Subject(s)
Coronary Artery Bypass/adverse effects , Hemothorax/diagnosis , Internal Mammary-Coronary Artery Anastomosis/adverse effects , Diagnosis, Differential , Hemothorax/diagnostic imaging , Hemothorax/etiology , Hemothorax/pathology , Humans , Male , Middle Aged , Postoperative Complications , RadiographySubject(s)
Cysts/complications , Heart Neoplasms/complications , Pericardium/pathology , Tachycardia, Ventricular/etiology , Aged , Cysts/pathology , Cysts/surgery , Female , Heart Neoplasms/pathology , Humans , Myocardium/pathology , Tachycardia, Ventricular/pathology , Tachycardia, Ventricular/surgeryABSTRACT
We describe a case of congenitally corrected transposition of great arteries (CCTGA). Tricuspid valve replacement was performed due to valve dysfunction following bacterial endocarditis. After two weeks' antibiotic therapy haemodynamic stabilisation was obtained and the patient was operated in the third week. On cardiopulmonary bypass with 28 degrees C degree systemic hypothermia, the left atrium was approached transeptally. At exploration, the systemic atrioventricular valve was tricuspid valve and pulmonary atrioventricular valve was in shape of a mitral valve. The posterior leaflet of the tricuspid valve was ruptured and vegetations above it were observed. The valve was excised and a 29 mm St-Jude mechanical heart valve prosthesis implanted using a teflon reinforced separated suture technique. After operation the patient recovered rapidly and following six weeks' antibiotic therapy, the patient was discharged.
Subject(s)
Endocarditis, Bacterial/complications , Endocarditis, Bacterial/surgery , Heart Valve Prosthesis Implantation , Transposition of Great Vessels/complications , Tricuspid Valve Insufficiency/surgery , Tricuspid Valve/microbiology , Adult , Female , Humans , Suture Techniques , Tricuspid Valve/surgery , Tricuspid Valve Insufficiency/microbiologySubject(s)
Aortic Aneurysm, Thoracic/diagnosis , Aortic Dissection/diagnosis , Cardiac Catheterization/adverse effects , Aortic Dissection/diagnostic imaging , Aortic Dissection/etiology , Aortic Dissection/surgery , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/etiology , Aortic Aneurysm, Thoracic/surgery , Diagnosis, Differential , Dyspnea/etiology , Female , Heart Septal Defects, Atrial/surgery , Humans , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology , Postoperative Complications/surgery , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Cognitive dysfunction (as an indicator of cerebral dysfunction after open heart surgery) was observed in as many as 70% of patients who underwent cardiopulmonary bypass. S-100beta protein is a sensitive indicator of cerebral injury. We aimed to compare the effects of hydroxyethyl starch and Ringer lactate prime solutions in the protection of cerebral tissue in cardiopulmonary bypass using serum S-100beta protein levels and informative cognitive tests. METHODS: Patients were randomized into two groups. Open heart surgery was performed by using hydroxyethyl starch solution in group 1 (n = 15) and Ringer lactate solution in group 2 (n = 15). Preoperative, perioperative, and postoperative S-100beta protein levels and informative cognitive test scores, clinical and operational characteristics of the patients were compared. RESULTS: A significant difference was found only between preoperative and postoperative results of verbal accuracy (human) test in group 1, whereas differences between preoperative and postoperative scores of continuous skill, verbal accuracy (human), verbal accuracy (animal), verbal accuracy (human-animal), go-no-go paradigm, calculation, and abstract thinking tests were significant in group 2 (p < or = 0.05). The S-100beta protein levels were not significantly different between the groups (group p = 0.97). CONCLUSIONS: Because hydroxyethyl starch prime solution used in extracorporeal circulation had significant positive effects with informative-cognitive tests when compared to Ringer lactate solution, it seems to be a better prime solution to prevent cerebral dysfunction in these patients.
Subject(s)
Cardiopulmonary Bypass/methods , Cognition/drug effects , Extracorporeal Circulation/methods , Hydroxyethyl Starch Derivatives/pharmacology , Isotonic Solutions/pharmacology , S100 Proteins/metabolism , Cardiopulmonary Bypass/adverse effects , Cognition Disorders/etiology , Cognition Disorders/prevention & control , Female , Humans , Male , Middle Aged , Monitoring, Intraoperative , Postoperative Care , Preoperative Care , Ringer's LactateABSTRACT
PURPOSE: To analyze the operation methods, injury etiologies and localizations, post-operative complications and the reasons for mortality in patients who were admitted for peripheral vascular injuries to our clinics. METHODS: From January 1979 to February 2002, 410 patients were operated for peripheral vascular injuries. Three hundred and one of the patients were male (73.5%) and 109 of them were female (26.5%), and their ages ranged between 1-88 (mean 35.5 years). RESULTS: The most common etiological reason was firearm injuries in 163 patients (39.8%). The most common injured artery was the brachial artery (83 patients, 22.5%) among a total of 369 patients whereas the most commonly injured vein was the common femoral vein (60 patients, 23.4%) in a total of 256 patients. Isolated venous injuries were encountered in 41 patients whereas isolated arterial injuries were detected in 154 patients (37.5%). Hospital admission duration of the patients after trauma was approximately 3 hours. CONCLUSION: The extremity-salvage rate in the group was 92.3%. The hospital stay period of the patients was 21.8 days. The mortality rate was 2.6% (11 patients).
Subject(s)
Blood Vessels/injuries , Extremities/blood supply , Peripheral Vascular Diseases/diagnosis , Vascular Surgical Procedures , Adolescent , Adult , Aged , Aged, 80 and over , Brachial Artery/injuries , Child , Child, Preschool , Collateral Circulation , Compartment Syndromes/diagnosis , Extremities/physiopathology , Extremities/surgery , Female , Femoral Vein/injuries , Humans , Infant , Male , Middle Aged , Patient Admission , Peripheral Vascular Diseases/physiopathology , Peripheral Vascular Diseases/surgery , Retrospective Studies , Survival Analysis , Treatment Outcome , Turkey/epidemiology , Ultrasonography, DopplerABSTRACT
A 16-month-old girl presented with the classic signs of Ellis-van Creveld syndrome. Mitral clefts were repaired by direct suturing. The single atrium was repaired by creating a new septum with a pericardial patch, leaving the coronary sinus in the left atrium. During perioperative exploration, thymic hypoplasia was recognized.