The Results of Rigid Titanium Plate Reinforcement and Only Conventional Wire Methods in Sternal Fixation in Morbidly Obese Patients.

INTRODUCTION: In this study, it was aimed to compare the clinical results and complications of rigid titanium plate reinforcement and only conventional wire methods for sternum fixation in morbidly obese patients who underwent sternotomy for open-heart surgery. METHODS: The study was planned as a retrospective case-control study. Morbidly obese patients who underwent open-heart surgery with median sternotomy between 2011 and 2021 were analyzed retrospectively. RESULTS: There was no statistically significant difference between the two groups in terms of characteristics of the patients (P≥0.05). Sternal dehiscence, sternum revision, wound drainage, and mediastinitis were significantly less common in the titanium plate group (P≤0.05). There was no statistically significant difference between the groups in terms of 30-day mortality (P≥0.05). CONCLUSION: Rigid titanium plate reinforcement application produced more positive clinical results than only conventional wire application. In addition, it was determined that although the rigid titanium plate application prolonged the operation time, it did not make a significant difference in terms of mortality and morbidity compared to the conventional wire applied group.

The Results of Rigid Titanium Plate Reinforcement and Only Conventional Wire Methods in Sternal Fixation in Morbidly Obese Patients

ABSTRACT Introduction: In this study, it was aimed to compare the clinical results and complications of rigid titanium plate reinforcement and only conventional wire methods for sternum fixation in morbidly obese patients who underwent sternotomy for open-heart surgery. Methods: The study was planned as a retrospective case-control study. Morbidly obese patients who underwent open-heart surgery with median sternotomy between 2011 and 2021 were analyzed retrospectively. Results: There was no statistically significant difference between the two groups in terms of characteristics of the patients (P≥0.05). Sternal dehiscence, sternum revision, wound drainage, and mediastinitis were significantly less common in the titanium plate group (P≤0.05). There was no statistically significant difference between the groups in terms of 30-day mortality (P≥0.05). Conclusion: Rigid titanium plate reinforcement application produced more positive clinical results than only conventional wire application. In addition, it was determined that although the rigid titanium plate application prolonged the operation time, it did not make a significant difference in terms of mortality and morbidity compared to the conventional wire applied group.

The Effect of External Apple Vinegar Application on Varicosity Symptoms, Pain, and Social Appearance Anxiety: A Randomized Controlled Trial.

Aim. We aimed to determine the effect of external apple vinegar application on the symptoms and social appearance anxiety of varicosity patients who were suggested conservative treatment. Method. The study was planned as an experimental, randomized, and controlled study. 120 patients were randomly selected and then were randomly allocated to either experimental or control group by simple blind random sampling method. In the collection of research data, a questionnaire questioning sociodemographic and clinical characteristics, the Visual Analog Scale (VAS) for pain, and the Social Appearance Anxiety Scale (SAAS) were used. The patients in the study group were suggested to apply apple vinegar to the area of the leg with varicosity alongside the treatment suggested by the doctor. The patients in the control group received no intervention during the study. Results. The sociodemographic and clinic characteristics of both groups were found to be similar (p > 0.05). The patients were evaluated with regard to cramps, pain, leg fatigue perception, edema, itching, pigmentation, and weight feelings in the leg, VAS, and SAAS averages in the second evaluation; the control group had a decrease in such symptoms (p > 0.05) although the decrease in the application group was higher and statistically meaningful (p < 0.05). Conclusion. We determined that the external application of apple vinegar on varicosity patients, which is a very easy application, increased the positive effects of conservative treatment.

The significance of gender in patients administered coronary angiography with respect to smoking, peripheral arterial disease, diabetes mellitus and the procedure used.

RATIONALE, AIMS AND OBJECTIVES: This descriptive study was planned and conducted to determine whether or not gender is significant in patients administered coronary angiography with respect to smoking, peripheral arterial disease, diabetes mellitus and the procedure used. METHODS: Based on the hospital records that were scanned retrospectively, the study included patients aged 18 and over who were diagnosed with coronary arterial disease and were administered for the first time a coronary angiography procedure in the Cardiology Clinic of Osmaniye Private New Life Hospital between 1 September 2012 and 31 December 2013. The data was evaluated on the SPSS 21.0 software. Percentages, averages, analysis of variance, Pearson's correlation analysis, chi-square independence test were used as our analysis method. RESULTS: 40.2% of the patients who took part in the study were female and 59.8% male; the mean age was 58.18 ± 11.73. It was observed that approximately 41% of the patients smoked, 5% of them had peripheral arterial disease, 23.9% were administered percutaneous transluminal coronary angioplasty + stent and a surgical treatment was planned for 16.1% of them. Gender was considered statistically significant in terms of smoking, peripheral arterial disease, diabetes mellitus and the procedure used (P < 0.05). CONCLUSIONS: We see that gender is important in the patient group consisting of patients with coronary arterial disease. We think that the information herein will provide a guideline for evaluating treatment strategies and prognoses as well as for the training and consultancy to be provided to patient groups.

Metabolic syndrome in patients undergoing coronary angiography.

INTRODUCTION: Metabolic Syndrome (MetS) is basically a cluster of cardiovascular risks that involve changes in metabolic and hemodynamic indicators; various organizations have defined it with small differences. Metabolic syndrome is a lethal endocrinopathy starting with insulin resistance and inviting a chain of systemic disorders such as abdominal obesity, glucose intolerance or diabetes mellitus (DM), dyslipidemia, hypertension (HT) and coronary artery disease (CAD). MATERIAL AND METHODS: This prospective and descriptive study was conducted at the Cardiology Clinic of a Private Hospital in Osmaniye between January 2014 and May 2014. The study population included all patients who were administered a CA procedure at the Cardiology Clinic of Private New Life Hospital in Osmaniye in 2014. RESULTS: The majority of the patients were male (63.3%), the mean age was 59.09±10.98, vast majority of them had social security (98.5%), 32.8% of them smoked, 7.2% had peripheral arterial disease (PAD), 52.5% were diagnosed with DM, 24.8% with HT, percutaneous transluminal coronary angioplasty (PTCA) or stent was administered to 40.3% of the patients who underwent CA and coronary artery bypass grafting (CABG) was decided for 15.5% of them. 41.8% of the patients met the MetS diagnosis criteria. The mean BMI was found to be 28.61±4.68, the mean FBS to be 143.20±74.83, the mean triglyceride value to be 168.73±96.94 and the mean HDL value to be 37.04±9.20. Although male gender came first among the patients who underwent CA, the prevalence of MetS did not show a statistically significant correlation with gender, mean age or smoking. The prevalence of HT, PAD and DM was significantly higher in the patients who met the MetS criteria. The mean values of FBS, HDL, CK-MB, triglyceride and cholesterol were also significantly higher in the patients who met the MetS criteria. As BMI increased, the rate at which MetS criteria are met also increased. CONCLUSION: The objective is to prevent diabetes and cardiovascular diseases. Weight loss achieved with proper nutrition and an exercise program will have a reversing effect on all the disorders seen in metabolic syndrome.

"V-PLASTY": a novel technique to reconstruct pulmonary valvular and annular stenosis in patients with right ventricular outflow tract obstruction.

BACKGROUND: The goal of repair of right ventricular outflow tract obstruction with or without Tetralogy of Fallot (TOF) is to eliminate valvular and/or subvalvular obstruction. However, this operation has a high risk of late complication of pulmonary insufficiency. In this study, we aimed to present early period results of our new technique that we call "V-Plasty" developed to prevent pulmonary insufficiency after pulmonary valve reconstruction in selected patients. METHODS: Between January 2006 and January 2010, we performed V-plasty for pulmonary valve reconstruction in 10 patients. Eight patients (5 males, 3 females) had TOF and 2 patients (1 male, 1 female) had atrial septal defect concomitant with pulmonary valve stenosis. Patient selection for V-plasty reconstruction was made due to the pulmonary valve anatomy and degree of stenosis. The mean follow-up time was 55.7 ± 16.2 months (ranging from 32 to 80 months). RESULTS: Functional capacity of the patients improved immediately after the surgery. There were no mortality and re-operation in follow-up period. Patients were followed up with echocardiography one week after the operation, at 1st, 6th, 12th months and annually. There was no pulmonary insufficiency. CONCLUSIONS: Operative correction of the pulmonary outflow tract obstruction with or without TOF, frequently requires transannular enlargement because of the infundibular and/or annular-valvular obstruction. This conventional technique is usually a reason for late pulmonary insufficiency. In our study, we have not seen pulmonary insufficiency in early term follow-up period. Our early term results are encouraging, but long term follow-up results are needed with large case series.

Leiomyosarcoma protruding into the left ventricle during diastole: report of a case.

Cardiac leiomyosarcoma is a rare tumor with poor survival prospects. Surgery prolongs survival, but the tumor often recurs early after surgery. The diagnosis is often made by transthoracic echocardiography. Magnetic resonance imaging and computed tomography are required to characterize the location and extent of cardiac masses. In this report, we present a patient with a leiomyosarcoma that was resected completely. The tumor was located in the left atrium, mimicked a myxoma, and protruded into the left ventricle during diastole.

Retrospective analysis of surgically treated infective endocarditis cases.

BACKGROUND: Prosthetic valve endocarditis (PVE) and native valve endocarditis (NVE) both cause high rates of morbidity and mortality and are significant health problems in our community. Optimal timing of the surgical intervention depends on the hemodynamic stability of the patient. In the present study, we retrospectively evaluated the clinical status, bacteriology, morbidity, and mortality parameters of infective endocarditis cases that were treated surgically. METHODS: Thirty patients (20 male and 10 female) who underwent cardiac valve surgery between April 2001 and December 2006 were included in the study. The mean (SD) age of the patients was 36.5 +/- 5.42 years. Thirty-five surgical operations were conducted on 30 patients. We evaluated the patient demographic, etiologic, and surgical data retrospectively with respect to mortality and morbidity. RESULTS: The mean time to develop PVE was 13 months. We recorded a mortality rate of 16.6% (2 deaths in NVE operations and 3 deaths in PVE operations). Repeat surgeries were performed in 2 aortic valve cases and 3 mitral valve cases in which paravalvular leakage was noticed in the prosthetic valves. CONCLUSION: Despite significant medical and surgical advances, both NVE and PVE still continue to be causes of high mortality and morbidity rates in cardiac surgery.

Predictive risk factors for early mortality in operative treatment for chronic ischemic mitral insufficiency.

BACKGROUND: The combination of coronary artery bypass grafting and mitral valve surgeries is closely associated with high in-hospital mortality and morbidity. In this study, we sought to analyze the factors that influence early mortality in 68 patients undergoing coronary artery bypass grafting + mitral valve surgery due to ischemic mitral insufficiency. METHODS: Of 1183 patients undergoing coronary bypass surgery between April 2002 and June 2006, 68 patients (42 male and 26 female) 42 to 78 years of age (mean +/- SD, 59.3 +/- 9.1) underwent mitral valve surgery accompanying coronary bypass surgery (survival, n = 59; mortality, n = 9). The cases were analyzed regarding the demographic, preoperative, and perioperative risk factors that influence mortality. RESULTS: The early mortality rate was found to be 13.2% (9/68) in patients with ischemic mitral regurgitation undergoing simultaneous coronary bypass and mitral valve surgeries. New York Heart Association class > or =3, left ventricle end-systolic volume, left ventricle end-systolic diameter, cardiopulmonary perfusion time, preoperative unstable angina pectoris, intra-aortic balloon application, and age >65 years were determined to be statistically significant risk factors that influence early in-hospital mortality.Conclusion. Surgery, despite having a high mortality risk in patients with ischemic mitral insufficiency, is considered to be a treatment measure that generally improves the quality of life and prolongs life.