An Important but Forgotten Technique: Aortic Fenestration.

Aortic fenestration is a technique that treats organ ischemia in descending aortic dissection. Open surgical aortic fenestration is an effective yet uncommonly used and widely forgotten procedure. Here, we describe 2 patients suffering from chronic thoracoabdominal aortic dissection, and we aimed to identify under what circumstances surgical aortic fenestration should be applied, to assess its safety and efficacy.

The APACHE II Score as a Predictor of Mortality After Open Heart Surgery.

OBJECTIVE: The Acute Physiology and Chronic Health Evaluation (APACHE) severity of disease classification system, which is one of the most widely used scoring systems to predict mortality, is used for intensive care units (ICU) patients. This study aimed to evaluate the predictive ability of APACHE II for mortality in patients after undergoing cardiac surgery. We studied if APACHE II could successfully predict the outcome in post-cardiac surgery patients. METHODS: This study involved retrospective data collection of all adult patients who were admitted to Ordu State Hospital cardiovascular surgery ICU following cardiac surgery from August 2013 to December 2015. Area under the receiver operating characteristic (ROC) curve (AUC) values were calculated for the APACHE II model. RESULTS: During the two years of data collection, we included 600 patients with a mean age of 64.77±10.148 years. Of these, 180 (30.0%) were females. The ICU mortality rate was 8.33%, and the mean length of ICU stay was 4.210±6.913 days. The mean pre-operative EuroSCORE was 3.890±2.565, and the mean pre-operative APACHE II score was 6.790±3.617. The AUC values for APACHE II and EuroSCORE were 0.743 and 0.767, respectively. CONCLUSION: The APACHE II model can be used to predict mortality in a Turkish population of patients who have undergone cardiac surgery.

Surgical Treatment of Right Ventricular Rupture Caused by Total Occlusion of the Right Coronary Artery.

The rupture of the right ventricular anterior wall after myocardial infarction is a rare and life-threatening complication associated with high mortality. Early diagnosis by echocardiographic examination and successful treatment is discussed in this case report.

Should patients undergo ascending aortic replacement with concomitant cardiac surgery?

AIM: To determine whether concomitant surgery is a predictor of mortality in patients undergoing surgery for ascending aortic aneursym. METHODS: Ninety-nine patients who underwent ascending aortic aneursym surgery between January 2010 and January 2015 were included in this study. Nineteen patients underwent ascending aortic replacement (RAA) only, 36 underwent aortic valve replacement (AVR) and RAA, 25 underwent coronary artery bypass grafting (CABG) and RAA, 11 underwent the Bentall procedure, and eight underwent AVR, CABG and RAA. RESULTS: Depending on the concomitant surgery performed with RAA, the mortality risk increased 2.25-fold for AVR, 4.5-fold for CABG, 10.8-fold for AVR + CABG and four-fold for the Bentall procedure, compared with RAA alone. CONCLUSION: Concomitant cardiac surgery increased the mortality risk in patients undergoing RAA, but the difference was not statisticaly significant. Based on these study results, patients undergoing cardiac surgery, with a pre-operative ascending aortic diameter of over 45 mm, should undergo concomitant RAA.

Postpartum aortic dissection in a patient without Marfan's syndrome.

Aortic dissection can occur in pregnancy or during the postpartum period without pre-existing disease and it is a rare but potentially life-threatening event. Herein, we present a young woman without Marfan's syndrome who developed a postpartum ascending aortic dissection 5 days after cesarean section.

Successful combination of interventional and surgical treatment of left atrium perforation.

Percutaneous interventions are increasingly used in the treatment of cardiac diseases which are resistant to medical treatment. However, the complications caused by these interventions can lead to serious results. In this article, we present a case of a successful combination of interventional and surgical treatment methods, following the development of left atrial perforation during radiofrequency catheter ablation (RFA), in a patient with atrial fibrillation resistant to medical treatment.