Reduction of the sinotubular junction in patients undergoing ascending aortic replacement with coexisting aortic insufficiency.

Background And Aim Of The Study: Dilatation of the STJ may cause consequent aortic insufficiency (AI) in patients with normal aortic valve, in patients with ascending aortic aneurysm. In this study, we analyzed the results of ascending aorta replacement with STJ diameter reduction to correct consequent AI in patients with ascending aortic aneurysm.

Methods: Forty-five consecutive patients who had ascending aortic aneurysm underwent replacement of ascending aorta with reduction of the STJ diameter to correct AI.

Diagnostic value of hemoglobin A1c and fasting plasma glucose levels in coronary artery bypass grafting patients with undiagnosed diabetes mellitus.

Background: Early detection, diagnosis, and treatment of diabetes are of utmost importance in preventing diabetic complications and improving short- and long-term outcomes in patients undergoing coronary artery bypass grafting surgery. The aim of this study was to evaluate the ability of preoperative hemoglobin A1c (HbA(1c)) measurement, either alone or in combination with fasting plasma glucose (FPG), to detect glycometabolic disturbances among patients undergoing elective on-pump coronary surgery.

Methods: A total of 166 patients who underwent elective isolated on-pump coronary surgery were included.

Determinants of mortality in patients requiring prolonged intensive care unit stay after elective isolated on-pump coronary artery bypass grafting surgery.

Background: In up to 36% of patients undergoing cardiac surgery prolonged intensive care unit stay may be necessary. Mortality rates of these patients range from 11% to 94%, causing enormous clinical and ethical issues.

Aim: To identify preoperative, perioperative and postoperative risk factors of mortality in patients with prolonged intensive care unit stay after elective, isolated on-pump coronary artery bypass grafting surgery.

Off-pump coronary artery bypass surgery can be completed safely in high risk patients.

Background: Off-pump coronary artery bypass (OPCAB) grafting has the potential to reduce morbidity and mortality, compared to on-pump cardiac surgery.

Aim: We compared the early results of OPCAB lateral and posterior wall revascularisations in 'low', 'intermediate' and 'high' risk patients as defined by the EuroSCORE system.

Methods: Eighty-nine patients who underwent OPCAB with lateral and posterior wall revascularisation from January 2006 to December 2008 were included in this study.

Left ventricular aneurysm using the Dor technique: mid-term results.

Objective: We have retrospectively analyzed the early and the mid-term results of the operations for modified endoventricular circular patch plasty for left ventricular aneurysm (LVA) repair in our clinic.

Patients And Methods: Sixty-seven cases with anterior LVA were included in the study. Mean age of the patients were 64.

Cusp shaving for concomitant mild to moderate rheumatic aortic insufficiency.

Background: The aim of this study was to assess the early and mid-term results of patients who underwent cardiac operations due to cardiac pathologies other than aortic valve (AV) disease, but also had mild-to-moderate aortic valve insufficiency that was repaired during the same session.

Methods: A total of 43 patients who underwent AV repair for mild-to-moderate aortic insufficiency between January 2003 and February 2009, in addition to the procedure performed for their main pathology necessitating the surgical intervention, were included in the present study. Cardiac function was evaluated, before and after the operation.

Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence.

Objective: Sternal dehiscence is a serious and potentially devastating complication. The present study compared the effects of two sternal closure techniques, simple wire technique and figure-of-eight technique, on the development and outcome of non-microbial sternal dehiscence.

Methods: Medical records of all adult patients (n=6211) that underwent cardiac operations in our clinic through median sternotomy between January 2002 and August 2008 were retrospectively reviewed for the development of non-microbial sternal dehiscence.

Ring annuloplasty in chronic ischemic mitral regurgitation: encouraging early and midterm results.

Ischemic mitral regurgitation, a complication of myocardial infarction, is associated with a poor prognosis and can result in postinfarction congestive heart failure. The preferred treatment of its chronic form is a matter of debate. Herein, we report the early and midterm results in 44 patients with chronic ischemic mitral regurgitation in whom concomitant mitral ring annuloplasty and coronary revascularization were performed at our hospital.

Is surgical therapy the only treatment of choice for cardiac echinococcosis with multiple organ involvement?

A 25-year-old male patient suffered from multi-organ hydatidosis including cardiac and bilateral pulmonary echinococcosis. Echocardiography revealed the hydatid cyst 20x35 mm in dimension located in the interventricular septum. The patient refused surgery; albendazole 400 mg/day was given orally and was continued for 24 months.

Cardiovascular reoperations in Marfan syndrome.

Background And Aim Of The Study: The purpose of this study is to analyze the outcome results of reoperations in Marfan syndrome patients.

Methods: Between 1985 and December 2004, 49 patients with Marfan syndrome were operated for aortic aneurysms. Of these 49 patients, 9 (18,4%) required > or =1 reoperations after a mean duration of 32.

Double supply to left anterior descending artery by additional saphenous vein graft in internal thoracic artery malperfusion syndrome.

Objective: Internal thoracic artery (ITA) grafting to the left anterior descending artery (LAD) may have catastrophic consequences and can be fatal due to "ITA malperfusion syndrome." We have investigated the efficacy of a second graft in this syndrome.

Methods: A total of 35 patients, 29 males (82.

In which patients should sheathless IABP be used? An analysis of vascular complications in 1211 cases.

Objective: The purpose of our study is to compare the results of the sheathed and sheathless techniques for intraaortic balloon pump (IABP) insertion and to determine the rate of vascular complications in both conditions.

Methods: A total of 1211 patients were examined representing a period of 19 years. Three hundred five sheathless (Group I) and 906 sheathed (Group II) IABP catheters were evaluated retrospectively.

Valvular surgery in Behcet's disease.

Background: Behcet's disease is a chronic inflammatory disease with a relapsing course. Behcet's disease affects many systems and causes hypercoagulability, and detection of an intracardiac mass in a Behcet patient should raise the question of an intracardiac thrombus. We analyzed our patients with Behcet's disease operated for valvular disease.

Risk factors for requirement of permanent pacemaker implantation after aortic valve replacement.

Background: The aim of this study was to evaluate the frequency of requirement for permanent pacing and related risk factors after aortic valve replacement.

Methods: Among 465 patients operated between 1994 and 2004, 19(4.1%) patients with a mean age 49.

Surgical treatment of aortobronchial and aortoesophageal fistulae due to thoracic aortic aneurysm.

We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing conditions associated with aortobronchial fistula were descending thoracic aortic aneurysm (n=8), previous aortic surgery (n=1), and concomitant aortoesophageal fistula (n=1).

Simultaneous Carotid Endarterectomy and Coronary Revascularization is Safe Using Either On-Pump or Off-Pump Technique.

The appropriate surgical strategy for patients with combined carotid and coronary artery disease remains controversial. We retrospectively compared our surgical results for 2 types of approaches in this disorder. The records of 76 patients consecutively operated on for carotid and coronary artery disease between August 1993 and October 2004 were reviewed.

Coronary bypass procedures in patients with renal artery stenosis.

Background And Aim Of The Study: We present our experience on patients with renal artery stenosis undergoing myocardial revascularization procedures.

Methods: Eighteen patients with varying degrees of renal artery stenosis were operated for coronary artery bypass grafting between 1996 and 2003. The overall incidence was 0.

Sequential radial artery grafting three-vessel coronary artery disease.

Our objective was to compare the results of revascularization by sequential radial artery (RA) grafting with a left anterior descending left internal mammary artery (LIMA)-RA t-composite grafting technique. Patients were grouped as those with proximal anastomoses performed on the ascending aorta (Group A; n = 38), and those with proximal anastomoses performed on the LIMA as t-grafts (Group T; n = 13). Neither of the two groups revealed any mortality.

Surgical management of cardiac myxoma.

Objective: Between 1994 and December 2003, 55 patients were operated for cardiac myxoma in Kosuyolu Heart and Research Hospital in Istanbul.

Methods: We retrospectively analyzed our results according to the preoperative characteristics, operative procedures, and postoperative courses.

Results: Of 55 patients operated, 36 (65.

Combined valve and coronary surgery in a patient with erythropoietic protoporphyria.

Erythropoietic protoporphyria (EPP) is an autosomal dominant disorder of heme synthesis, causing excess of protoporphyrin in blood, skin, liver, and other organs. A 58-year-old male patient with EPP underwent aortic valve replacement and a concomitant aortocoronary bypass. The patient has been followed without complications due to EPP postoperatively.

[Cardiovascular manifestations and treatment in Marfan syndrome].

Marfan syndrome is a dominantly inherited connective tissue disease characterized by cardiovascular, skeletal and ocular manifestations, which was firstly described by Antoine Marfan in 1896. The underlying disorder is a mutation, which impairs fibrillin synthesis and is associated with the FBN-1 gene on the 15th chromosome. Ghent Nosology is used for diagnosis.

Surgical treatment of aortic abscess and fistula.

The formation of annular abscess and fistulous communication, the most devastating complication of destructive aortic valve endocarditis, requires extensive surgical débridement. Five men experienced destructive native aortic valve endocarditis in association with congestive heart failure (New York Heart Association functional class IV) and hemodynamic deterioration that developed from severe aortic regurgitation. To eradicate the aortic valve endocarditis, we performed (from July 1998 through November 2002) aortic annular skeletonization by dissecting all infectious and necrotic tissue within the abscess cavity and the fistula between the ventriculoarterial junction and the sinotubular junction.

Can revascularization restore sinus rhythm in patients with acute onset atrioventricular block?

Background: We studied patients with coronary artery disease (CAD) and complete atrioventricular (AV) block of acute onset that were treated with coronary artery bypass grafting (CABG) to see whether revascularization can restore the sinus rhythm.

Methods: CABG was performed on eight patients with newly developed complete AV block and severe CAD. The distribution of coronary artery lesions showed a type IV pattern in six patients and a type II pattern in two patients.

Long-term outcome after total correction of tetralogy of Fallot in adolescent and adult age.

Although most patients with tetralogy of Fallot (TOF) undergo radical repair during infancy and childhood, patients remaining undiagnosed and untreated until adulthood can still be treated. These patients have either a previous palliative or natural collateral circulation to the lung or a mild form of right ventricular outflow tract (RVOT) obstruction. The aim of this study is to analyze the perioperative and long-term results of radical corrective procedures in patients who reached adult ages.

Surgical treatment of subaortic obstruction in adolescent and adults: long-term follow-up.

Subaortic stenosis (SAS) is a wide spectrum of anatomical derangements ranging from a discrete fibrous membrane to tortuous fibrous tunnel with or without aortic annulus hypoplasia. We have reviewed 88 patients undergoing surgery for SAS over a 15-year period. There were 47 male and 41 female patients with a mean age of 19.