Stent implantation into the patent ductus arteriosus in cyanotic congenital heart disease with duct-dependent or diminished pulmonary circulation.

We assessed the efficacy and safety of stent implantation into the ductus arteriosus in infants with cyanotic heart disease. Ten patients with duct-dependent or diminished pulmonary circulation underwent cardiac catheterization with the aim of stent implantation. Coronary stents of 3.

The comparison of angiographic lesions and clinical outcomes in identical twins.

Both genetic and environmental factors are involved in the development of coronary artery disease (CAD). The degree of contribution of each individual risk factor on CAD is unknown. The extent to which the familial occurrence of coronary heart disease is due to genetic mechanisms can be assessed in twins.

Does atherosclerotic aortic plaque detected by telecardiography indicate an increased risk of coronary artery disease?

Objective: The purpose of this study was to determine the cause of aortic arch calcification and to evaluate its prognostic value as an indicator of cardiovascular disease and its severity.

Methods And Results: The study was conducted prospectively among 1027 patients who underwent a coronary angiography in our hospital between April 2002 and September 2002 for suspected coronary artery disease. All chest x-rays were reviewed by a radiologist, who categorized aortic arch calcifications by their presence or absence.

Noncardiogenic pulmonary edema associated with clopidogrel: a serious but unexpected side effect of clopidogrel.

Clopidogrel has a favourable side effect profile, in which the most serious complications are related to bleeding diathesis. Drug reactions represent frequently encountered clinical problems that can also be life-threatening. In the present case, serious noncardiogenic pulmonary edema was observed as an idiosyncratic reaction after clopidogrel use.

Successful transcatheter balloon dilatation of coarctation of aorta and coil occlusion of patent ductus arteriosus in a single catheterization procedure.

Simultaneous transcatheter coil occlusion of patent ductus arteriosus and balloon angioplasty of coarctation of aorta is avoided since intimal tearing after angioplasty is believed to increase the risk for dissection of the aorta during catheter manipulation. We report a 14-month-old boy, with weight of 7.6 kg, with aortic coarctation and patent ductus arteriosus with a large left-to-right shunt who underwent successful simultaneous balloon angioplasty of native coarctation and coil embolization of the patent ductus arteriosus.

The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery.

Problems of wound healing are commonly observed after coronary bypass grafting (CABG) operations. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complications after coronary artery bypass surgery. One hundred twenty six patients operated in the specified period were included in this prospective study.

Aorta-right atrial fistula after VSD operation.

We describe a late complication after ventricular septal defect surgical repair. Proximally, the fistula spread into the right atrium, resulting in an aorta-right atrium fistula. This is a previously unreported iatrogenic complication after a cardiac operation.

PercuTwist: a new alternative to Griggs and Ciaglia's techniques.

Background And Objective: Tracheostomy is one of the most common procedures in intensive care units worldwide. In this study we aimed to compare three different tracheostomy techniques with respect to duration of procedure and complications.

Methods: One hundred and thirty patients requiring endotracheal intubation for more than 10 days due to acute respiratory distress syndrome, infections or cerebrovascular events were consecutively selected to undergo the percutaneous dilatational tracheostomy technique (PDT n = 44), the guide-wire dilating forceps technique group (GWDF n = 41) or the PercuTwist technique (n = 45).

Abdominal aortic aneurysm surgery: retroperitoneal or transperitoneal approach?

Aim: Mortality and morbidity of abdominal aortic aneurysm surgery have decreased significantly in time and transperitoneal approach (TPA) still preserves its popularity although retroperitoneal approach (RPA) is known to cause lower incidence and shortened duration of ileus, shorter intensive care unit (ICU) and hospital stay, earlier oral intake and less patient discomfort or pain.

Methods: One hundred and fifty patients that underwent abdominal aortic aneurysm repair at our Cardiovascular Surgery Center between January, 1990 and March, 2000 were reviewed and analyzed based on the elective/emergent nature of the surgery and the type of the incision as either TPA or RPA.

Results: Significantly shorter mechanical ventilation (15.

Continuous positive airway pressure does not improve lung function after cardiac surgery.

Purpose: Despite the well-documented impairment of pulmonary function after cardiopulmonary bypass, effective precautions and ideal management strategies for this problem are still under debate. This study aimed to evaluate the effects of continuous positive airway pressure (CPAP) applied during cardiopulmonary bypass on respiratory and hemodynamic variables.

Methods: In this randomized, prospective, controlled trial, 120 male patients, aged 45 to 70 yr undergoing first-time elective bypass surgery, were randomly assigned to receive either 10 cm H2O of CPAP (Group I; n = 60) during cardiopulmonary bypass, or serve as control (Group II; n = 60), where the patient's lungs were vented to atmosphere during the bypass period.

Determinants of hospital mortality after repeat mitral valve surgery for rheumatic mitral valve disease.

Objective: The aim of this study is to detect the risk factors for hospital mortality in patients who underwent reoperative mitral valve replacement.

Methods: Rheumatic mitral valve patients who underwent primary mitral valve replacement (386 cases) and repeat mitral valve replacement (94 cases) were analysed retrospectively. The incremental effects of the reoperative procedure on hospital mortality were studied by comparing primary and reoperative procedures and analyzing a series of possible predisposing factors.

The acute cardioprotective effect of glucocorticoid in myocardial ischemia-reperfusion injury occurring during cardiopulmonary bypass.

The purpose of this study was to evaluate the acute cardioprotective effect of high-dose methylprednisolone (25 mg/kg) in the controlled in vivo model of myocardial ischemia-reperfusion injury occurring during cardiopulmonary bypass. Forty nondiabetic male patients with three-vessel disease undergoing first-time bypass surgery were enrolled for this double-blind prospective study. Patients were randomized to be given 25 mg/kg methylprednisolone (Group I) and saline (Group II) 1 h before cardiopulmonary bypass.

Is single or double aortic clamping safer in terms of cerebral outcome during coronary bypass surgery?

The purpose of the present study was to investigate retrospectively which aortic clamping technique, the single clamp technique (SCT) or double clamping technique (DCT), is safer in terms of cerebral functions in patients who have undergone coronary bypass surgery. We evaluated 1100 patients who underwent coronary artery bypass graft surgery at our institute from 1998 to 2004. The two groups, SCT (n = 550, 50%) and DCT (n = 550, 50%), were comparable with respect to smoking, hypertension, hypercholesterolemia, diabetes mellitus, chronic obstructive pulmonary disease, peripheral arterial disease, history of neurological events, creatinine levels, and existence of a carotid lesion.

True aneurysm of extracranial internal carotid artery in a 10-year-old.

Introduction: In this report, we describe a very unusual case, true aneurysm of the internal carotid artery, in a child.

Report: A 10-year-old boy with a pulsating mass on his right neck was admitted with the diagnosis of a 25 mm by 50 mm true aneurysm of the right internal carotid artery, which was resected, and a 5-mm ePTFE graft was interposed. He was discharged on day 3 without complications.

Echocardiographic study on the origin of the innocent flow murmurs.

To investigate the origin of the pulmonary systolic ejection innocent flow murmur (IFM), echocardiographic examinations were undertaken in 30 children with IFM and in a control group consisting of 28 healthy children without murmur. Compared to the controls, the diameters of the left ventricular outflow tract (LVOT) and aortic valve annulus and aortic valve area tended to be smaller, whereas stroke volume (SV) and cardiac output were slightly greater in children with IFM, but they were not statistically significant. Mean fractional shortening was significantly higher in children with IFM.

Midterm results with the use of polycarbonate urethane heterografts for dialysis access.

Dialysis access surgery is currently one of the most common vascular operations as the dialysis patient population increases. Although autogenous arteriovenous fistulae stand as the preferred method of access due to excellent patency and lower complication rates, grafts may provide alternative approaches when an autogenous fistula is impractical usually due to depleted veins. We aimed in this study to assess early and midterm outcome with the use of Expedial heterografts (LeMaitre Vascular Ltd.

A modified combined approach to operative carotid and coronary artery disease: 82 cases in 8 years.

Background: A significant number of patients undergoing coronary artery surgery have severe carotid artery disease. It is also true that up to half of the patients undergoing carotid endarterectomy (CEA) have severe treatable coronary lesions. This study aims to review data regarding 82 patients of combined approach in 8 years; the second half consists of 44 patients whose CEA was performed under local anesthesia.

Spontaneous pseudoaneurysm of the vertebral artery in Behçet's disease.

A pulsatile mass and severe neck pain developed suddenly in a 15-year-old female patient suffering from Behçet's disease. Magnetic resonance imaging showed a pseudoaneurysm at the C3-C4 level that was 51 x 49 x 45 mm in size, originating from the left vertebral artery, with a thin neck and thrombus inside. Repair of the vertebral artery wall by percutaneous transluminal intervention was not successful.

Candida albicans endocarditis and a review of fungal endocarditis: case report.

Endocarditis due to fungal etiology is rare, but it is the most severe form of infective endocarditis. Fungal endocarditis is commonly complicated by systemic embolizations, and the difficulty in isolating the fungi with routine blood cultures complicates the diagnostic process. In these culture-negative cases of endocarditis, etiologic diagnosis is made with histopathologic examination of the cardiac valve, embolic materials, and systemic ulcers.

Assessing the effect of low dose dobutamine on various diastolic function indexes.

Objective: The aim of this study was to evaluate the effect of low dose dobutamine (LDD) on various diastolic function parameters in patients without wall motion abnormality.

Methods: Thirty-one volunteer patients who had no regional wall motion abnormality were included in the study. Echocardiographic measurements were taken both at pre-dobutamine and during LDD infusion.

Carotid-subclavian bypass in occlusive disease of subclavian artery: more important today than before.

After left internal mammary artery graft is anastomosed to the coronary artery, atherosclerotic occlusion of subclavian artery becomes more important, because the vascular segment between the origin of the subclavian artery and the coronary artery becomes a part of the coronary circulation functionally. The subclavian artery occlusion may be treated through percutaneous intervention including balloon angioplasty alone or with stent. But failure of initial treatment by percutaneous intervention is possible especially in some proximal and total occlusions.

Hydatid Cyst in the Pulmonary Artery: An Uncommon Localization.

Abstract Pulmonary artery involvement of hydatid disease caused by the Echinococcus granulosus parasite is an uncommon condition resulting from the opening of a visceral hydatid cyst into the venous circulation or the rupture of a cardiac hydatid cyst. We report a case of a 31-year-old woman with a hydatid cyst located in the right pulmonary artery. Clinical presentation was fatigue, cough, and dyspnea.

Comparative assessment of chordal preservation versus chordal resection in mitral valve replacement for mitral stenosis (long-term follow-up: 8 years).

Carrying out a mitral valve replacement (MVR) while preserving all chordae tendineae in patients with mitral regurgitation has been proven beneficial to the left ventricular performance. To evaluate the effectiveness of this technique in patients with mitral stenosis, a comparison of the echocardiographic data between patients who were operated on using this technique (Group Preservation = GroupP, n = 15), and those operated on using the conventional method of MVR (Group Conventional = GroupC, n = 15) was made. All patients were examined before surgery, 6 months after surgery and 8 years after surgery.