Influence of methylprednisolone on levels of neuron-specific enolase in cardiac surgery: a corticosteroid derivative to decrease possible neuronal damage.

Background: Cerebral injury is a well-known complication after cardiac surgery with cardiopulmonary bypass (CPB), especially in adult patients. Specific biochemical markers like neuron-specific enolase (NSE) and S-100beta protein were developed previously for early detecting neuronal damage after CPB. Corticosteroids are shown to reduce multisystemic deleterious effects of cardiopulmonary bypass due to their anti-inflammatory characteristics.

Aortic arch branches are occluded: which artery nourishes the brain?

Takayasu arteritis is an inflammatory vascular disease that primarily affects the aorta and its major branches. In this report, we present a 47-year-old woman whose aortic arch branches were totally occluded and the cerebral circulation is dependent on a dilated right vertebral artery.

Complication of Behcet's disease: spontaneous aortic pseudoaneurysm.

Behcet's disease is an autoimmune multisystemic disorder based on vasculitis. In this disease, the most important predictor of morbidity and mortality is the vascular complications. Appropriate surgical interventions are critical and must be planned strategically.

Successful bleomycin pleurodesis in a patient with prolonged pleural effusion after extracardiac fontan procedure.

Pleural effusions after modified Fontan operations are unpredictable and contribute significantly to the morbidity and prolonged hospitalization. Chemical pleurodesis is widely performed in adults for malignant pleural effusions, but has found less chance of usage for benign cases or the cases with unidentified etiology. Although it is a safe and easily performed procedure, the use of bleomycin for the treatment of pleural effusions in the pediatric age population has been rarely reported in the literature.

Endoluminal stenting of mycotic saccular aneurysm at the aortic arch.

Endovascular grafts have been widely used for the treatment of aneurysms since the early 1990s. They are preferred especially for use in patients in whom conventional surgical methods carry high risks of death and morbidity. Increasing operator experience and technical refinements in endovascular grafting have enabled these procedures to be performed even in critical segments of the aorta, such as the thoracic and arch levels.

Over 14 years of experience with cardiac myxomas.

Atrial myxomas are the most commonly encountered tumours of the heart and can present at different ages with different clinical symptoms. They are one of the curable tumours of the heart. Appropriate surgical treatment and surgery must be performed with great precautions in order to prevent fatal systemic embolizations.

Common carotid trunk and right vertebral artery originating from the right common carotid artery in a patient with carotid stenosis.

Truncus bicaroticus is a very rare vascular malformation. In this report, we present a very rare anomaly in a patient with left internal carotid artery stenosis together with truncus bicaroticus and right vertebral artery originating from the right common carotid artery.

Childhood mediastinal masses in infants and children.

We reviewed all cases of primary pediatric mediastinal masses diagnosed and treated over a 24-year period. In this study, out of 187 primary mediastinal mass cases diagnosed between 1980 and 2004 in Istanbul University Istanbul Faculty of Medicine, Cardiovascular Surgery Department, 37 pediatric primary mediastinal mass cases were retrospectively evaluated according to age, sex, symptoms, diagnostic procedure, anatomical location, surgical treatment, histopathological evaluation and postoperative adjuvant therapy. The patients ranged in age from 2 months to 15 years at the time of diagnosis, with a mean age of 8 years.

Serum lactate level has prognostic significance after pediatric cardiac surgery.

Objective: The determination of postoperative course after cardiac surgery has always been a challenging issue. It is more sophisticated in the pediatric age group. The aim of this investigation was to identify whether increased concentrations of lactate in arterial blood has a predictive value for postoperative morbidity and mortality after heart surgery.

Results of surgical treatment for infective endocarditis in children.

Objective: Infective endocarditis is uncommon condition, with a high degree of morbidity and mortality. It is less common in children, albeit tending to be associated with congenital cardiac malformations. We describe our experience of the need for surgical treatment in children with infective endocarditis.

Patency and venous pressure of arteriovenous fistulas for hemodialysis.

The early patency of arteriovenous fistulas created for hemodialysis is affected by various factors, including venous stenosis. We conducted a study to investigate the effect of venous stenosis on early patency by examining perioperative arterial and venous pressures of the fistula. Among the 15 patients selected for the study, 11 had snuff-box fistulas, 3 Brescia-Cimino, and 1 brachial.

Idiopathic aneurysm of the inferior caval vein.

Idiopathic aneurysms of the inferior caval vein are uncommon in children and adults. We describe a 14 year old boy with a saccular aneurysm of the inferior caval vein, in whom no surgical intervention was required to repair the aneurysm. The patient is being followed-up periodically for the evaluation of any increase in the diameter of the inferior caval vein.

Epitheloid hemangioendothelioma of the heart in infancy.

We report a case of primary cardiac epithelioid hemangioendothelioma arising from the right atrium of a 2-month-old infant. The tumor was found incidentally during exploratory sternotomy for recurrent pericardial effusion. This case represents a very rare situation, because this is the youngest patient found in relevant literature, and because it involves extensive infiltration by the tumor without any development of intracardiac mass appearance.

Aortic arch reconstruction with pulmonary autograft patch in coarctation and interruption of the aorta.

The surgical management of the aortic arch pathologies is still subject to discussion. Primary end-to-end anastomosis has some complications such as bronchial compression, tension in the suture lines, and probability of recurrence. On the other hand, patch aortoplasties combined with end-to-end anastomosis carry the risk of aneurysm formation and recurrence.

The benefits of continuous ultrafiltration in pediatric cardiac surgery.

Background: Systemic inflammatory response and capillary leak syndrome, caused by extracorporeal circulation, have negative effects on the function of vital organs during the postoperative period. Modified ultrafiltration (MUF) has been developed as an alternative method to reduce the detrimental effects of cardiopulmonary bypass. The aim of this prospective, randomized study is to analyze the effects of MUF in a pediatric population undergoing congenital cardiac surgery.

Repair of ascending aortic aneurysm in a patient with fibrosarcoma over sternum.

The combination of an ascending aortic aneurysm and suprasternal soft tissue tumor is rarely reported in the literature. This case involves a 62-year-old man diagnosed with an ascending aortic aneurysm and a fibrosarcoma over the sternum that was successfully treated by surgery. The patient underwent an aortic replacement operation with a Dacron graft and a muscle flap transposition procedure to cover the defect over the sternum.

Results of surgical treatment for nonthymomatous myasthenia gravis.

Purpose: To clarify the factors that influence improvement and remission after thymectomy for patients with nonthymomatous myasthenia gravis (MG).

Methods: We retrospectively reviewed 204 patients with nonthymomatous MG who underwent thymectomy and anterior mediastinal dissection through a partial median sternotomy, between 1980 and 2001, and examined whether age, sex, preoperative classification, and duration of symptoms influenced their prognosis.

Results: There was no perioperative or hospital mortality.

Peri-operative comparison of different transient external shunt techniques in bidirectional cavo-pulmonary shunt.

Objective: In patients with functional single ventricular physiology, the avoidance of cardiopulmonary bypass offers many advantages including earlier extubation, decreased necessity of inotropic support, improved hemodynamical status and reduced likelihood of post-operative prolonged pleural effusion. We believe that the bidirectional cavopulmonary anastomosis operations may be performed with transient external shunt techniques. The purpose of this prospective study is the peri- and post-operative comparison of different transient external shunt methods used in bidirectional cavopulmonary shunt operations.

Role of transesophageal echocardiography in diagnosis and management of cardiac hydatid cyst: report of three cases and review of the literature.

Although diagnostic value of transthoracic echocardiography in cardiac echinococcus is well established, the role of transesophageal echocardiography in both the diagnosis and the management of this entity is not well known. We present 3 unusual cases of cardiac hydatid cyst in which transesophageal echocardiography was used. A review of the literature on the subject is also presented.