Horowitzterrell7931

Background In this study, we aimed to present our mid-term results of basilic vein transposition in the forearm to create an arteriovenous fistula. Methods Between January 2015 and October 2017, a total of 21 patients (13 males, 8 females; mean age 54.2±11.3 years; range, 32 to 74 years) with an adequate basilic vein and radial arterial systems who underwent basilic vein transposition in the forearm were retrospectively analyzed. All operations were performed under local anesthesia and mild sedation. The basilic vein was harvested using a single incision from elbow joint to wrist as an in situ vein graft. If the harvested basilic vein did not extend easily to the radial artery in the wrist region, the saphenous vein was harvested to extend arteriovenous fistula tract. Results The mean follow-up was 25.3±9.8 (range, 2 to 32) months. All patients underwent arteriovenous access surgery using transposed basilic vein in the forearm. In all patients, except for two, transposed basilic vein in the forearm stayed patent during follow-up with a patency rate of 90.5%. Seliciclib cell line The mean fistula maturation time was 45.2±10.7 (range, 28 to 59) days. Conclusion If cephalic vein diameters are too small for arteriovenous fistula creation, basilic vein system in the medial surface of the forearm may be considered a favorable option. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background The aim of this study was to present clinical characteristics, peri-procedural outcomes, early and late complications, and management strategies in patients undergoing totally implantable venous access port insertion through percutaneous subclavian vein. Methods A total of 2,084 port devices were inserted to 2,000 cancer patients (1,066 males, 934 females; mean age 58.4±12.7 years; range, 18 to 88 years) through subclavian vein using percutaneous landmark method between March 2012 and June 2018. Medical data including demographic features, primary diagnosis, technical success, procedural time, duration of device use, reasons for the device removal, and early and late complications were retrospectively analyzed. Results The most common type of cancer was colon cancer in males and breast cancer in females. Technical success rate of the procedure was 98.5%. Right subclavian vein was accessed in the majority of patients (92.4%). Early complications including inadvertent arterial puncture, catheter malposition, superficial hematoma, and pneumothorax occurred in 143 patients (6.9%), while late complications including infection, catheter occlusion, venous thrombosis, wound problems, catheter migration and embolization and pinch-off syndrome was developed in 118 patients (5.7%). Inadvertent arterial puncture in 63 patients (3%) was the most common early complication, while infection in 44 patients (2.1%) was the most common late complication. A total of 192 devices were removed due to the completion of chemotherapy or development of complications. Conclusion Our study confirmed the safety and tolerability of totally implantable venous access port insertion through percutaneous subclavian vein with high technical success and low complication rates. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background The aim of this study was to investigate whether routine complete blood count parameters such as the mean platelet volume, red cell distribution width, white blood cell and platelet counts, and novel inflammatory biomarkers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio could be used as the predictors of acute deep vein thrombosis. Methods This retrospective study included a total of 68 patients (29 males, 39 females; mean age 55.2±1.6 years; range, 22 to 80 years) with acute lower extremity deep vein thrombosis and 34 healthy controls (15 males, 19 females; mean age 52.8±2.5 years; range, 21 to 77 years) without acute lower extremity deep vein thrombosis between March 2016 and August 2018. Demographic and clinical characteristics of the participant and laboratory data including complete blood count parameters were recorded. Univariate and multivariate analyses were used to identify significant predictors of deep vein thrombosis. Results Demographic and clinical characteristics were similar between the groups. According to the univariate analysis, platelet count and red cell distribution width were found to be significantly higher in the patient group compared to the control group. However, the red cell distribution width was not considered a significant predictor of acute deep vein thrombosis. According to the multivariate logistic regression analysis, the platelet-to-lymphocyte ratio and platelet count were significant predictors of acute deep vein thrombosis. Conclusion Our study results show that the platelet-tolymphocyte ratio may be a useful biomarker to support the diagnosis of acute deep vein thrombosis. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background In this study, we aimed to investigate the effects of thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting. Methods Between January 2018 and October 2018, a total of 51 patients (43 males, 8 females; mean age 61.8±8.7 years; range, 38 to 78 years) who underwent isolated on-pump coronary artery bypass grafting were included. Thiol-disulfide homeostasis parameters were studied in the preoperative period (T1), 30 min after the removal of cross-clamp (T2), and postoperative sixth h (T3). Hemodynamic parameters such as atrial fibrillation and inotropic support requirement of the patients were evaluated in the postoperative period. Results There were significant differences in the measured thiol-disulfide homeostasis parameters at different time points of surgery (p less then 0.001). Binary logistic regression analysis showed that T2-disulfide/native thiol ratio was an independent predictor of the development of postoperative atrial fibrillation (p=0.042). There were positive and significant correlations between the T2-disulfide levels and cross-clamp time (r0.307, p=0.029). Conclusion Thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting changes toward to disulfide. Disulfide levels increase in parallel with prolonged ischemia time. Decreased native thiol and increased disulfide levels during ischemic period may be predictive of postoperative atrial fibrillation. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background In this study, we present our clinical experience and midterm results with the robotic-assisted concomitant procedures during mitral valve operations. Methods Between March 2010 and February 2018, a total of 34 patients (8 males, 26 females; mean age 58.3 years; range, 34 to 78 years) who underwent robotic-assisted concomitant procedures during mitral valve surgery were retrospectively analyzed. Demographic characteristics of the patients, comorbidities, medical, and surgical histories, operative and laboratory results, electrocardiographic findings, postoperative intensive care unit and ward outcomes, and cardiac follow-up data were recorded. Atrial fibrillation-related medication use, stroke, or other thromboembolic events, and electrocardiographic reports in patients who underwent cryoablation were reviewed at three and 12 months after the operation. Results A total of 76 robotic-assisted concomitant procedures were performed during mitral valve repair (n=11) or replacement (n=23) in 34 patients. Concomitant procedures in addition to mitral valve operations can be performed with low complication rates in centers with experience of robotic surgery. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection. Methods Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females; mean age 45±41 days; range, 2 days to 6 months) who underwent total anomalous pulmonary venous connection repair were retrospectively analyzed. Results Eighteen (45%) of the patients were supracardiac, seven (17.5%) were cardiac, eight (20%) were infracardiac, and seven (17.5%) were mixed-type anomaly. Twelve patients (30%) had obstruction of the pulmonary venous pathways. Hospital mortality was seen in three patients (7.5%). All of non-survivors received emergent surgery and the causes of death were sepsis and multiple organ failure. A total of 23 complications were seen in 20 patients (50%) mainly delayed sternal closure (n=11; 27.5%) and prolonged mechanical ventilation (n=6; 15%). The mean follow-up was 12.2±9.6 (range, 1 to 36) months in all patients, except one. link2 Pulmonary vein stenosis developed in three patients (8.3%) after repair. All of them underwent sutureless repair. Conclusion Total anomalous pulmonary venous connection can be repaired with low mortality and morbidity rates and favorable mid-term outcomes. Close follow-up is necessary due to the risk of development of pulmonary vein stenosis. Sutureless repair may provide relief in such cases. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Background This study aims to present clinical outcomes of mitral valve repair in patients with different etiologies. Methods Between June 2006 and August 2017, a total of 421 consecutive patients (266 males, 155 females; mean age 53.1±15.6 years; range, 5 to 89 years) who underwent mitral valve repair with or without concomitant cardiac procedures were retrospectively analyzed. All pre-, intra-, and postoperative data were collected. link3 Echocardiographic examinations were performed at discharge and during follow-up. Kaplan-Meier analysis was used to estimate overall survival and from residual severe mitral regurgitation, endocarditis and reoperation-free survival rates. Results The mean follow-up was 58.9±35.1 months. Of the patients, 12 (2.8%) had previous cardiac operations. The most predominant pathology was degenerative disease in 265 patients (62.9%). Repair techniques included ring annuloplasty (n=366, 86.9%), artificial chordae implantation (n=185, 44%), and commissurotomy (n=38, 9%). Overall in-hospital mortality rate was 1.2% (n=5). Echocardiography before discharge showed no/trivial mitral regurgitation in 64.9% (n=270) and mild mitral regurgitation in 34.85% (n=145) of the patients. At the late postoperative period, transthoracic echocardiography revealed moderate mitral regurgitation in 23 patients (5.7%) and severe in 11 patients (2.7%). The mean late survival and freedom from endocarditis, reoperation, and recurrent severe mitral regurgitation rates were 92±0.03%, 98.5±0.07%, 98.1±0.01%, and 94.7±0.02%, respectively. Conclusion Our study results suggest that mitral valve repair is a safe and effective procedure associated with favorable longterm outcomes in experienced centers. Copyright © 2019, Turkish Society of Cardiovascular Surgery.Anemia, transfusion and bleeding independently increase the risk of complications and mortality in cardiac surgery. The main goals of patient blood management are to treat anemia, prevent bleeding, and optimize the use of blood products during the perioperative period. The benefit of this program has been confirmed in many studies and its utilization is strongly recommended by professional organizations. This consensus report has been prepared by the authors who are the task members appointed by the Turkish Society of Cardiovascular Surgery, Turkish Society of Cardiology (TSC), and Society of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care to raise the awareness of patient blood management. This report aims to summarize recommendations for all perioperative blood- conserving strategies in cardiac surgery. Copyright © 2019, Turkish Society of Cardiovascular Surgery.