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

{"title":"Posterior mediastinal unicentric Castleman disease treated by video-assisted thoracoscopic surgery.","authors":"Elgün Valiyev, İsmail Tombul, Muhammet Sayan, Nalan Akyürek, Olgun Kadir Arıbaş","doi":"10.4274/tjtcs.2026.2026-2-19","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-2-19","url":null,"abstract":"<p><p>Castleman disease (CD) represents an uncommon lymphoproliferative condition that can manifest as a mediastinal mass and resemble other thoracic pathologies. Establishing a definitive diagnosis before surgery is often difficult, making histopathological analysis crucial. We present the case of a 38-year-old man in whom a posterior mediastinal lesion was incidentally identified and initially interpreted as a neurogenic tumor on imaging. The mass was successfully removed via video-assisted thoracoscopic surgery (VATS). Subsequent pathological evaluation revealed hyaline-vascular unicentric CD. This case underscores the need to consider CD in the differential diagnosis of posterior mediastinal masses and further supports the role of VATS as a safe and effective minimally invasive approach.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: A cardiac surgery protocol for suspected malignant hyperthermia.","authors":"Filiz Ata, Tuğba Onur, Ahmet Burak Tatlı, Arda Aybars Pala, Ümran Karaca, Ayşe Neslihan Balkaya, Mesut Öztürk, Nuri Burkay Soylu, Pelin Köseoğlu, Harun Karaoğlu","doi":"10.4274/tjtcs.2026.2026-4-41","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-4-41","url":null,"abstract":"<p><p>Cardiac surgery in patients with suspected malignant hyperthermia (MH) susceptibility poses a distinct diagnostic and management challenge, as cardiopulmonary bypass (CPB)-induced hypothermia may mask early manifestations of MH. Given the rarity of this clinical scenario, we present our institutional perioperative protocol-encompassing preoperative workstation decontamination, trigger-free total intravenous anesthesia, CPB-specific precautions, and serial creatine kinase surveillance-illustrated through its successful application in a 47-year-old male undergoing elective four-vessel coronary artery bypass grafting. No clinical or biochemical evidence of MH occurred. We outline this structured approach as a practical reference for the cardiac surgical community.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of changes in coagulation profile by thromboelastography in patients undergoing lobectomy for malignancy.","authors":"Gizem Keçeci Özgür, Rza Mammadov, Esranur Akpunar, Tevfik İlker Akçam, Ali Özdil, Ayşe Gül Ergönül, Ufuk Çağırıcı, Alpaslan Çakan","doi":"10.4274/tjtcs.2026.2026-5-16","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-5-16","url":null,"abstract":"<p><strong>Background: </strong>Thromboelastography (TEG) provides a global assessment of coagulation and fibrinolytic activity. This study aimed to evaluate postoperative coagulation changes in patients undergoing lobectomy for lung malignancy using TEG.</p><p><strong>Methods: </strong>In this prospective observational study, sixteen patients undergoing lobectomy for lung malignancy were included. TEG analyses were performed preoperatively, on postoperative day 0 (POD0) before low-molecular-weight heparin (LMWH) initiation, and on postoperative day 3 (POD3) after initiation of routine LMWH thromboprophylaxis. r time (clot initiation), k time (clot kinetics), α-angle (rate of clot strengthening), maximum amplitude (MA; maximum clot strength), Ly30 (fibrinolytic activity), and coagulation index (CI; overall coagulability) were evaluated. Temporal changes were analyzed using linear mixed models with Bonferroni-adjusted pairwise comparisons (Clinical trial registration: ClinicalTrials.gov identifier: NCT06484231).</p><p><strong>Results: </strong>No significant temporal change was observed in r time (p=0.293). Significant changes were detected in k time, α-angle, MA, Ly30, and CI (all p<0.001). On POD0, k time was prolonged and MA decreased compared with preoperative values, whereas α-angle increased and Ly30 showed a decreasing tendency, indicating heterogeneous postoperative coagulation responses. On POD3, α-angle significantly decreased compared with POD0, while Ly30 significantly increased compared with both preoperative values and POD0, suggesting evolving coagulation dynamics under ongoing thromboprophylaxis. CI progressively increased throughout the postoperative period, indicating a shift toward a more hypercoagulable profile.</p><p><strong>Conclusion: </strong>TEG revealed a dynamic, multidimensional postoperative coagulation profile rather than a uniform hypercoagulable shift. Early (POD0) changes-prolonged k time and reduced MA with an increased α-angle-likely reflected surgical trauma and perioperative hemodilution, whereas POD3 findings appeared to combine physiological recovery with thromboprophylaxis. The progressive rise in CI indicated an evolving shift toward hypercoagulability, while α-angle and Ly30 emerged as the most responsive parameters and may be useful for monitoring perioperative coagulation. Because postoperative recovery and LMWH effects could not be disentangled in this design, these findings are hypothesis-generating and warrant confirmation in larger controlled studies.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-to-outcome analysis of multidisciplinary tumor board-managed NSCLC patients.","authors":"Erhan Özer, Hüseyin Melek, Adem Deligönül, Ahmet Sami Bayram, Cengiz Gebitekin","doi":"10.4274/tjtcs.2026.2026-2-25","DOIUrl":"10.4274/tjtcs.2026.2026-2-25","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant therapy is recommended for selected patients with non-small cell lung cancer; however, concerns about disease progression, loss of surgical opportunity, and treatment-related mortality limit its adoption. Multidisciplinary tumor board (MDT) aims to optimize treatment sequencing, yet comprehensive real-world data integrating treatment-related and oncologic outcomes remain limited. This study evaluated progression, resection rates, treatment-related mortality, and long-term oncologic outcomes within a multidisciplinary management framework.</p><p><strong>Methods: </strong>This retrospective cohort included 769 patients discussed by a thoracic oncology board between May 2015 and November 2019. Treatment strategies comprised upfront surgery, neoadjuvant therapy followed by planned surgery, definitive chemoradiotherapy, or non-surgical management. The primary outcome was progression during neoadjuvant therapy. Secondary outcomes included resection rates, treatment-related mortality, pathological response, and overall survival.</p><p><strong>Results: </strong>Neoadjuvant therapy was recommended in 275 patients (35.8%). Disease progression occurred in 8 patients (2.9%). Curative-intent resection was achieved in 246 patients (89.5%). Treatment-related mortality during neoadjuvant therapy was 1.1%, compared with 5.3% after definitive chemoradiotherapy and 0.4% overall surgical mortality. Pathological complete response was observed in 13.4%. Among stage III patients, five-year overall survival was 69.0% in the neoadjuvant surgery group versus 20.0% in the non-surgical group.</p><p><strong>Conclusion: </strong>In this MDT-managed non-small cell lung cancer cohort, low progression rates and high resection rates were observed among patients selected for neoadjuvant therapy. These findings describe real-world treatment completion and clinical outcomes within a multidisciplinary management framework.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular salvage of type IIIa endoleak from graft infolding after emergency TEVAR.","authors":"Mustafa Ferhat Keten, İsmail Balaban, Azmican Kaya, Doğancan Çeneli","doi":"10.4274/tjtcs.2026.2026-4-33","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-4-33","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Station distribution of lymph node evaluation in surgically managed pulmonary carcinoid tumors: A 20-year single-institution series.","authors":"Serkan Uysal, Ayşe Ali Hasan, Yiğit Yılmaz, Burcu Ancın, Olcay Kurtulan, Ulaş Kumbasar, Erkan Dikmen","doi":"10.4274/tjtcs.2026.2026-4-36","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-4-36","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary carcinoid tumors are rare lung neuroendocrine neoplasms in which the adequacy of lymph node evaluation remains debated, and real-world station-level staging patterns are incompletely described.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent surgical management for pulmonary carcinoid tumors or related neuroendocrine proliferation-spectrum lesions at a single institution between 2004 and 2024 (n=71). Primary analyses focused on pulmonary carcinoid tumors (n=66; typical n=53, atypical n=11, unclassified n=2). Pathologic extent was harmonized to the current ninth-edition staging framework. Kaplan-Meier survival estimates generated in Numiqo were cross-checked in SPSS.</p><p><strong>Results: </strong>Median age was 55 years, and 55/71 patients (77.5%) were female. Among 70 lung resections, anatomic resection was performed in 55/70 (78.6%) and sublobar resection in 15/70 (21.4%). Earlier cases were predominantly thoracotomy-based, whereas later cases increasingly underwent video-assisted thoracoscopic surgery; systematic nodal evaluation remained integral regardless of access route. Lymph node dissection or sampling was performed in 58/71 patients (81.7%), identifying nodal metastasis in 5/71 (7.0%), including two typical carcinoids with N2 disease and three atypical carcinoids (two N1, one N2). Among cases with documented nodal stations (45/58), a median of 5 stations was assessed, most commonly stations 7, 10, and 11. Median follow-up was 64.8 months; estimated 5-year overall survival was 93.2% and 5-year recurrence-free survival was 84.6%.</p><p><strong>Conclusion: </strong>Systematic nodal evaluation disclosed clinically meaningful occult disease, including in typical carcinoid. These findings support routine hilar-mediastinal staging and risk-adapted surveillance after resection and reinforce that minimally invasive surgery should preserve the same oncologic nodal intent as open surgery.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve-in-valve transcatheter aortic valve implantation for degenerated surgical bioprosthesis and closure of mitral-aortic intervalvular fibrosa pseudoaneurysm.","authors":"İsmail Balaban, Azmican Kaya, Doğan Şen, Emine Gazi, Elnur Alizade","doi":"10.4274/tjtcs.2026.2026-4-34","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-4-34","url":null,"abstract":"<p><p>Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is a minimally invasive and effective alternative to redo surgery in high-risk patients with degenerated surgical bioprosthetic valves. We report a 67-year-old woman with a history of Bentall and redo Bentall procedures who presented with degeneration of a surgical bioprosthesis complicated by a mitral-aortic intervalvular fibrosa (MAIVF) pseudoaneurysm. ViV-TAVI resulted in marked symptomatic improvement and optimal hemodynamic valve performance and was unexpectedly associated with spontaneous closure of the MAIVF pseudoaneurysm.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Seesaw technique: A novel hybrid single-bar approach for asymmetric pectus excavatum correction.","authors":"Caner İşevi, Mehmet Gökhan Pirzirenli, Elif Sarıkaya Özel, Yasemin Büyükkarabacak","doi":"10.4274/tjtcs.2026.28935","DOIUrl":"10.4274/tjtcs.2026.28935","url":null,"abstract":"<p><p>Asymmetric pectus excavatum (PE) is surgically challenging due to combined depressive and protrusive components. We describe a novel hybrid \"Seesaw\" technique that integrates the Nuss and Abramson principles using a single pectus bar. In six patients with asymmetric PE, the bar followed an extra-thoracic path on the protruded side to provide compression and an intra-thoracic path on the depressed side to provide elevation through a single-incision access. Early outcomes were favorable, with excellent cosmetic correction, high patient satisfaction, and one case of bar rotation. The Seesaw technique appears to be a simple, minimally invasive, and promising option for selected patients.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"330-334"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628905","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":"Aortic aneurysms: Endovascular at all costs?","authors":"Eric Verhoeven","doi":"10.4274/tjtcs.2026.2026-6-16","DOIUrl":"10.4274/tjtcs.2026.2026-6-16","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"218-219"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354482","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":"Vitamin K antagonists and structural valve deterioration in bioprosthetic aortic valves.","authors":"Onur Barış Dayanır, Fatih Emre Kılıç, Ceren Sayarer, Tuğra Gençpınar, Serdar Bayrak, Şevket Baran Uğurlu","doi":"10.4274/tjtcs.2026.28879","DOIUrl":"10.4274/tjtcs.2026.28879","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effect of postoperative vitamin K antagonist (VKA) exposure on structural valve deterioration (SVD) after bioprosthetic aortic valve replacement (AVR).</p><p><strong>Methods: </strong>We retrospectively analysed 123 patients who underwent surgical bioprosthetic AVR between 2010 and 2025 with adequate echocardiographic follow-up. VKA exposure was recorded during follow-up; for the primary time-fixed Cox model, VKA exposure was defined as cumulative postoperative use ≥3 months (yes/no), and VKA was additionally evaluated as a time-varying covariate in a time-dependent sensitivity analysis. The primary endpoint was VARC-3-defined SVD; secondary endpoints were all-cause mortality, bioprosthetic valve failure, and reoperation/valve-in-valve.</p><p><strong>Results: </strong>Mean age was 71.3±6.1 years; 65% were male. Porcine and bovine bioprostheses accounted for 71.5% and 28.5% of implants. Median SVD-free survival was 2073 days (95% confidence interval [CI]: 0-4212) in VKA users, while the median was not reached in non-users; the difference was significant (logrank p=0.017). In the adjusted time-fixed Cox model, VKA exposure was associated with higher SVD risk (adjusted hazard ratio [aHR] 2.14; 95% CI 1.08-4.26; p=0.030). In a time-dependent sensitivity Cox model with VKA as a time-varying covariate, periods on VKA were similarly associated with higher SVD hazard (hazard ratio 2.16; 95% CI 1.10-4.23; p=0.025). Porcine bioprostheses were also independently associated with higher SVD risk (aHR 2.71; 95% CI 1.09-6.76; p=0.031).</p><p><strong>Conclusion: </strong>After bioprosthetic AVR, VKA exposure and porcine bioprostheses were independently associated with SVD. Antithrombotic strategies should consider the potential long-term adverse effects of VKA in the context of prosthesis material and patient characteristics. Prospective multicenter studies are needed to confirm these findings.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"231-238"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463924","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}