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

{"title":"A rare complication of transaxillary TAVI: Management of a bioprosthetic valve entrapment in the subclavian artery.","authors":"Şükriye Uslu, Nermin Bayar, Şakir Arslan","doi":"10.4274/tjtcs.2025.28745","DOIUrl":"10.4274/tjtcs.2025.28745","url":null,"abstract":"<p><p>The transaxillary (TAx) approach represents the most commonly preferred alternative access route for transcatheter aortic valve implantation (TAVI) when transfemoral (TF) access is not feasible. Therefore, vascular complications and their management remain of particular importance. In this case report, we present a 75-year-old male patient with severe iliofemoral calcification who underwent TAx-TAVI and developed entrapment of the transcatheter aortic valve in the subclavian artery- a complication reported here for the first time in the literature. The entrapped valve was implanted in the subclavian artery and in the second session, the patient was successfully treated via the TF route using a low-profile in-line sheath (sheathless) system.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"365-367"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127165","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":"Interhospital transfer dynamics in foreign body aspiration: Age-stratified nationwide retrospective cohort study.","authors":"Muhammed Saltuk Deniz, Kadir Baturhan Çiflik, Büşra Özdemir Çiflik, Ayşenur Yetik Aras, Ümit Alper Özcan, Eray Çınar","doi":"10.4274/tjtcs.2026.2026-4-11","DOIUrl":"10.4274/tjtcs.2026.2026-4-11","url":null,"abstract":"<p><strong>Background: </strong>Foreign body aspiration (FBA) is an acute clinical emergency that is particularly common in the pediatric population and, if not managed promptly, can lead to serious morbidity and mortality across all age groups. The need for bronchoscopy, intensive care capabilities, and experienced teams often makes interhospital transfer unavoidable. This study aimed to evaluate the transfer dynamics of patients transferred due to FBA and to identify potential differences among age groups.</p><p><strong>Methods: </strong>In this retrospective cohort nationwide study, patients who underwent interhospital transfer due to FBA across Türkiye between 2022 and 2024 were included. Patients were stratified into three age groups: Pediatric (0-17 years), adult (≥18 years), and geriatric (≥65 years). The primary variables analyzed included transfer distance, transfer timing (working hours <i>vs</i>. off-hours), transfer type (intra-provincial <i>vs</i>. inter-provincial), and transfer mode (ground <i>vs</i>. air ambulance).</p><p><strong>Results: </strong>A total of 2.816 patients were analyzed, including 1.135 (40.3%) females and 1.681 (59.7%) males. The median age was three years (12, 0-97). Pediatric patients were more frequently transferred to out-of-province centers compared to adults (odds ratio [OR] 1.90; 95% confidence interval [Cl]: 1.44-2.52; p<0.001) and had significantly longer transfer distances (p<0.001). In comparisons with other age groups, geriatric patients had higher rates of intra-provincial transfers (OR =1.65; 95% Cl: 1.08-2.51; p=0.013) and shorter transfer distances (p=0.010). However, when directly compared with pediatric patients, geriatric patients were more frequently transferred out of province (OR 1.74; 95% CI 1.18-2.57; p=0.006) and over longer di stances (p=0.004).</p><p><strong>Conclusion: </strong>Age groups have a significant impact on the type and distance of interhospital transfers in FBA cases. In contrast, the timing of transfer and mode of transportation do not differ significantly by age.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"439-445"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139540","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":"Regarding: \"The impact of the Naples prognostic score on outcomes in patients undergoing coronary artery bypass grafting\".","authors":"Abdullah Burak Balcı","doi":"10.4274/tjtcs.2026.2026-6-26","DOIUrl":"10.4274/tjtcs.2026.2026-6-26","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"370-371"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664768","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":"Comment on: Effect of preoperative vitamin B12 levels on postoperative outcomes in CABG patients.","authors":"Mehmet Yılmaz, Hale Yılmaz","doi":"10.4274/tjtcs.2026.2026-4-15","DOIUrl":"10.4274/tjtcs.2026.2026-4-15","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"368-369"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609423","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":"Emergency physician-modified endograft for ruptured thoracoabdominal aneurysms: Should renal preservation always be pursued?","authors":"André Pinheiro Ribeiro Alves, Queise da Costa Cettolin, Gustavo Dos Santos Domingues, Aliomar Cardoso Dourado Junior, Kissa Pereira de Oliveira","doi":"10.4274/tjtcs.2026.2026-6-4","DOIUrl":"10.4274/tjtcs.2026.2026-6-4","url":null,"abstract":"<p><p>Fenestrated and branched endovascular devices have expanded the treatment options for complex aortic pathology, and physician-modified endografts (PMEGs) have emerged as a potential alternative for urgent repair. However, an important unresolved question is whether renal artery preservation should always be pursued during emergent repair. We report two cases of ruptured thoracoabdominal aneurysms treated with PMEGs at Hospital Geral Roberto Santos between January and February 2026. Based on computed tomography angiography, fenestrations were created using electrocautery and reinforced with a snare catheter loop, whereas directional branches were constructed using self-expanding covered stents. Both patients presented with ruptured Crawford type IV aneurysms and retroperitoneal hematomas. In the first case, a 26-year-old man underwent PMEG repair with preservation of the celiac trunk and superior mesenteric and right renal arteries, while the left renal artery was intentionally sacrificed. In the second case, a 68-year-old woman underwent repair with directional branches to the superior mesenteric artery and celiac trunk, without preservation of the renal arteries. Technical success was achieved in both cases; however, clinical outcomes differed substantially. Emergency repair of ruptured thoracoabdominal aneurysms using PMEGs is a feasible strategy when custom devices are unavailable. Although renal artery preservation remains an important objective, these two cases illustrate that intentional renal artery sacrifice may occasionally be unavoidable in critically unstable patients with unfavorable renal anatomy.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"421-427"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921267","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":"Frequency and determinants of reintubation following pediatric cardiac surgery.","authors":"Emine Hekim Yılmaz, Hacer Kamalı, Halise Zeynep Genç, Kaan Altunyuva, Aslıhan Karaman, Behzat Tüzün, Erkut Öztürk, Nurgül Yurtseven, Sertaç Haydın, Ali Can Hatemi, Alper Güzeltaş, Ahmet Çelebi","doi":"10.4274/tjtcs.2026.2026-1-19","DOIUrl":"10.4274/tjtcs.2026.2026-1-19","url":null,"abstract":"<p><strong>Background: </strong>Reintubation is a significant complication after pediatric cardiac surgery and is associated with increased morbidity and prolonged intensive care unit (ICU) stay. This study aimed to evaluate the incidence of reintubation and to identify the independent risk factors in this patient population.</p><p><strong>Methods: </strong>A retrospective analysis was performed across three tertiary centers between January 1, 2023, and January 1, 2025. Pediatric patients undergoing congenital heart surgery and monitored in the cardiac ICU were included. Demographic characteristics, operative details, and intensive care parameters were extracted from medical records. Reintubation was defined as the need for reintubation within 72 hours following initial extubation. Statistical analyses were conducted to determine predictors of reintubation.</p><p><strong>Results: </strong>Among 4.000 pediatric cardiac surgery patients, the reintubation rate was 4%, with most events occurring within 24 hours. In a matched cohort of 320 patients, reintubated patients more frequently had airway anomalies, genetic syndromes, newborn status, higher surgical complexity, and technical performance score (TPS)-3 scores. They also experienced longer mechanical ventilation, prolonged ICU and hospital stays. Multivariable analysis showed independent associations between reintubation and airway anomalies, genetic syndromes, newborn status, risk adjustment for congenital heart surgery-1 ≥4, TPS-3, pre-extubation extracorporeal membrane oxygenation support, diaphragm paralysis or vocal cord dysfunction, and sternal closure ≥2 days. Mortality did not differ between groups.</p><p><strong>Conclusion: </strong>The incidence of reintubation after pediatric cardiac surgery remains relatively high, with multifactorial underlying causes. The identification of these potential risk factors may facilitate the detection of high-risk patients following cardiac surgery and contribute to improved clinical outcomes by ensuring a more cautious approach to extubation in these groups.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"381-386"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473855","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":"The Naples prognostic score in coronary artery bypass grafting: From perioperative risks to long-term graft patency.","authors":"Şahhan Kılıç, Süha Asal","doi":"10.4274/tjtcs.2026.2026-6-1","DOIUrl":"10.4274/tjtcs.2026.2026-6-1","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"372-373"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664736","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":"Best pain management after video-assisted thoracoscopic surgery: A best evidence topic report.","authors":"Dilara Gürsoy, Esranur Akpunar, Tevfik İlker Akçam, Ufuk Çağırıcı","doi":"10.4274/tjtcs.2026.28518","DOIUrl":"10.4274/tjtcs.2026.28518","url":null,"abstract":"<p><p>A best evidence topic in thoracic surgery was written according to a structured protocol. The clinical question addressed was: \"What is the best pain management after video-assisted thoracoscopic surgery (VATS)\"? The literature search identified a total of 485 papers, of which 10 studies were selected as providing the strongest evidence to answer the clinical question. These included 4 meta-analyses, 6 randomized controlled trials. The selected studies are presented in tabular form, summarizing the author, year of publication, journal, country of origin, study design, patient population, relevant outcomes, and key findings. Serratus anterior plane block has emerged as a promising analgesic method for VATS, demonstrating effectiveness in relieving postoperative pain, reducing opioid consumption, and decreasing the incidence of postoperative nausea and vomiting. Thoracic epidural analgesia, although historically regarded as the gold standard for pain management, does not demonstrate a clear superiority based on current evidence. Thoracic paravertebral block is considered a superior regional analgesic option in thoracic surgery, and its combination with other techniques may further enhance postoperative pain control after VATS. Additionally, intravenous dexamethasone, when added to VATS protocols, may reduce opioid consumption and promote early mobilization.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"464-467"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876354","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":"Postoperative transient left ventricular outflow tract obstruction after mitral valve surgery: A systematic review of anatomical and hemodynamic factors.","authors":"Kristian Kurniawan, Arinto Bono Adji Hardjosworo, Bagus Herlambang, Sugisman Sugisman, Audrey Vanessa, Vony Yurike, Vania Carolyn, Putri Chantica, Lavenia Pangestu, Brigitta Yuliana Wea, Tulifejastri Santa Maria, Nathalie Cynthia","doi":"10.4274/tjtcs.2026.2026-4-37","DOIUrl":"10.4274/tjtcs.2026.2026-4-37","url":null,"abstract":"<p><p>Transient left ventricular outflow tract obstruction (LVOTO) is a rare but potentially life-threatening complication after mitral valve surgery. It is primarily caused by systolic anterior motion (SAM) of the mitral valve and postoperative geometric changes involving the left ventricle and aorto-mitral angle. Despite advances in perioperative imaging, evidence regarding the mechanisms, predisposing factors, and management of postoperative LVOTO following mitral interventions remains limited. This systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251127617) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and ProQuest were searched for reports of postoperative LVOTO following mitral valve surgery published through July 2025. Eligible studies comprised observational studies, case series, and case reports describing clinically or imaging-confirmed LVOTO after mitral valve intervention. Thirty studies (28 case reports, one case series, and one cohort study) comprising 58 patients were included. Most patients were elderly women with degenerative or rheumatic mitral disease. Predisposing anatomical features included an elongated anterior mitral leaflet, a small native or neo-LV outflow tract, a narrow aorto-mitral angle, and basal septal hypertrophy. SAM was documented in more than two-thirds of cases. Management strategies ranged from medical therapy to surgical or transcatheter septal or leaflet modification, with generally favorable clinical outcomes. Postoperative LVOTO following mitral valve surgery results from complex geometric interactions among the mitral leaflets, interventricular septum, and LVOT. Identification of high-risk anatomical features through quantitative imaging may support anticipatory procedural planning and facilitate timely intervention, potentially improving perioperative safety.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"340-348"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076432","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":"Relationship between serum potassium concentration, NT-pro-BNP, and risk of MACE in elderly patients with chronic heart failure.","authors":"Fang Lin, ZhangXin Fan","doi":"10.4274/tjtcs.2026.2025-12-40","DOIUrl":"10.4274/tjtcs.2026.2025-12-40","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between serum potassium concentration, N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels, and short-term major adverse cardiovascular events (MACE) in elderly patients with chronic heart failure (CHF) after percutaneous coronary intervention (PCI), and to evaluate their predictive value.</p><p><strong>Methods: </strong>General clinical characteristics, echocardiographic parameters, and laboratory indices were collected from 124 enrolled patients. All patients were followed for 3 months beginning immediately after PCI, encompassing both the in-hospital and post-discharge periods. According to the occurrence of MACE (defined as cardiovascular death, non-fatal myocardial infarction, stroke, or rehospitalization due to worsening heart failure) during follow-up, patients were categorized into a MACE group (n=44) and a non-MACE group (n=80). Multivariate logistic regression analysis was performed to identify independent factors associated with MACE. Restricted cubic spline (RCS) analysis was used to evaluate the dose-response relationships between serum potassium concentration, NT-pro-BNP levels, and MACE risk. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive performance of each indicator individually and in combination.</p><p><strong>Results: </strong>Multivariate logistic regression analysis demonstrated that each natural log-unit increase in NT-pro-BNP (corresponding to an approximately 2.72-fold increase in NT-pro-BNP concentration) was an independent risk factor for MACE (odds ratio [OR] =1.27), whereas each 0.1 mmol/L increase in serum potassium concentration was independently associated with a lower risk of MACE (OR =0.82). RCS analysis revealed a non-linear inverse association between serum potassium concentration and MACE risk, whereas NT-pro-BNP levels showed a significant positive association with MACE risk. The area under the ROC curve for the combined assessment of serum potassium and NT-pro-BNP was 0.73, which was significantly greater than that of either biomarker alone.</p><p><strong>Conclusion: </strong>Hypokalemia and elevated NT-pro-BNP levels are closely associated with an increased short-term risk of MACE in elderly patients with CHF. The combined assessment of these two indicators may provide clinical value for the early identification of high-risk patients.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"349-357"},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347100","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}