RESUMEN
BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting (CABG), pulsatile cardiopulmonary bypass (CPB), and non-pulsatile CPB techniques on oxidative stress and the respiratory system in the current study. MATERIALS AND METHODS: The patients were allocated into three different groups according to perfusion techniques, as follows: off-pump CABG group (n=10); pulsatile CPB (n=11); and non-pulsatile CPB group (n=11). Serum carbonyl level was measured and a pulmonary function test was performed preoperatively and postoperatively. RESULTS: The postoperative increase in the carbonyl level was significantly lower in the off-pump CABG group compared to the other two groups, while there was no significant difference between the pulsatile and non-pulsatile CPB groups with respect to carbonyl levels. Arterial partial pressure of oxygen, forced expiratory volume in one second, and forced vital capacity were significantly higher in the off-pump CABG group compared to other two groups in the postoperative period. CONCLUSION: We found that off-pump CABG had less negative effects on oxidative stress and the respiratory system compared to pulsatile CPB and non-pulsatile CPB techniques. Additionally, there was no significant difference between pulsatile and non-pulsatile CPB.
Asunto(s)
Proteínas Sanguíneas/metabolismo , Puente de Arteria Coronaria Off-Pump/métodos , Puente de Arteria Coronaria/métodos , Inflamación/sangre , Oxígeno/sangre , Mecánica Respiratoria/fisiología , Femenino , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estrés Oxidativo , Presión Parcial , Periodo Posoperatorio , Estudios ProspectivosRESUMEN
BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study. METHODS: A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively. RESULTS: The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100ß levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05). CONCLUSION: We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.
Asunto(s)
Puente Cardiopulmonar/métodos , Enfermedad de la Arteria Coronaria/cirugía , Inflamación/sangre , Factores de Crecimiento Nervioso/sangre , Proteínas S100/sangre , Anciano , Puente Cardiopulmonar/clasificación , Femenino , Humanos , Interleucina-6/sangre , Interleucina-8/sangre , Masculino , Persona de Mediana Edad , Subunidad beta de la Proteína de Unión al Calcio S100 , Factores de Tiempo , Factor de Necrosis Tumoral alfa/sangreRESUMEN
Neurofibromatosis is a dominantly inherited, progressive, generalized dysplasia of mesodermal and neuroectodermal tissues. Vascular lesions associated with neurofibromatosis type 1 (NF-1) are mainly characterized by stenosis, occlusion, aneurysm, pseudoaneurysm, and rupture or fistula formation of small, medium, and large-sized arteries. The authors hereby present a rare case of NF-1 with bilateral aneurysms and large pseudoaneurysms of the femoral and popliteal arteries and occlusion of the left superficial femoral artery.
Asunto(s)
Aneurisma Falso/etiología , Aneurisma/etiología , Neurofibromatosis 1/complicaciones , Enfermedades Vasculares Periféricas/etiología , Aneurisma/diagnóstico por imagen , Aneurisma Falso/diagnóstico por imagen , Niño , Femenino , Arteria Femoral , Humanos , Enfermedades Vasculares Periféricas/diagnóstico por imagen , Arteria Poplítea , RadiografíaRESUMEN
Cardiac hydatid cysts are rare and represent 0.5-2% of all cases. Cardiac localization of hydatid cysts usually occurs in adults. Diagnosis is difficult because of the long latency between infection and manifestation of the disease, and also symptoms are nonspecific. We present a case study of 13-year-old girl with lots of hydatid cysts localized in the neighbourhood of the inferior vena cava right atrium and the superior vena cava right pulmonary artery aorta and posterior portion of the left atrium and the left ventricle, and the intramyocardium of the posterior wall of the left ventricle. An abdominal computed tomography scan showed a solitary cyst in the right posterior lobe of the liver. Following albendazole therapy for 3 weeks, she was operated on without cardiopulmonary bypass. Numerous alive and dead cysts were removed. Hepatic cysts were drained by percutaneous ultrasonography guided aspiration technique after surgery. On the 8th postoperative day, she was discharged while she was still on albendazole therapy.
Asunto(s)
Equinococosis/diagnóstico por imagen , Equinococosis/terapia , Cardiopatías/diagnóstico por imagen , Cardiopatías/terapia , Adolescente , Albendazol/administración & dosificación , Procedimientos Quirúrgicos Cardíacos/métodos , Terapia Combinada , Drenaje/métodos , Equinococosis/diagnóstico , Femenino , Estudios de Seguimiento , Cardiopatías/diagnóstico , Humanos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , UltrasonografíaRESUMEN
Thirty-six patients ranging in age from 7 months to 15 years and weighing from 5300 g to 49 kg (24 undergoing corrective surgery and 12 cases with reversed shunt and no operation) underwent technetium 99m hexamethyl propylenamine oxime (Tc-99m HMPAO) lung clearance study and the results were compared with catheterization and pathology. Patients were allocated into three groups with respect to pathological grading (Heath-Edwards' classification) and the results were correlated on the basis of pathology. In group I (grades I and II), Pearson correlation coefficient was 0.86 with pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), and Tc-99m HMPAO lung clearance (t1/2). Pearson correlation coefficients were 0. 863 and 0.88 in the second (grade III) and third group (with reversed shunt and no operation). There were statistically significant differences among the groups with respect to PAP, PVR, or t1/2. The results of radionuclide study (t1/2) were very well correlated within the groups with respect to hemodynamic parameters (PAP and PVR). Tc-99m HMPAO has potential as a highly sensitive indicator for detecting early and minimal microvascular lung injuries, and it may reflect accurate lung clearance and retention enabling an estimation of the state of pulmonary hypertension.
Asunto(s)
Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/cirugía , Hipertensión Pulmonar/diagnóstico , Pulmón/metabolismo , Radiofármacos/farmacocinética , Exametazima de Tecnecio Tc 99m/farmacocinética , Adolescente , Análisis de Varianza , Cateterismo Cardíaco , Niño , Preescolar , Femenino , Cardiopatías Congénitas/patología , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Humanos , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/patología , Lactante , Masculino , Estudios Prospectivos , Valores de Referencia , Pruebas de Función Respiratoria , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
The use of prosthetic valves carries a high incidence of complications including thromboembolism, hemolysis, infection, impaired hemodynamic function and mechanical failure. Unstented homograft valves provide a good quality of life, particularly in terms of a reasonable freedom from these complications. This paper presents the first simultaneous replacement of the mitral and aortic valves using fresh unstented pulmonary and aortic homografts collected from the same donor. We believe that this technique will be especially useful in developing countries facing financial difficulties and problems with patient education.