Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"[MSB-30] Clinical Outcomes of Bicuspid Aortic Valve Pathologies Treated with Tricuspidization Using the Ozaki Procedure.","authors":"Furkan Burak Akyol, Tayfun Özdem, Mehmet Emin Varol, Tuna Demirkıran, Yiğit Tokgöz, Emre Kubat, Murat Kadan, Kubilay Karabacak","doi":"10.5606/tgkdc.dergisi.2024.msb-30","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-30","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to share early- and mid-term results in patients with bicuspid aortic valve (BAV) disease who underwent tricuspidization with the Ozaki procedure.<b>METHOD:</b> The data of 44 patients (32 males, 12 females; mean age: 51.47±15.18 years) diagnosed with BAV who underwent tricuspidization with the aortic valve neocuspidization technique between February 2019 and July 2024 were retrospectively analyzed.</p><p><strong>Results: </strong>Additional surgical procedures were performed on 21 (47.72%) patients with BAV morphology. Echocardiographic measurements showed a significant reduction in preoperative peak and mean aortic valve pressures at one and 12 months. In patients who underwent simultaneous surgical procedures, the mean aortic cross-clamp time was 111±29.7 min, and the mean cardiopulmonary bypass time was 153±43.9 min. For isolated BAV defects, the mean aortic cross-clamp and cardiopulmonary bypass times were 89.9 ±19.5 and respectively. During the follow-up period, no patient required mechanical aortic valve replacement. One patient required pacemaker implantation on the seventh postoperative day due to the development of a third-degree atrioventricular block. In one patient, an ischemic cerebrovascular event occurred in the early postoperative period.</p><p><strong>Discussion: </strong>Although aortic valve neocuspidization requires experience, the application of standardized procedures allows for successful outcomes in BAV defects through the tricuspidization procedure. The tricuspidization procedure provides a more physiological structure and excellent hemodynamic performance of the aortic valve.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"052-53"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-71] Optimizing Total Coronary Revascularization: Exploring Total Coronary Revascularization with Anterior Thoracotomy Access Via Third vs. Fourth Intercostal Space in Coronary Artery Bypass Graft Surgery.","authors":"Muhammet Sefa Sağlam, Ozan Ertürk, Fatih Gümüş, Cengiz Bolcal, Mustafa Serkan Durdu","doi":"10.5606/tgkdc.dergisi.2024.msb-71","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-71","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the feasibility and comparative advantages of accessing total coronary revascularization with right anterior thoracotomy (TCRAT) for coronary artery bypass grafting (CABG) through the third and fourth intercostal spaces.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 465 patients who underwent CABG utilizing TCRAT via either the third or fourth intercostal space between January 2022 and April 2024. The third intercostal space was utilized in 315 (67.7%) patients (Group 1), while the fourth intercostal space was utilized in 150 (32.2%) patients (Group 2). Data regarding patient demographics, intraoperative details, postoperative outcomes, and longterm follow-up were collected and analyzed. The primary endpoints included procedural success, perioperative complications, and left internal mammary artery (LIMA) length.</p><p><strong>Results: </strong>The LIMA length was significantly higher in Group 2 (16.8±0.18 cm <i>vs.</i> 18.2±1.12 cm, p=0.013), despite efforts to turn the retractor back and remove the distal side in Group 1. The mean cardiopulmonary bypass time was shorter in Group 1 (73.8±17.2 min <i>vs.</i> 89.3±13.4 min) since CPB was not needed for proximal LIMA harvesting, and proximal anastomosis was mostly performed with a cross-clamp. However, cross-clamp time was similar between the groups.</p><p><strong>Conclusion: </strong>Total coronary revascularization with right anterior thoracotomy for CABG surgery is feasible and effective when accessed through either the third or fourth intercostal space. The fourth intercostal space may provide slightly better visualization for the distal part of LIMA, a longer LIMA graft, and lesser rib fracture, leading to lesser postoperative pain. On the other hand, the third intercostal space is best for proximal LIMA harvesting with lesser LIMA injury without the need for CPB initiation for proximal LIMA harvesting. Surgeon preference, patient anatomy, and procedural considerations should guide the choice of intercostal space for TCRAT implementation in CABG.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"093-93"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-61] Open Heart Surgery in Patients with A Lung Mass: A Single-Center Experience.","authors":"Abdussamet Asaroğlu, Zeki Temiztürk, Gökhan Güneş, Mehmed Yanartaş","doi":"10.5606/tgkdc.dergisi.2024.msb-61","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-61","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to share our experience with patients with heart disease requiring open heart surgery who also had a concomitant lung mass.</p><p><strong>Methods: </strong>This retrospective study included 22 patients (20 males, 2 females; mean age: 63.6 years; range, 43 to 79 years) who required open heart surgery and had a detected lung mass during preoperative evaluation. All the patients were discussed between cardiac and thoracic surgery teams, and different approaches according to patient and mass characters were chosen. Thoracic computed tomography and positron emission tomography scans and, when needed, biopsies were used to determine mass characters.</p><p><strong>Results: </strong>Seven patients were deemed to have small benign nodules, and it was decided not to intervene on the mass. A biopsy before surgery was performed in two patients, and an intervention was not deemed necessary in these patients. One patient was evaluated as having late-stage lung cancer, and no cardiac surgical intervention was performed. Ten patients underwent cardiac surgery and lung resections or lobectomies in a simultaneous operation. Two of the patients subsequently underwent a separate thoracic surgery after the cardiac surgery. There was no perioperative mortality or myocardial infarction.</p><p><strong>Conclusion: </strong>Managing patients with both cardiac disease requiring surgery and a lung mass is complex and necessitates a multidisciplinary approach. The decision to perform combined surgery or staged procedures should be individualized based on patient-specific factors, the nature of the lung mass, and the urgency of the cardiac condition. While outcomes for combined procedures are generally favorable in well-selected patients, they require meticulous perioperative planning and long-term follow-up.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"085-85"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-23] Investigation of the Effects of Sex On Shunt Use in Patients Undergoing Carotid Endarterectomy.","authors":"Abdullah Burak Balci, Hasan Tezcan, Gökhan Güneş, Zeki Temiztürk, Mehmed Yanartaş","doi":"10.5606/tgkdc.dergisi.2024.msb-23","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-23","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether the use of shunts differs between sexes in patients undergoing carotid endarterectomy (CEA) and to reveal the effect of patient sex on postoperative events.</p><p><strong>Methods: </strong>In this retrospective study, 225 patients (152 males, 73 females) aged 18 years and older who underwent CEA between September 2020 and November 2023 were analyzed. The patients were divided into two groups according to their sex. Patient characteristics were obtained from electronic medical records. Whether the use of shunts differed between the sexes and the outcomes were evaluated.</p><p><strong>Results: </strong>Intraoperative shunt use was present in 60 (26.7%) patients; this rate was 30.9% in males and 17.8% in females. A statistically significant difference was found between the groups in shunt use (p=0.037); however, this difference did not affect perioperative complications.</p><p><strong>Conclusion: </strong>The results revealed that the use of shunts was significantly higher in males than in females. This may be interpreted as indicative of a more complex or advanced disease in males, or it may reflect a surgical bias or different approaches to managing the perceived risks during CEA. Despite this difference in treatment approach, there was no significant difference in mortality and stroke rates between the sexes, which warrants further investigation of the criteria used for shunt use and its effect on outcomes.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"043-43"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-72] Comparison of Different Surgical Approaches for Ascending Aortic Surgery with or without Aortic Valve Involvement: Right Anterior Minithoracotomy Versus Conventional Median Sternotomy.","authors":"Ozan Ertürk, Muhammet Sefa Sağlam, Fatih Gümüş, Cengiz Bolcal, Mustafa Serkan Durdu","doi":"10.5606/tgkdc.dergisi.2024.msb-72","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-72","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present our initial clinical experience and show the feasibility and safety of the right anterior minithoracotomy (RAT) approach for ascending aorta surgery with or without aortic valve involvement.</p><p><strong>Methods: </strong>This single-center study included 112 patients who underwent ascending aortic replacement with or without aortic valve intervention between September 2018 and March 2024. Patients with aortic dissection and a history of previous cardiac surgery were excluded. RAT was performed in 48 (42.9%) patients, and conventional median sternotomy was performed in 64 (57.1%) patients. The primary endpoints included operative variables, reoperation for bleeding, transfusion requirements, extubation time, length of intensive care unit (ICU) and hospital stays, and postoperative complications. The secondary endpoint was 30-day mortality. Ascending aorta and aortic valve morphology were evaluated preoperatively using computed tomography angiography and Doppler echocardiography. Surgical procedures for both groups included the Bentall procedure, valve sparing root replacement (the David procedure), supracoronary ascending aorta replacement, and supracoronary ascending aorta replacement+aortic valve replacement.</p><p><strong>Results: </strong>Total operation time was significantly lower in the conventional median sternotomy group (237.84±24.87 min <i>vs.</i> 259.57±27.41 min, p=0.0001). The mean ventilation time (12.73±2.96 h <i>vs.</i> 19.43±4.21 h) and the mean length of ICU stay (1.71±0.86 days <i>vs.</i> 3.6±1.71 days) were both shorter in the RAT group (p<0.0001 for both). The rate of wound infection was significantly lower in the RAT group (p=0.036).</p><p><strong>Conclusion: </strong>Right anterior minithoracotomy is a novel and promising approach for ascending aortic surgery with or without aortic valve involvement. This study suggests that this approach is both feasible and safe. Furthermore, it has the advantages of better wound healing, shorter ICU and hospital stays, less blood transfusion, and a quicker extubation period.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"094-94"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-11] Arrhythmia Course After Surgical Treatment of Mitral Annular Disjunction.","authors":"Serkan Ertugay, Zehra Ünlü, Sedat Karaca, Yaprak Engin, Evrim Şimşek, Mustafa Özbaran","doi":"10.5606/tgkdc.dergisi.2024.msb-11","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-11","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the course of arrhythmia in patients with mitral annular disjunction (MAD) based on 24-h Holter electrocardiogram.</p><p><strong>Methods: </strong>In this retrospective study, 140 patients who underwent mitral valve surgery for type 2 dysfunction between 2017 and 2024 were reviewed. Forty-five patients with MAD were identified. A history of arrhythmia was identified in 30 (18 females, 12 males; mean age: 38.5±13.76 years) of these 45 patients.</p><p><strong>Results: </strong>The mean cardiopulmonary bypass time was 134.2 min, and the mean cross-clamp time was 99.1 min. One patient died due to low cardiac output. Control echocardiograms performed one month later showed no severe mitral regurgitation. The prevalence of supraventricular arrhythmia was 17.1% prior to surgery and 3.9% postoperatively. The prevalence of ventricular arrhythmia was 8.1% prior to surgery and 2.8% postoperatively. The relationship between MAD distance and the occurrence of arrhythmia was investigated. A notable correlation was observed between MAD exceeding 10 mm and a reduced prevalence of ventricular arrhythmia, with statistical significance (p<0.05).</p><p><strong>Conclusion: </strong>Mitral annular disjunction can lead to severe arrhythmic episodes and sudden death. In the presence of MAD over 10 mm, surgical treatment may reduce the incidence of ventricular arrhythmias. Surgical treatment of MAD decreased the incidence of arrhythmia; therefore, early operation may be considered in the presence of severe arrhythmic events, even if mitral regurgitation is not severe.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"028-29"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-70] Prognostic Value of the Hemoglobin, Albumin, Lymphocyte, Platelet Score in Predicting One-Year Mortality and Complications in Patients Undergoing Isolated Coronary Artery Bypass Grafting.","authors":"Ahmet Ozan Koyuncu, Tolunay Toy, Meryem Ertekin, Ayşegül Aydın, Görkem Can, Faruk Gencoğlu","doi":"10.5606/tgkdc.dergisi.2024.msb-70","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-70","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between the hemoglobin, albumin, lymphocyte, platelet (HALP) score, a novel scoring system that reflects systemic inflammation, and one-year mortality and complications in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>The retrospective study included 359 consecutive patients (287 males, 72 females; mean age: 60.9 years) diagnosed with coronary artery disease who underwent CABG between January 2020 and February 2023. Patients with concomitant mitral valve replacement, aortic surgery, carotid endarterectomy, aortofemoral bypass, intracardiac tumor excision, mediastinal tumor excision, or those who underwent emergency or urgent procedures were excluded from the study. The patients were divided into two groups based on a HALP score cutoff value of 34.1. Group 1 included patients with a HALP score lower than the cutoff value, while Group 2 included those with a HALP score higher than the cutoff value.</p><p><strong>Results: </strong>The one-year mortality rate was significantly higher in Group 1 compared to Group 2 (16% <i>vs.</i> 5%). Additionally, rates of major adverse cardiovascular and cerebrovascular events, atrial fibrillation, high-dose inotropic support, pneumonia, pleural effusion, prolonged intubation, acute kidney injury, cerebrovascular events, and length of stay in both the intensive care unit and hospital were significantly higher in Group 1 than in Group 2.</p><p><strong>Conclusion: </strong>The findings of our study indicate that the HALP score can be used to assess one-year mortality and complication risks in patients undergoing isolated CABG. However, to establish it as an independent factor, further analyses with a larger patient population are warranted.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"092-92"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-35] Initial Single-Center Experience: Outcomes of Minimally Invasive Extracorporeal Circulation vs. Conventional Circuits in Cardiac Surgery.","authors":"Ahmet Daylan, Ömer Faruk Rahman, Ayşe Daylan, Dağlar Cansu, Şahin Bozok","doi":"10.5606/tgkdc.dergisi.2024.msb-35","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-35","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present our early experience with minimally invasive extracorporeal circulation (MiECC) circuits and compare it with conventional cardiopulmonary bypass (cCPB).</p><p><strong>Methods: </strong>Two hundred thirty-nine patient registries (169 males, 70 females; mean age: 63.5 years) who underwent surgery were retrospectively analyzed between June 2021 and February 2024. All patients were operated by the same surgical team with a restrictive blood transfusion protocol.</p><p><strong>Results: </strong>Forty-five (18.8%) cases were identified as MiECC. Most of the operations were coronary artery bypass grafting. Significant differences were observed between those operated on with MiECC and cCPB regarding the transfusion of red blood cell (RBC) suspensions and the total amount of drainage. No significant differences were observed in the duration of intubation, incidence of postoperative acute kidney injury, and intensive care unit or hospital stay. In geriatric patients, transfusion of RBC suspensions and drainage was significantly lower. Duration of intubation and intensive care unit or hospital stay did not reach statistical significance. In patients with an ejection fraction ≤45, transfusion of RBC suspensions were similarly low.</p><p><strong>Conclusion: </strong>The utilization of MiECC resulted in a reduction in transfusion of RBC suspensions and postoperative drainage. No significant differences were observed in intubation time, postoperative acute kidney injury, hospitalization, or mortality. Although intubation time was observed to be shorter, no statistically significant result could be reached. There is a potential for bias in patient selection due to the potential benefits of MiECC. We believe that with a larger number of blinded studies, the benefits of MiECC can be demonstrated in more detail, particularly in specialized populations such as geriatric patients and patients with low EF.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"059-60"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MSB-28] Treatment of Ruptured Abdominal Aortic Aneurysm: Long-Term Results of Endovascular Aortic Aneurysm Repair Versus Open Surgery.","authors":"Dilşad Amanvermez Şenarslan, Aylin Yıldız, Funda Yıldırım","doi":"10.5606/tgkdc.dergisi.2024.msb-28","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-28","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether endovascular aortic aneurysm repair (EVAR) had a long-term survival benefit compared to open repair in ruptured abdominal aortic aneurysms (rAAAs).</p><p><strong>Methods: </strong>This retrospective study involved 58 patients (mean age: 69.6±10 years) who underwent either open surgery or EVAR for rAAA between January 2015 and June 2024.</p><p><strong>Results: </strong>Open surgery and EVAR groups were similar in terms of age. There were more male patients in the open surgery group. Intensive care unit and hospital stays were similar in both groups. The mean follow-up time was 41.2±40 months. The estimated cumulative survival rate in Kaplan-Meier analysis was %87.9 for the EVAR group and %40 for the open surgery group. Most of the deaths occurred in the first 30 days postoperatively. The reason for high mortality in open surgery was due to the hemodynamic status at arrival to the emergency service. Hemodynamically unstable patients usually had no time to wait for stent graft availability, and direct open surgery was required in these patients. A secondary factor that was important for successful treatment was the patient's anatomic convenience with EVAR treatment. Conversion to open surgery was approximately 40% due to the anatomy of the hostile neck and iliac vessels.</p><p><strong>Conclusion: </strong>An experienced team and a hybrid operation room with adequate equipment for optimal imaging and conversion to open surgery are essential for reducing mortality in rAAA. Mortality and morbidity with EVAR appear to be low compared to open surgical treatment in patients with rAAA.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"048-49"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MEP-48] Perioperative Management Strategies in Cardiac Surgery for Patients with Ankylosing Spondylitis.","authors":"Murat Yücel","doi":"10.5606/tgkdc.dergisi.2024.mep-48","DOIUrl":"10.5606/tgkdc.dergisi.2024.mep-48","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to discuss preoperative, intraoperative, and postoperative management strategies in patients with ankylosing spondylitis undergoing cardiac surgery.</p><p><strong>Methods: </strong>A retrospective analysis was performed with patients who underwent cardiac surgery between 2009 and 2024. Fourteen patients diagnosed with ankylosing spondylitis and followed by relevant clinics were identified. These patients were compared with 15 randomly selected patients who had similar profiles in terms of age, sex, and type of cardiac surgery. Age, sex, mode of intubation, length of hospital stay, duration of intubation, postoperative pulmonary complications, transfusion requirements, mobilization time, and the incidence of postoperative venous thromboembolism were evaluated.</p><p><strong>Results: </strong>Of the patients, 78.6% were male, with a mean age of 55±8 years. The postoperative intubation duration was significantly longer in the ankylosing spondylitis group (14±8 h vs. 6±5 h). Due to intubation difficulty, the need for fiberoptic intubation was higher in the ankylosing spondylitis group (16.6% vs. 0%). There were no significant differences between the groups in terms of hospital stay, postoperative exploration rates, transfusion requirements, or venous thromboembolism incidence. No postoperative sternal dehiscence was observed in either group. The need for rehabilitation due to postoperative pulmonary complications was higher in the ankylosing spondylitis group (33.3% vs. 13.3%). Cardiovascular mortality rates were similar in both groups.</p><p><strong>Conclusion: </strong>The management of cardiac surgery in patients with ankylosing spondylitis requires a multidisciplinary approach. Appropriate perioperative management, including preoperative patient planning as well as intraoperative and postoperative follow-up and care, is essential.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"148"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}