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

{"title":"Endoscopic micro-invasive cardiac surgery: State-of-the-art.","authors":"Farhad Bakhtiary, Saad Salamate, Kaveh Eghbalzadeh, Ali El-Sayed Ahmad","doi":"10.5606/tgkdc.dergisi.2024.56934","DOIUrl":"10.5606/tgkdc.dergisi.2024.56934","url":null,"abstract":"<p><p>The advancement of micro-invasive cardiac surgery techniques has introduced a viable alternative to conventional full-sternotomy operations. These approaches are designed to reduce tissue trauma, shorten recovery time, and meet the increasing demand for less invasive treatment options. In this review, we discuss current progresses in endoscopic micro-invasive cardiac surgery, which utilizes refined tools and advanced imaging technologies to perform complex heart procedures, including valve surgery, coronary artery bypass grafting, and congenital defect corrections. By reviewing our experience with these techniques, we provide practical insights for surgeons interested in adopting micro-invasive cardiac surgery. The highlighted innovations in planning and execution of micro-invasive cardiac surgery reflect the growing trend toward safer and more efficient cardiac surgeries.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4","pages":"355-366"},"PeriodicalIF":0.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802892","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":"Femoral vein cannulation passing through patent foramen ovale and injuring left atrial appendage: An unusual complication.","authors":"Denyan Mansuroglu, Kenan Sever, Oguz Konukoglu, Mehmet Balkanay, Ali Dogan","doi":"10.5606/tgkdc.dergisi.2024.26110","DOIUrl":"10.5606/tgkdc.dergisi.2024.26110","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4","pages":"462-464"},"PeriodicalIF":0.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802893","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":"Documentation of the current state of cardiopulmonary bypass management in Türkiye.","authors":"Fehmi Bors, Hatice Büyükkol, Nihat Şencan, Hüseyin Gümüş, Eşe C Çaran Karaoğlu, Mücella Kaçar, Sedef Dündar","doi":"10.5606/tgkdc.dergisi.2024.26509","DOIUrl":"10.5606/tgkdc.dergisi.2024.26509","url":null,"abstract":"<p><p>Since the first successful use of cardiopulmonary bypass (CPB), much has changed in its technology, area of use, and management. Despite suggestions in guidelines, the institutional behavior may change based on institutional experience and established habits. This so-called \"deviation\" may alter management strategies in favorable or unfavorable ways. As the official Cardiopulmonary Bypass Study Group of the Association of Perfusionists in Türkiye, we aimed to document the current state of CPB management in Türkiye and make suggestions based on current guidelines. A 20-item questionnaire e-mailed to 682 perfusionists in 110 centers in Türkiye, and 177 (25.95%) responses were recorded from 97 centers. The questionnaire included main parameters regarding the management of CPB. We believe that by documenting the current state of CPB management strategies in Türkiye, suboptimal management strategies can be improved and suggestions for more favorable outcomes can be made.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4","pages":"467-468"},"PeriodicalIF":0.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802875","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":"Early postoperative outcomes of modified del Nido cardioplegia in coronary artery bypass surgery in patients with low ejection fraction.","authors":"Mehmet Emir Erol, Deniz Sarp Beyazpınar, İsa Civelek, Sertan Özyalçın, Ufuk Mungan","doi":"10.5606/tgkdc.dergisi.2024.26359","DOIUrl":"10.5606/tgkdc.dergisi.2024.26359","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the intraoperative and early postoperative effects of modified del Nido cardioplegia (DNC) compared to classic blood cardioplegia (BC) in patients with impaired left ventricular ejection fraction (EF) who underwent isolated coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>A total of 123 patients (108 males, 15 females; mean age: 62.2±8.5 years; range, 42 to 78 years) with an EF of 35% or lower who underwent on-pump CABG were included in the retrospective study between December 2022 and December 2023. The patients were divided into two groups according to the type of cardioplegia used: Group 1 (n=74) was designated as the BC group, and Group 2 (n=49) was designated as the DNC group. The groups were compared in terms of aortic cross-clamp duration, cardiopulmonary bypass (CPB) duration, need for defibrillation during weaning from CPB, positive inotrope requirement, intra-aortic balloon pump requirement, postoperative troponin-I levels, postoperative atrial fibrillation occurence, postoperative prolonged ventilation, development of postoperative neurologic complications, need for reintervention due to postoperative bleeding, postoperative transfusion requirement, and EF values at one month after the operation.</p><p><strong>Results: </strong>There was no significant difference between the two groups in the terms of aortic cross-clamp and CPB duration (p=0.955 <i>vs.</i> p=0.816). Additionally, there was no significant difference in the need for intra-aortic balloon pump usage between the two groups (p=0.105). Dopamine and dobutamine usage were significantly lower in Group 2 (p=0.04 and p=0.05, respectively). The intraoperative requirement for defibrillation was significantly lower in Group 2 (p=0.01). In addition, troponin levels at 12 h postoperatively were significantly lower in Group 2 (p=0.03). The incidence of postoperative atrial fibrillation was significantly lower in Group 2 (p=0.02). Moreover, there was no significant difference in EF values at one month after the operation (p=0.08).</p><p><strong>Conclusion: </strong>In patients who underwent CABG with reduced EF, modified DNC provided myocardial protection comparable to classic BC. Additionally, the need for intraoperative defibrillation and postoperative inotropic agents, as well as the incidence of postoperative atrial fibrillation, were lower in patients operated with DNC.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4","pages":"387-393"},"PeriodicalIF":0.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802877","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 predictive value of the Haller index for recurrent pneumothorax risk after primary spontaneous pneumothorax.","authors":"Mesut Buz, Yunus Emre Özsaray, Mehmet İlhan Sesigüzel, Mahmut Talha Doğruyol, Rıza Berk Çimenoğlu, Attila Özdemir, Recep Demirhan","doi":"10.5606/tgkdc.dergisi.2024.26856","DOIUrl":"10.5606/tgkdc.dergisi.2024.26856","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to evaluate the predictive value of the Haller index for recurrence risk in primary spontaneous pneumothorax patients.</p><p><strong>Methods: </strong>Between January 2018 and December 2023, a total of 285 patients (260 males, 25 females; median age: 23 years; range, 17 to 35 years) with primary spontaneous pneumothorax who underwent thoracic computed tomography and followed for at least one year were retrospectively analyzed. The patients were divided into two groups as the non-recurrence group (n=170) and recurrence (n=115) group. The Haller index was calculated from computed tomography scans at presentation and its predictive value for recurrent pneumothorax was estimated.</p><p><strong>Results: </strong>The median age was significantly higher in the non-recurrence group than in the recurrence group (p <0.001). The median time to recurrence was two (IQR 1-3) months. The diagnostic validity of Haller index for predicting recurrence showed an area under the receiver operating characteristic of 0.824 (95% confidence interval [CI]: 0.775-0.866) (p <0.001). The optimal cut-off value of Haller index (>2.4) showed a sensitivity of 70.43% (95% CI: 61.2-78.6) and specificity of 76.47% (95% CI: 69.4-82.6).</p><p><strong>Conclusion: </strong>A high Haller index is associated with increased recurrent pneumothorax risk in primary spontaneous pneumothorax patients. Traditionally used for pectus excavatum severity, incorporating Haller index in the management of these patients may help to identify high-risk patients and guide personalized management strategies.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4","pages":"436-444"},"PeriodicalIF":0.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802921","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":"Deep learning in distinguishing pulmonary nodules as benign and malignant.","authors":"Muhammed Bilal Akıncı, Mesut Özgökçe, Murat Canayaz, Fatma Durmaz, Sercan Özkaçmaz, İlyas Dündar, Ensar Türko, Cemil Göya","doi":"10.5606/tgkdc.dergisi.2024.26027","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26027","url":null,"abstract":"<p><strong>Background: </strong>Due to the high mortality of lung cancer, the aim was to find convolutional neural network models that can distinguish benign and malignant cases with high accuracy, which can help in early diagnosis with diagnostic imaging.</p><p><strong>Methods: </strong>Patients who underwent tomography in our clinic and who were found to have lung nodules were retrospectively screened between January 2015 and December 2020. The patients were divided into two groups: benign (n=68; 38 males, 30 females; mean age: 59±12.2 years; range, 27 to 81 years) and malignant (n=29; 19 males, 10 females; mean age: 65±10.4 years; range, 43 to 88 years). In addition, a control group (n=67; 38 males, 29 females; mean age: 56.9±14.1 years; range, 26 to 81 years) consisting of healthy patients with no pathology in their sections was formed. Deep neural networks were trained with 80% of the three-class dataset we created and tested with 20% of the data. After the training of deep neural networks, feature extraction was done for these networks. The features extracted from the dataset were classified by machine learning algorithms. Performance results were obtained using confusion matrix analysis.</p><p><strong>Results: </strong>After training deep neural networks, the highest accuracy rate of 80% was achieved with the AlexNET model among the models used. In the second stage results, obtained after feature extraction and using the classifier, the highest accuracy rate was achieved with the support vector machine classifier in the VGG19 model with 93.5%. In addition, increases in accuracy were noted in all models with the use of the support vector machine classifier.</p><p><strong>Conclusion: </strong>Differentiation of benign and malignant lung nodules using deep learning models and feature extraction will provide important advantages for early diagnosis in radiology practice. The results obtained in our study support this view.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"317-324"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607172","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":"Surgical ablation of atrial fibrillation: Rationale and technique.","authors":"Stephen D Waterford, Niv Ad","doi":"10.5606/tgkdc.dergisi.2024.86520","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.86520","url":null,"abstract":"<p><p>The Cox maze procedure is the most effective treatment for atrial fibrillation with the best long-term success rate compared to any other treatment modality, particularly in persistent and long-standing persistent atrial fibrillation. Cardiac surgeons have an unparalleled opportunity to treat atrial fibrillation as a concomitant operation during the treatment of ischemic or valvular disease. In addition, there are many options for surgical ablation of atrial fibrillation. In this review, we share the anatomic basis for surgical atrial fibrillation ablation, focusing on the Cox maze procedure and discuss some key technical points and common pitfalls to provide an effective ablation of atrial fibrillation. These include a discussion of avoidance of pacemaker implantation and other complications, and also how to produce the most effective lesions from a rhythm standpoint.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"245-252"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607188","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":"Coronary cameral fistula in a Fontan physiology patient with pulmonary atresia and intact ventricular septum: Should it be closed?","authors":"Ensar Duras, Perver Arslan, Selman Gokalp, Alper Guzeltas","doi":"10.5606/tgkdc.dergisi.2024.25827","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.25827","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"343-345"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607169","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":"Effects of intraoperative fluid management on hemodynamics and tissue oxygenation according to the Pleth Variability Index in thoracic surgery.","authors":"Semanur Savaser, Ali Akdogan, Engin Erturk, Dilek Kutanis, Rauf Gul, Bekir Sami Karapolat, Kubra Nur Kılıç","doi":"10.5606/tgkdc.dergisi.2024.25372","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.25372","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to compare the total fluid volume performed by noninvasive Pleth Variability Index in thoracic surgery patients in comparison to conventional fluid management.</p><p><strong>Methods: </strong>In this prospective randomized controlled study conducted between May 2019 and May 2020, 80 patients (68 males, 12 females; mean age: 58.5±6.7 years; range, 18 to 65 years) were divided into two groups: control (Group C) and the Pleth Variability Index (Group P). After performing routine anesthesia and Pleth Variability Index monitoring for all patients, fluids were given at a rate of 2 mL/kg/h with the standard anesthesia technique. Additional fluid supplementation was provided based on hemodynamic data in Group C. In Group P, 250 mL bolus crystalloid fluid was provided when Pleth Variability Index was >14%. Mean arterial pressure, heart rate, oxygen saturation, arterial blood gas, and blood biochemistry were recorded. Total fluid volumes and urinary output were also recorded.</p><p><strong>Results: </strong>There was no significant difference between the groups in terms of total fluid volumes or urinary output. In the postoperative period, the oxygen saturation and mean arterial pressure of Group P were found to be higher than those of Group C. The postoperative creatinine and lactate values of Group P were lower than those of Group C.</p><p><strong>Conclusion: </strong>Although there was no significant difference in the total fluid given to the patients, fluid management by Pleth Variability Index monitoring had a positive effect on mean arterial pressure, oxygen saturation, lactate, and creatinine levels.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"307-316"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607176","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 role of radiological and clinical findings in determining lobectomy decision in patients with undiagnosed resectable lung lesions.","authors":"Burcu Oksuz Gungor, Omer Topaloglu, Sami Karapolat, Atila Turkyilmaz, Ali Akdogan, Celal Tekinbas","doi":"10.5606/tgkdc.dergisi.2024.26403","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26403","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the role of radiological and clinical findings in determining lobectomy decision in undiagnosed resectable lung lesions.</p><p><strong>Methods: </strong>Between January 2014 and April 2023, a total of 135 patients (114 males, 21 females; mean age: 60.8±11.5 years; range, 17 to 84 years) who underwent lobectomy or wedge resection based on clinical and radiological data were retrospectively analyzed. Patients with undiagnosed lung lesions, whose diagnosis could not be confirmed through transthoracic fine needle aspiration biopsy or bronchoscopic endobronchial ultrasound, were included in the study. Clinical data including age, sex, smoking status, history of extrapulmonary cancer, family history of lung cancer, and presence of chronic obstructive pulmonary disease/idiopathic pulmonary fibrosis were noted. Radiological data including lesion size, margin characteristics, internal structure of the lesion, relationship of the lesion with surrounding tissues, and nuclear imaging results were also recorded.</p><p><strong>Results: </strong>Malignant lesions were detected in 74 patients, while benign lesions were detected in 61 patients. Comparing benign and malignant lesions, age, lesion size, lesion localization, presence of pleural retraction, and moderate-to-high maximum standardized uptake value (SUV_max) on positron emission tomography-computed tomography were found to be correlated with malignancy.</p><p><strong>Conclusion: </strong>The accurate assessment of lung lesions and prompt identification of possible malignancy are of paramount importance for implementing appropriate treatment strategies.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"325-332"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607241","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}