[Penetrating cardiac injuries: assessment of 21 patients]. / Penetran kardiyak yaralanmalar: 21 olgunun degerlendirilmesi.

BACKGROUND: Penetrating cardiac injuries carry high mortality rates due to serious clinical outcomes. This study was planned to investigate patients treated surgically in our hospital for penetrating cardiac injury. METHODS: In this article, we reviewed retrospectively 21 patients (18 male, 3 female) suffering from penetrating heart injuries who admitted to our hospital between February 2006 and January 2011. Patients were evaluated with respect to clinical findings, treatment methods and clinical outcomes. RESULTS Among the patients, 19 cases were due to stab injury and 2 cases to gunshot injury. Emergent surgical interventions were performed in all patients. Cardiac injuries involved the right ventricle in 13 patients, left ventricle in 5 patients and right atrium in 3 patients. There was no left atrial injury. Cardiac injuries were repaired by primary suturing method. Mortality was determined in 6 patients (28.6%). CONCLUSION: Penetrating cardiac injuries are seen generally in young people. Early transport, proper resuscitation and emergent surgery treatment improved survival in patients who sustained penetrating cardiac injuries.

Repair of anomalous origin of the left coronary artery arising from right pulmonary artery with rolled-conduit-extended reimplantation in an adult.

The left coronary artery arising from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It causes high mortality if untreated in childhood. Only 10% to 15% of patients reach adulthood. We report a successful repair of ALCAPA in an adult with a rolled-conduit-extended-reimplantation technique. The procedure is easily applicable and has technical advantages for creating a longer and wider conduit and may decrease bleeding.

The cerebroprotective effects of pentoxifylline and aprotinin during cardiopulmonary bypass in dogs.

OBJECTIVE: The purpose of this study was to investigate the cerebroprotective effects of pentoxifylline (PNX) and aprotinin in dogs using cardiopulmonary bypass (CPB). MATERIALS AND METHODS: Eighteen clinically healthy dogs were divided into three groups: Group 1 (control, n = 6), Group 2 (PNX, n = 6), and Group 3 (aprotinin, n = 6). PNX was administered at a dose of 300 mg/day in Group 2 three days before the operation and during the operation. Half a million IU aprotinin were added to the prime solution and 500,000 IU were transfused via a central venous jugular catheter preoperatively in Group 3. Blood samples were taken from the central jugular vein before and after CPB and interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and S100beta protein were measured. Gliosis was investigated histopathologically in cerebral cortex biopsy samples under light microscopy. RESULTS: The preoperative results of IL-6, TNF-alpha, and S100beta protein values were found to be significantly higher (p < 0.001) when compared with postoperative values. This significant difference was observed in the same parameters between Groups 1 and 2, and 1 and 3 (p < 0.001). There was no significant difference between Groups 2 and 3. Comparison between pre- and postoperative levels of IL-6 and TNF-alpha for Group 2 and Group 3 revealed statistically significant differences (p < 0.001), whereas S100beta protein levels did not. Histopathological examinations showed significant differences between the control group and PNX and aprotinin, and between aprotinin and PNX groups (p < 0.001). CONCLUSION: PNX and aprotinin might be useful in order to reduce postoperative cerebral damage in patients undergoing cardiac surgery with CPB.