPO levels were increased in CAD but there were no effect of MPO -463 G/A polymorphism on MPO levels.

Autologous right pulmonary artery tissue for repair of left pulmonary artery originating from left patent ductus arteriosus in a patient with tetralogy of Fallot and absent pulmonary valve.

Left pulmonary artery (PA) originating from patent ductus arteriosus is an exceptionally rare variant of tetralogy of Fallot with absent pulmonary valve. We described an alternative technique for the repair of discontinuous left PA with the use of the redundant pulmonary artery tissue as material for the conduit in a 3-year-old boy.

Testicular germ cell tumor metastatic to the right atrium.

We describe a right atrial metastasis of a testicular germ cell tumor, which was successfully removed from the tricuspid valve and subvalvular apparatus without the need for valve replacement.

Associations of lipoprotein lipase S447X and apolipoprotein E genotypes with low-density lipoprotein subfractions in Turkish patients with coronary artery disease.

BACKGROUND: This study investigated associations of specific lipoprotein lipase (LPL) S447X and apolipoprotein (Apo)E allelic patterns with low-density lipoprotein (LDL) size and subfraction profiles in patients with coronary artery disease (CAD) and healthy individuals. PATIENTS AND METHODS: Forty-one cases with CAD and 23 controls were compared regarding the occurrence of the Ser-->Stop codon of the LPL and ApoE polymorphism. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) techniques were utilized to perform genotyping, and LDL size and subfractions were assessed by a high-resolution, nongradient polyacrylamide gel electrophoresis technique. RESULTS: The lowest small dense (sd) LDL level was observed for the homozygous LPLX447 genotype (6.00 +/- 4.00 mg/dl) while the highest sdLDL level was observed for LPLX447(+)/ApoE4(+) carriers (14.33 +/- 20.55 mg/dl) in the patient group. No protective effect of LPLX447 allele on the atherogenic LDL profile was observed when it was together with the ApoE4 allele. Furthermore, the detrimental effect of LPLS447 on the atherogenic LDL profile increased when it was present together with the ApoE4 allele. CONCLUSION: The X447 allele of the LPL gene may protect from atherogenic LDL subfraction, although this effect is small. We suggest that the S447X polymorphism of the LPL gene may modify the risk of atherogenic sdLDL fraction in an ApoE-dependent fashion.

A simple maneuver on sternal saw facilitates to perform curved sternal mini-incisions like J- and C-shaped partial sternotomies.

Minimal invasive approaches, including partial J- or C-shaped sternotomies, have gained a worldwide acceptance in cardiac surgical practice. To increase the cosmetic benefit and improve the surgical exposure, the length of underlying partial sternotomy is usually 3 to 5 cm longer than the length of skin incision in most of these approaches. Using a standard sternal saw or a rotary craniotome, it is quite difficult to make sternal incision under subcutaneous tissue at both ends of skin incision. Moreover, standard sternal saws do not allow doing fine manipulations on sternum that may cause inadvertent sternal cutting, especially at the curved parts of C- or J-type partial sternotomies. We removed the blade protector part of a standard sternal saw. This simple maneuver enables surgeons to perform several challenging mini-sternotomies easily for adult cardiac procedures.

[The effect of transmyocardial laser revascularization on anginal symptoms and clinical results in patients with incomplete surgical revascularization]. / Tam cerrahi revaskülarizasyon yapilamayan hastalarda transmiyokardiyal lazer revaskülarizasyonu isleminin anjinal semptomlar ve klinik sonuçlar üzerine etkisi.

OBJECTIVES: We evaluated the effect of transmyocardial laser revascularization (TMR) on anginal symptoms and clinical results in patients in whom coronary artery bypass grafting (CABG) surgery was not sufficient to provide complete revascularization. STUDY DESIGN: This retrospective study included 45 patients who underwent CABG surgery with incomplete revascularization between 2003 and 2006. Of these, 35 patients (mean age 61.7 years) had CABG alone, while 10 patients (mean age 62 years) underwent TMR at the same session as an adjunct to CABG. All the patients were assessed by transthoracic echocardiography and myocardial perfusion scintigraphy at three months and after a mean follow-up period of 22.3+/-6.1 months. Anginal symptoms were assessed using the CCS (Canadian Cardiovascular Society) classification system. RESULTS: Preoperative variables were similar in both groups. All the patients were symptomatic preoperatively with mean CCS scores of 2.6+/-0.5 and 2.3+/-0.8 in the TMR and CABG-alone groups, respectively. The duration of cardiopulmonary bypass (CPB) was significantly longer in the TMR group (p=0.022). During weaning from CPB, the need for inotropic support was significantly less in the TMR group (10% vs. 48.6%; p=0.034). While there was no early mortality, late mortality occurred in three patients (1 in TMR, 2 in CABG-alone groups; p=0.329). At three months, 50% (n=5) of the TMR patients were asymptomatic, compared to 14.3% (n=5) in the CABG-alone group (p=0.016). Patients in the TMR group had significantly lower CCS angina scores at three months (1.2+/-0.6 vs. 2.2+/-0.7; p=0.001) and at the end of the follow-up (1+/-0.6 vs. 2+/-0.7; p=0.001). There were no significant differences between the two groups with regard to the findings of myocardial perfusion scintigraphy and echocardiography. CONCLUSION: Patients with incomplete surgical revascularization benefit from TMR in terms of decreased need for inotropic support during weaning from CPB and short- and mid-term relief of angina symptoms.

Characteristics of Coronary Artery Disease Patients Who Have a Polymorphism in the Cholesterol Ester Transfer Protein (CETP) Gene.

BACKGROUND/AIM: Cholesterol ester transfer protein (CETP) is responsible for the transformation of high density lipoprotein (HDL) to low density lipoprotein (LDL) and is a risk factor for atherosclerosis. Our study investigated the association of the rs5883 CETP gene polymorphism with HDL and LDL levels, in 45 coronary artery disease patients and 45 control patients. MATERIALS AND METHODS: CETP gene polymorphism was detected using Real Time-Polymerase Chain Reaction (RT-PCR). Lipoprotein levels were measured using Quantimetrix system. RESULTS: There were lack of associaition regarding CETP polymorphism in atherosclerosis and HDL and LDL levels (p>0.05) BMI was higher among coronary artery disease patients (CADP) compared to the control group (28.97±6.38, 26.52±4.39 respectively, p<0.03). Frequency of CADP (82.6 %, n=19) who were taking treatment was higher (17.4 %, n=4) (p<0.00). The frequencies of hypertension and type-2 diabetes were higher among CADP (p<0.00). Families of CADP have more CADP (p<0.02). Small HDL particle levels were higher in the control group (p<0.00). CONCLUSION: In Turkey, BMI, and frequencies of hypertension and type-2 diabetes were higher among CADP than among healthy controls. Furthermore, the genotypes of the rs5883 CETP gene polymorphism did not differ between CADP and healthy controls.

Investigation of ABCA1 C69T and G-191C polymorphisms in coronary artery disease.

BACKGROUND: Defects of lipoprotein metabolism are common risk factors for coronary artery disease. The ATP binding cassette transporter 1 (ABCA1) plays an important role in carrying cholesterol from peripheral tissues to the liver. The role of ABCA1 C69T and G-191C gene polymorphisms on plasma lipid levels of patients with coronary artery disease was investigated. PATIENTS AND METHODS: Seventy-seven patients with coronary artery disease and fifty healthy controls were studied. Gene polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: No differences in the distribution of C69T and G-191C polymorphisms were observed in the study groups. Plasma triacylglycerol and VLDL-cholesterol levels were shown to be higher in the patient group with the C69T CC genotype compared to these patients with the CT genotype. The C69T polymorphism was associated with HDL-cholesterol levels, which insignificantly increased in the order of the CC>CT>TT genotypes in our study. No association was found between G-191C genotype and lipid levels. CONCLUSION: The results of our study suggested that polymorphisms of ABCA1 C69T polymorphism may be associated with plasma triacylglycerol and VLDL-cholesterol levels in coronary artery patients.

Effect of Ala16Val genetic polymorphism of MnSOD on antioxidant capacity and inflammatory response in open heart surgery.

BACKGROUND: Ischemia-reperfusion injury and inflammation in cardiac surgical patients involves complex humoral and cellular interactions. We investigated the effect of genetic polymorphism of manganase superoxide dismutase (MnSOD) a natural antioxidant, on cytokine release and manganesuperoxide dismutase in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). PATIENTS AND METHODS: Forty-two patients undergoing elective CABG with CPB were included in the study. MnSOD polymorphism was performed by polymerase chain reaction (PCR). Levels of interleukin-6 and mangane superoxide dismutase (MnSOD) were measured by enzyme linked immunoabsorbent assay (ELISA). RESULTS: Baseline IL-6 did not differ between patients with different MnSOD genotypes. Postoperatively IL-6 levels were significantly higher in all patients but more significantly in V(VV+AV) carriers (p=0.003). The wild-type AA genotype had the highest preoperative (p<0.05) and postoperative IL-6 level. The MnSOD VV genotype was associated with significantly lower preoperative MnSOD levels compared to the AA carriers (p<0.05). CONCLUSION: These data demonstrate that MnSOD Ala16Val polymorphism influences IL-6 production and baseline MnSOD activity, suggesting that preoperative MnSOD concentration plays a role in cytokine release.

APE1 and XRCC3 polymorphisms and myocardial infarction.

BACKGROUND: In most cells, DNA is regularly damaged by mutagens. Different DNA repair mechanisms operate on specific types of damaged DNA. When DNA damage resulting from free radicals is not repaired, it might lead to deteriorated gene expression, the development of a number of diseases such as cancer, diabetes, vascular diseases, and aging. In the present study, APE1 and XRCC3 gene polymorphisms were investigated in patients with myocardial infarction. MATERIALS AND METHODS: Forty-five first time elective coronary artery bypass grafting (CABG) patients with cardiopulmonary bypass (CPB) and 40 healthy individuals were studied. Gene polymorphisms were determined by a polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: For the APE1 gene, the AG genotype was significantly higher in the patient group than in the control group. The patient group had significantly more G carriers but there was no statistically significant difference between patient and control groups the A allele. The XRCC3 TT genotype was found to be significantly more frequent in the patient group than it was in the control group. CONCLUSION: The results of our study suggested that the XRCC3 gene TT genotype and the APE1 gene AG genotype might increase the risk of myocardial infarcts.

The future of surgical aortic valve replacement and the role of sutureless technology.

Aortic valve stenosis has become the most frequent type of valve disease in worldwide. Surgical aortic valve replacement is still the gold standard therapy. More recently transcatheter aortic valve implantation has been demonstrated to be not inferior in patients with high and intermediate risk patients. Sutureless aortic valves were designed to simplify the surgical aortic valve replacement. With the aid of this new technology, the invasiveness of surgery can be reduced with potential improvements in outcome.

Circulating microRNAs as Novel Biomarkers for Atherosclerosis.

BACKGROUND/AIM: In this study, we determined the expression of selected circulating microRNAs (miRNA) and their potential roles as biomarkers in patients with atherosclerosis and a control group. MATERIALS AND METHODS: In order to obtain insight into miRNA expression levels in atherosclerosis, we analyzed miRNA expression levels by real-time polymerase chain reaction (RT-PCR) in case (n=89) and healthy control (n=93) groups. Receiver operating characteristic curve analysis was performed to assess the diagnostic capability of miRNAs. RESULTS: miRNA221 and miRNA221 expression levels were significantly lower in patients than controls (p=0.011 and p=0.004, respectively). Receiver operator curve analysis demonstrated that expression levels of miRNA221 [area under curve (AUC)=0.623, p=0.0086) and miRNA222 (AUC=0.654, p=0.0006) were significantly different between groups. There were positive correlations between miRNA122a and triglyceride (p=0.046) and very-low-density lipoprotein (p=0.029) levels. CONCLUSION: miRNA221 and miRNA222 could be convenient biomarkers for diagnosis of atherosclerosis.

Endothelial Lipase Gene Polymorphism (584 C/T) in Coronary Artery Patients Among a Turkish Population.

BACKGROUND/AIM: The endothelial lipase gene (LIPG) has a major role in regulating high density lipoprotein cholesterol (HDL-C), therefore this study investigated whether LIPG is associated with coronary artery disease (CAD) in a Turkish population. MATERIALS AND METHODS: The LIPG (584 C/T) mutation was analyzed in 74 CAD patients and 73 controls. RESULTS: There was a significant difference between the two groups regarding the mutant T allele frequencies (χ2=0.456, p=0.020; 26.7% and 41.8% in patient and control groups, respectively) for 584 C/T. Even though the TT genotype was not significantly different, it had p=0.054 which supported our results. CONCLUSION: The endothelial lipase gene (584 C/T) T allele might be protective in association with coronary artery disease. Therefore, LIPG gene is related to risk for CAD in the Turkish population probably through altering HDL-C metabolism.

Genetic polymorphisms contribute to acute kidney injury after coronary artery bypass grafting.

BACKGROUND: Acute kidney injury is one of the most serious complications after cardiac surgery. Genetic polymorphisms are reported to be associated with postoperative renal impairment. The aim of this study was to investigate the relationship between selected gene polymorphisms and acute kidney injury after cardiac surgery. METHODS: Two hundred forty-eight elective coronary artery bypass grafting procedure patients were enrolled in the study. Angiotensin-converting enzyme (ACE) II, ID, and DD, apolipoprotein E (APO E), and angiotensin II type 1 receptor (AGTR1) A1166C genotypes were detected by polymerase chain reaction. Plasma levels of ACE were analyzed by enzyme-linked immunosorbent assay. Acute kidney injury after cardiac surgery was graded according to the RIFLE (risk, injury, failure, loss, and end-stage kidney disease) classification. RESULTS: In our study, 21.8% of patients had acute renal impairment after cardiac surgery. Among the 54 patients with acute kidney injury, ACE D allele frequency was 0.620. The plasma levels of ACE were significantly higher in the D allele carriers (P = .018). Three of the 54 patients with acute kidney injury were APO E epsilon 4 allele carriers (P = .002). AGTR1 C allele carriers constituted 46% of all patients with postoperative acute kidney injury. There was no statistically significant difference between A allele homozygotes and C allele carriers with respect to postoperative renal dysfunction (P > .05). CONCLUSIONS: The present findings support the hypothesis that ACE I/D and APO E gene polymorphisms may play a role in the development of acute kidney injury after cardiac surgery. However, AGTR1 does not have a unique association with postoperative renal impairment.

Coronary artery bypass grafting in idiopathic myelofibrosis: a case report.

The concomitant presence of myeloproliferative disorders and the need for coronary artery bypass surgery is a surgical dilemma. Thrombosis and hemorrhage can cause difficult problems and might require different approaches during and after surgery. We report a patient who had idiopathic myelofibrosis and underwent a successful coronary artery bypass surgery.