Extrapelvic intravenous uterine leiomyomatosis mimicing cardiac myxoma and deep vein thrombosis.

Extrapelvic intravenous uterine leiomyomatosis is a rare smooth muscle neoplasm. Uterine leiomyomatosis is a histologically benign pathology. Rarely, it can be confused with a cardiac mass. A 44-year-old female patient was admitted with increasing severity of pain and swelling in both legs for the past week. The patient was initially diagnosed with bilateral deep vein thrombosis. After further evaluation, we decided that the patient had cardiac myxoma. However, we intraoperatively observed that the lesion in the right atrium was arising from the inferior vena cava. In the final postoperative histopathological evaluation, the definite diagnosis was extrapelvic intravenous leiomyomatosis. The patient was discharged uneventfully following her second operation.

Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency.

OBJECTIVE: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV) insufficiency. METHODS: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. RESULTS: A complete clinical and radiological healing was observed in 50 patients (60%). In 13 cases (15.6%), a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6%) developed superficial vein thrombosis, and only one patient (1.2%) developed deep vein thrombosis. Contact was lost from 32 patients (38.5%) for different reasons. CONCLUSION: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping.

Surgical treatment of a case with rapidly growing mass lesion after trauma: on the left forearm arteriovenous malformation.

In this case, we report a vascular malformation with high flow pattern complicated with trauma. A postoperative histopathology examination confirmed an arterio-venous malformation in specimens of surgical excision material. In our opinion, posttraumatic progression of a vascular malformation is an emergency and requires an urgent evaluation with surgery at any localization of the body.

An experience of arteriovenous fistulas created for hemodialysis in the largest health center in eastern Turkey.

BACKGROUND: The aim of the study was to evaluated the primary and secondary (after reoperation) patency rates and some effect factors in fistula patency for hemodialysis patients. MATERIAL AND METHODS: Over a 10-year period, 1529 arteriovenous fistulas (AVFs) were fashioned in 1003 (611 males, 392 females; median age range 7-72) patients using the native vascular tissue and prosthetic graft material. We also evaluated the effects of various factors in fistula patency and primary and secondary patency rates in AVF patients. RESULTS: The primary patencies of fistulas in this series were 72%, 64%, 51%, 41%, and 26%, and secondary patencies were 79%, 70%, 56%, 46%, and 33% at 6 months, 1, 2, 4, and 6 years, respectively. There was no statistically significant difference between the primary and secondary patencies (p = 0.082) in the 6-year follow-up. Factors affecting the patency of fistulas were diabetes mellitus (p < 0.005), hypertension (p < 0.005), and smoking habits (p < 0.005). CONCLUSION: Even if shown to be not statistically significant, successful surgical revision after fistula occlusion improves secondary patency with potential benefits in terms of patient morbidity. Besides, the AVF patency was shortened in chronic renal-insufficiency patients with diabetes mellitus, hypertension, and smoking habits.

The effect of partial cross clamping administration on postoperative healing of pulmonary functions for coronary artery bypass graft operations.

OBJECTIVE: To compare partial cross clamping and mechanic pulmonary ventilation technique with total cross clamping utilization during cardiopulmonary bypass in coronary artery bypass graft operations in terms of pulmonary healing. METHODS: Between February and April 2007, isolated coronary artery bypass graft operation was performed for 30 patients in the Cardiovascular Surgery Department, Erzurum Regional Training and Research Hospital, Erzurum, and the Cardiovascular Surgery Department, Medical Faculty, Akdeniz University, Antalya, Turkey. The patients were divided into 2 groups; Group A (n=15) with total cross clamping, and Group B (n= 15) partial cross clamping and mechanic pulmonary ventilation in cardiopulmonary bypass. RESULTS: Postoperative pulmonary functions were studied in 2 main data; 1) the oxygenization rate of artery blood gas, and 2) spirometer results. Additionally, total cardiopulmonary bypass and total cross-clamping times, extubation times, numbers and types of grafts, days of intensive care unit treatment, and hospitalizations were recorded. There was no statistically significant difference between the 2 groups for oxygenization rate, and surgery hospitalization details. We observed a statistically significant difference with advantage in Group B in spirometric results in terms of healing of pulmonary functions. CONCLUSION: Total cross clamping and circulatory arrest of the lungs are the main sources of postoperative pulmonary complications based on the pulmonary inflammatory response in coronary artery bypass surgery.

Surgical management of coronary artery stenosis and peripheral artery occlusive disease of the lower extremity in a patient with neurofibromatosis: report of a case.

We herein report the case of a patient demonstrating both coronary artery and peripheral artery occlusive disease with neurofibromatosis, which were successfully treated during the same session with coronary artery bypass graft surgery and a femoropopliteal bypass graft surgery procedure. The recognition of a possible association between neurofibromatosis and coronary artery and other vascular structures will further facilitate the successful surgery and clinical management of this rare clinical entity.

Incidence of postoperative acute renal failure among violence-related cardiovascular trauma patients: a review of our experience in 117 cases.

BACKGROUND: The purpose of this retrospective study was to determine the incidence of renal failure and hemodialysis (HD) in postoperative period after cardiovascular surgery associated with trauma. METHODS: One hundred and seventeen cases of violence-related cardiovascular trauma patients had emergent surgery between 1996 and 2009. Cases were reviewed in three main groups: Cardiac trauma in 11 patients (Group A), vascular trauma in 78 patients (Group B), and cardiovascular trauma in 28 patients (Group C). Postoperative incidence of HD requirements with acute renal failure (ARF) was investigated in these groups of patients postoperatively. RESULTS: Multiorgan deficiency developed in 10 patients from Group A, in 45 patients from Group B, and in 26 patients from Group C. Overall mortality was 81 cases in 117 patients. Total hospitalization periods were 21 +/- 2, 17 +/- 3, and 27 +/- 1 days for Group A, Group B, and Group C, respectively. HD administrations were indicated in 3 patients in Group A, 41 patients in Group B, and 9 patients in Group C. No statistically significant difference presented in any study parameter between groups. CONCLUSIONS: Cardiovascular trauma is a common reason for emergent cardiovascular surgery. Postoperative renal failure occurs among these patients in a wide percentage. We strongly advocate a close and detailed follow-up of renal functions in these patients during the hospitalization period and immediate HD at indication.