Novel variant of dual left anterior descending artery arising from single right coronary artery anomaly presenting with angina inversa.

A 55-year-old female without a history of coronary artery disease, hypertensive for the past 17 years, was admitted with resting chest pain. Electrocardiography revealed a negative T-wave in anterior chest leads. Coronary angiography visualised anomalous coronary anatomy, with a common origin of the right coronary artery and the left main coronary artery in the right sinus of Valsalva serving as a common coronary trunk.

Can preoperative erythrocyte sedimentation rate serve as an indicator for midterm adverse events after coronary bypass grafting?

Objective: Erythrocyte sedimentation rate (ESR) may serve as a reasonably good indicator for coronary heart disease as usually ESR is elevated in these patients. The measurement of ESR is a very simple and cheap laboratory test that can be performed in routine blood examinations. In this study, we investigated the association between preoperative erythrocyte sedimentation rate and postoperative midterm adverse events after coronary artery bypass grafting (CABG).

Does mild renal failure affect coronary flow reserve after coronary artery bypass graft surgery?

Introduction: There are only a limited number of studies on the link between mild renal failure and coronary artery disease. The purpose of this study is to investigate the effects of mild renal failure on the distal vascular bed by measuring the coronary flow reserve (CFR) in transthoracic echocardiography after coronary artery bypass grafting (CABG).

Methods: The study included 52 consecutive patients (12 women and 40 men) who had undergone uncomplicated CABG.

Is crystalloid cardioplegia a strong predictor of intra-operative hemodilution?

Introduction: Complications due to hemodilution (hematocrit value less than 22%) after cardiopulmonary bypass inevitably resulted with significantly greater intensive care requirements, long hospital stays, more operative costs, and increased mortality rates. We tried to identify whether crystalloid cardioplegia is the strongest predictor of intraoperative hemodilution or not.

Materials And Methods: One hundred patients were included into this randomized prospective study.

Coronary artery anomalies: Anomalous origin of the left coronary artery and circumflex branch in two patients.

Coronary anomalies may be isolated defects or accompany congenital malformations of the heart. The determination of these anomalies is important in the treatment approach and the surgical procedure in bypass and valve surgery. The present article reports on clinical and angiographic findings in two patients with coronary artery anomalies -one patient with an anomalous origin of the left coronary artery from the right aortic sinus, and another patient with an anomalous origin of the circumflex branch of the left coronary artery from the right coronary artery.

Interpleural versus epidural analgesia with ropivacaine for postthoracotomy pain and respiratory function.

Study Objective: To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory function as an alternative to thoracic epidural analgesia (TEA).

Design: Prospective, randomized study.

Setting: Tertiary-care military hospital.

Left anterior descending artery arising as a terminal extension of posterior descending artery (a rare coronary artery anomaly).

Several types of left anterior descending artery anomalies have been detected. In these anomalies, left anterior descending artery usually originates from the right coronary artery or right sinus of Valsalva. A case of left anterior descending artery arising as a terminal extension of posterior descending artery presented.

A concealed penetrating cardiac injury.

We present the case of a 29-year-old man who had been the victim of a stab wound. The cardiac wound was localized in the left ventricular apex and the posterior side of the left ventricle. When he was brought to the emergency department, he had no significant symptoms related to the cardiac wound regardless of ECG changes in the V(2)-V(4) precordial derivation.

Management of a retained catheter in an arteriovenous malformation. Case report.

The long-term effects of retained catheters in patients are not well known; therefore, the clinical presentation may differ. The authors present the case of a 21-year-old man with a pseudoaneurysm of the left common femoral artery, which developed 3 months after a transfemoral microcatheter embolization of a cerebral arteriovenous malformation (AVM) in which the catheter was inadvertently glued into the AVM and was retained at the groin.

Prophylactic dialysis in elderly patients undergoing coronary bypass surgery.

Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery (CABG), especially in elderly patients. In the current study, we aimed to determine the impact of prophylactic preoperative hemodialysis on operative outcome in patients with mild renal dysfunction. Between March 2002 and May 2005 a total of 64 patients, all of whom were more than 70 years of age and with preoperative creatinine levels greater than 2 mg/dL, underwent primary elective on pump coronary artery bypass surgery.

Does combination of antegrade and retrograde cardioplegia reduce coronary artery bypass grafting-related conduction defects?

Background: Conduction disorders appearing after coronary artery bypass surgery (CABG) may have many different causes. In this study, we evaluated the postoperative conduction disorders after CABG with respect to the ante-grade blood cardioplegia and ante-grade plus continuous retrograde cardioplegia delivery methods.

Materials And Methods: This retrospective study included 1824 patients undergoing CABG between January 2001 and December 2005.

["Retro-sartorius bypass" an alternative method during graft infection due to gunshot wound: a case report].

Graft infections can be seen after the peripheric vascular operations using synthetic graft. The patient who had femoro-femoral bypass with synthetic graft after a gunshot wound admitted to our department with graft infection and wide tissue loss. The distal pedal pulses were palpable.

Endovascular repair in management of thoracic aortic aneurysms.

Objective: Aneurysms of the thoracic aorta are still potentially life-threatening situations. The conventional operation is still associated with morbidity. Endovascular stent graft repair offers an alternative to conventional operation for management of aortic diseases.

The effect of oral prednisolone with chronic obstructive pulmonary disease undergoing coronary artery bypass surgery.

Background: Chronic obstructive pulmonary disease is still one of the most important problems in patients undergoing cardiopulmonary bypass. The purpose of this prospective study was to assess the beneficial effects of oral prednisolone on pulmonary functions in patients undergoing cardiopulmonary bypass.

Methods: Forty patients with chronic obstructive pulmonary disease were divided into two groups randomly and were given 20 mg oral prednisolone once daily perioperatively (Group I, n = 20) or identical placebo (Group II, n = 20).

Surgical therapy for acute superior mesenteric artery embolism.

Background: Acute mesenteric artery embolism has a high rate of morbidity and mortality. Early diagnosis and appropriate treatment are the most important factors associated with morbidity and mortality.

Methods: During the period between 1997 and 2002, 24 patients underwent superior mesenteric artery embolectomy.

Surgical treatment of coronary artery fistulas: 15 years' experience.

We report our experience of surgical treatment of coronary artery fistula and focus on the electrocardiographic changes that may be seen postoperatively. Between 1988 and 2003, cardiac operations were carried out on 9,487 patients, of whom 21 had a coronary artery fistula. The mean age of these 21 patients was 36.

Brachial artery cannulation facilitates lower ministernotomy cardiac surgery.

Background: Lower ministernotomy has become a more popular approach for many heart operations. However, cannulation of the ascending aorta may cause serious complications. Femoral and brachial arteries have been used for alternative arterial cannulation sites.

[Middle and late-term results of coronary artery bypass graft surgery in very young (20-29 years) patients].

Objective: The purpose of this study is to evaluate the etiologic factors of coronary artery disease (CAD) in very young patients. We want to indicate the importance of selection of the bypass graft materials and to investigate mid and long-term results of coronary artery bypass surgery (CABG) in young patients.

Methods: Coronary artery bypass surgery was performed in 7734 patients in Gülhane Military Medical Faculty between April 1991-June 2001.

Vascular complications related to lumbar disc surgery.

Object: Vascular complications related to lumbar disc operations are rare but extremely fatal conditions. The authors analyzed data retrospectively obtained in 13 patients with vascular complications that occurred during lumbar disc operations performed between January 1990 and January 2002.

Methods: One patient underwent an L5-S1 procedure and the remaining underwent L4-5 surgery.

[The efficacy of local T-pa infusion in the treatment of axillary vein thrombosis].

Background: We evaluated the results of local tissue plasminogen activator (t-PA) infusion in the treatment of axillary vein thrombosis.

Methods: Fourteen male patients (mean age 23+/-2 years) who presented with pain and swelling in the arm were diagnosed as having axillary vein thrombosis. Besides physical examination, diagnoses were made with the use of venous Doppler ultrasound, duplex scanning or venography.

[The relationship between rhythm disturbances and incisions in adult sinus venosus atrial septal defects].

Objective: Sinus venosus type atrial septal defects (SVASD) differ from the secundum atrial septal defects by its location and high incidence of combination with other cardiac anomalies, which inherently increases the risk of postoperative complications. Right atriotomy is the most preferred approach for repairing the SVASD. Postoperative sinus node dysfunction or other rhythm disturbances can be observed.

[Rupture of operated celiac artery aneurysm].

Celiac artery aneurysm is a rare and its rupture is the most frequent and serious complication. The patient who underwent aneurysmectomy and aorto - celiac artery synthetic prosthesis graft interposition in another cardiovascular surgery center two years ago, was admitted to our department with complaints of fever and abdominal discomfort. Computed tomography revealed an aneurysm with 1 cm of diameter at the beginning of celiac artery and intraperitoneal hemorrhage.