Cardioprotective effect of aprotinin on myocardial ischemia/reperfusion injury during cardiopulmonary bypass.

Background: Aprotinin is a serine protease inhibitor used extensively in cardiac operations to reduce postoperative bleeding. It also has cardioprotective effects in ischemia/reperfusion injury. In this study, the effects of aprotinin on the release of cardiac markers were evaluated in patients who had good ventricular function and were undergoing coronary artery bypass grafting with cardiopulmonary bypass (CPB).

Evaluation of risk factors associated with femoral pseudoaneurysms after cardiac catheterization.

Background: Femoral pseudoaneurysm (FPA) is one of the common complications of percutaneous catheterization procedures performed via the femoral artery. The aim of this research was to evaluate factors associated with FPA of sufficient clinical significance that they required surgical treatment after diagnostic or interventional cardiac catheterization.

Methods: We evaluated 41,322 transfemoral catheterization procedures performed in our center within 7 years.

Novel approach to aortic cannulation suturing: tangential suture technique.

Background: Pursestring suture for ascending aortic cannulation in open heart surgery that requires cardiopulmonary bypass may cause serious events, especially in patients who have a thin or calcific aorta. We introduce a novel suturing method, called the 'tangential suture technique', and submit our clinical experience.

Methods: Adult patients undergoing cardiopulmonary bypass were included in this study.

Could mean platelet volume be a predictive marker for acute myocardial infarction?

Background: Platelets play an important role in developing intravascular thrombus, the major cause of acute coronary syndromes. We investigated the clinical value of mean platelet volume (MPV) in coronary atherosclerosis and its possibility of being an independent risk factor for acute myocardial infarction (MI).

Material/methods: Two hundred patients who underwent coronary angiography were included in the study.

Peripheral mycotic aneurysms in infective endocarditis.

Background And Aim Of The Study: Today, infective endocarditis (IE) remains a severe illness, with high mortality and morbidity. Mycotic aneurysms (MAs) are rare complications of IE. For most patients, surgical intervention represents the only hope for radical cure of extracranial MAs, and survival.

Factors predicting 10-year survival after heart transplantation.

Background: We sought to identify factors predictive of long-term (>10-year) survival in heart transplant (HTx) recipients.

Methods: Four hundred fifteen adult patients underwent HTx at our institution between August 1982 and May 1997. The 158 patients who survived >10 years (Group A) and the 116 patients who died between 2 and 6 years (Group B) of HTx were compared in terms of gender, gender mismatch, ethnicity, age, height, weight, United Network for Organ Sharing status, type of induction therapy (OKT3 or anti-thymocyte globulin), infections (bacterial, viral, fungal and protozoal), cytomegalovirus (CMV) status, CMV mismatch, diabetes mellitus, hypertension and incidence of rejection episodes and transplant coronary artery disease within 2 years of HTx.

A novel reporting approach to coronary angiography: "segmental coding system".

Background: A new systematic reporting system for coronary angiography has been developed, which is capable of describing any visible intraluminal or extraluminal conditions with the exact coordinates.

Methods: In this method, called "segmental coding system"(SCS), the part of the artery that is located between its two subsequent branches is considered to be an "angiographic segment". Conditions are localized according to their relationship with these angiographic segments and the anatomic border of the segments (coronary ostiums, primary, secondary and tertiary branches, grafts and proximal and distal anastomosis sites).

Systematic approach on postoperative care of the cardiac surgical patients.

With the medical advances and rising expectations among cardiac surgeons and patients, older and sicker patients now undergo ever more complex operations. However, fortunately, postoperative care of cardiac surgical patients also have shown important changes parallel to the surgical improvements. Although, the events within the operating room are accepted as the main determinants for the faith of the patient, some patients, who are very ill upon arrival in the intensive care unit, may have a good long-term prognosis when postoperative care is meticulously provided.

Ellis-van Creveld syndrome associated with thymic hypoplasia.

A 16-month-old girl presented with the classic signs of Ellis-van Creveld syndrome. Mitral clefts were repaired by direct suturing. The single atrium was repaired by creating a new septum with a pericardial patch, leaving the coronary sinus in the left atrium.

Effects of seasonal variations on coronary artery surgery.

Background: In this study, we compared profiles and early results of patients who underwent coronary artery bypass graft surgery (CABG) during the winter season with those who underwent CABG during the summer season. We also investigated whether possible seasonal variations in performance of health care professionals had any effects on surgical outcome.

Methods: The data from patients who had undergone CABG surgery in the winter (group A) and summer (group B) seasons of the period from December 1998 to August 2001 were analyzed retrospectively.

Creating a bicuspid valve from the aortic wall: a new surgical approach on aortic valve disease (in vitro study).

We described a new technique (called 'bicuspidization'), which is performed by using autogenous material, without replacement of the aortic valves for the surgical treatment of aortic stenosis and/or insufficiency and tested it in in vitro sheep model. Different stress conditions were simulated by applying three different flow patterns (hemodynamic challenge tests) successively by using a centrifugal pump. It was demonstrated that the competency of the new bicuspid valves was excellent (zero insufficiency).

Comparison of histopathologic effects of carnitine and ascorbic acid on reperfusion injury.

Objective: Reperfusion injury can be seen after acute arterial occlusion, acute myocardial infarctus and during open heart surgery and vascular surgery. Protective effects of ascorbic acid and carnitine on reperfusion damage were tested and compared using histopathologic examination on ischemia model in the rabbit hind limb.

Methods: Four groups (each containing ten animals) were used.

Effect of partial oxygen supply on mitochondrial electron transport system during complete cardiac ischemia.

During complete ischemia we assessed myocardial utilization of the small amount of oxygen available. We also determined whether blood cardioplegia has any advantage over crystalloid cardioplegia in this setting. Patients with preserved left ventricular myocardial function and without anterolateral wall infarct or aneurysm were included to the study.

Sternal closure with resorbable synthetic loop suture material in children.

Purpose: The reliability of poly-p-dioxanone (PDS) suture for sternal closure was tested on 264 consecutive sternotomies in the authors' department from April 1987 to May 1998.

Methods: The reason for sternotomy was tetralogy of Fallot in 65 cases (24.6%), ventricular septal defect (VSD) in 38 cases (14.

The use of a stentless porcine bioprosthesis to repair an ascending aortic aneurysm in combination with aortic valve regurgitation.

Over the years, many surgical methods have evolved for the treatment of ascending aortic aneurysm in combination with aortic valve regurgitation; however, precise guidelines for optimal surgical techniques for varying presentations have not been defined. We describe the use of a stentless porcine bioprosthesis (Medtronic Freestyle) in a patient with an ascending aortic aneurysm and aortic regurgitation. We used the complete root replacement method, and anastomosed a Dacron graft (Hemashield) between the bioprosthetic valve and the native aorta to replace the distal part of the aneurysm.

A no-touch technique for calcified ascending aorta during coronary artery surgery.

Despite improvements in cardiovascular surgery techniques over the years, the incidence of neurologic complications has not declined, and stroke remains a possible (and devastating) sequela to coronary artery surgery. In this report, we describe a moderate hypothermic fibrillatory arrest technique that avoids cross-clamping or otherwise touching the aorta; use of the internal thoracic arteries and the right gastroepiploic artery provides optimum revascularization and minimizes the risk of cerebrovascular accident. Over a 1-year period, we used the technique in 21 patients who had heavy calcifications of the ascending aorta.

Ultrasonic decalcification of calcified valve and annulus during heart valve replacement.

A heavily calcified heart valve annulus increases the likelihood of sequelae after prosthetic valve replacement. Such sequelae include cerebral embolism, paravalvular leakage, valvular dysfunction, rhythm disturbance, hemolysis, communication of the heart chambers, and rupture of the posterior wall of the left ventricle. From January 1991 through June 1994, we performed heart valve replacement on 30 patients, using an ultrasonic surgical aspirator to remove calcific deposits.