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

{"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}

{"title":"Sternal wound types after median sternotomy and reconstruction using dead space-based approach.","authors":"Bilgen Can, Yusuf Furkan Kırış, Hatip Dağ, Yunus Çağrı Güzel, Ahmet Dolapoğlu","doi":"10.5606/tgkdc.dergisi.2024.26053","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26053","url":null,"abstract":"<p><strong>Background: </strong>This study aims to classify wound complications after median sternotomy and provide an up-to-date reconstructive algorithm for multidisciplinary use.</p><p><strong>Methods: </strong>A total of 15 patients (9 males, 6 females; mean age: 68±5 years; range, 60 to 75 years) who underwent sternal reconstruction for wound complications following median sternotomy between August 2020 and October 2023 were retrospectively analyzed. Wound complications requiring reconstruction were classified into three categories based on the extent of the dead space caused by sternal debridement. Type 1, 2, and 3 wounds presented with only skin defects and an intact sternum, with partial and total sternectomy, respectively. The time to consultation for plastic surgery and the duration of hospitalization were compared.</p><p><strong>Results: </strong>Among the wounds, type 2 wounds were the most common type seen in 11 patients. Two patients each had type 1 and type 3 wounds. A superior epigastric artery perforator skin flap was used for type 1 wounds. Bilateral pectoral and split pectoral turnover muscle flaps from the side where the internal mammary artery was intact were used for type 2 wounds. A rectus abdominis muscle flap was used for type 3 wounds. Early consultation from plastic surgery reduced the length of hospital stay.</p><p><strong>Conclusion: </strong>For type 1 wounds, skin flaps ensured sufficient coverage as they involved skin and subcutaneous fat, matching the defect. However, sternal excision required muscle flaps to fill the dead space, in which the vital organs were exposed.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"261-270"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607186","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":"Malignant transformation of posterior mediastinal teratoma to adenocarcinoma.","authors":"Yener Aydın, Betül Gündoğdu, Ali Bilal Ulas, Omer Araz, Atilla Eroğlu","doi":"10.5606/tgkdc.dergisi.2024.25795","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.25795","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"346-347"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607178","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":"Mid-term results and late events after the Fontan operation: A single-center experience.","authors":"Tolga Akbaş, Fadli Demir, Sevcan Erdem, Orhan Kemal Salih, Mehmet Şah Topçuoğlu, Hakan Poyrazoğlu, Nazlı Totik, Nazan Özbarlas","doi":"10.5606/tgkdc.dergisi.2024.25793","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.25793","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to review our institutional experience with the Fontan operation, the adverse severe events we encountered during mid-term follow-up, and the associated risk factors.</p><p><strong>Methods: </strong>In the study, the medical records of 40 patients (22 males, 18 females) who underwent Fontan operation between August 1993 and August 2020 were retrospectively reviewed. The patients were followed up for at least six months.</p><p><strong>Results: </strong>The Fontan operation was performed at a median age of 6.5 years (range, 3 to 22 years), and the mean follow-up time was 4.1±3.8 years (range, 0.5 to 17 years). The most frequently occurring defect was tricuspid atresia (45.0%). Fifteen (37.5%) patients experienced 24 late adverse events. Late complications and severe side effects, in order of frequency, were arrhythmia in eight (53.3%) patients, hypoxia in five (33.3%) patients, and ventricular dysfunction in three (20%) patients. While protein-losing enteropathy and mortality were each observed in two (13.3%) patients, Fontan failure, thromboembolic event, pulmonary arteriovenous fistulae, and ascites were each observed in one (6.6%) patient. When possible risk factors for late complications were examined, a statistical significance was not found.</p><p><strong>Conclusion: </strong>Life expectancy and quality of life of patients with Fontan circulation have increased with advances in surgical technique and increased management success. However, complications are not uncommon after the Fontan operation, and late events remain a significant problem. The results of our study indicate that in mid-term follow-up of patients who underwent Fontan surgery at our institution, although not statistically significant, those who underwent fenestration and those operated at a later age tended to experience more severe events and late complications.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"280-290"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607180","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":"Prevent III score as a predictor of limb salvage and mortality after aortoiliac revascularization.","authors":"Lara Romana-Dias, Diogo Alves, José Vidoedo, João Rocha-Neves, José P Andrade, António Pereira-Neves","doi":"10.5606/tgkdc.dergisi.2024.26066","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26066","url":null,"abstract":"<p><strong>Background: </strong>This prospective study aimed to validate the prognostic value of Prevent III (PIII) risk score in patients undergoing aortoiliac revascularization, both in limb-related outcomes and cardiovascular risk.</p><p><strong>Methods: </strong>The prospective cohort study included 130 consecutive patients (122 males, 8 females; mean age: 62.1±9.2 years; range, 53 to 71 years) undergoing elective aortoiliac revascularization between January 2013 and September 2022. Patients' demographic and clinical characteristics were retrieved and PIII scores were calculated. A risk category was assigned according to the total points: low-risk (score ≤3), medium-risk (score 4-7), or high-risk (score ≥8).</p><p><strong>Results: </strong>The median follow-up period was 55 months (interquartile range, 39 to 70 months). Twenty-four (18.5%) patients had a PIII score ≥4. Regarding short-term outcomes, patients with PIII scores ≥4 exhibited lower ankle-brachial index changes at 30 days and more extended hospital stays. There were no significant associations between PIII scores and major adverse events at 30 days. However, during follow-up, a PIII score ≥4 was associated with increased major adverse limb events (p=0.036) and all-cause mortality (p=0.007).</p><p><strong>Conclusion: </strong>The PIII score is a reliable predictor of long-term limb and mortality risk in patients undergoing aortoiliac revascularization procedures, leveraging five user-friendly clinical parameters. More research with larger cohorts and studies comparing PIII with other validated scores should be performed in the future.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"253-260"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607184","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":"An alternative to chest tube thoracostomy equipment.","authors":"Hilmi Keskin, Emre Kuran","doi":"10.5606/tgkdc.dergisi.2024.26588","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.26588","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"348-349"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607167","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 effect of non-pharmacological methods on pain in patients undergoing open heart surgery: A systematic review and meta-analysis.","authors":"Tülin Yıldız, Merve Oyuktaş, Çagla Avcu","doi":"10.5606/tgkdc.dergisi.2024.25603","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.25603","url":null,"abstract":"<p><strong>Background: </strong>In this meta-analysis, we aimed to determine the effect of non-pharmacological methods on pain in patients undergoing open heart surgery.</p><p><strong>Methods: </strong>Scientific articles published between January 2002 and April 2022 were scanned in ScienceDirect, Scopus, PubMed, Web of Science, Google Scholar, Mendeley, Wiley Online Library databases. The keywords \"open heart surgery,\" \"cardiovascular surgery,\" \"non-pharmacological,\" \"complementary medicine,\" and \"pain\" were used in Turkish and English language. As a result of the search, 7,952 studies were identified and analyzed. Research data were obtained from 49 scientific articles.</p><p><strong>Results: </strong>The total sample size of the studies included in the analysis was 3,097. The total effect size was found to be 3.070, with a 95% confidence interval of 2.522 at the lower limit and 3.736 at the upper limit. Non-pharmacological pain methods in open heart surgery included positive environmental experience, distraction, massage therapy, hand massage, foot massage, acupuncture therapy, lavender essential oil inhalation, cold application, music therapy, breathing and relaxation exercises, neurolinguistic programming, guided visualization, imagery, therapeutic touch, osteopathic treatment, and transcutaneous electrical nerve stimulation.</p><p><strong>Conclusion: </strong>The pain of patients who underwent open heart surgery with non-pharmacological methods combined with pharmacological methods was three times less than those without non-pharmacological methods. Based on these findings, non-pharmacological methods are recommended for use due to their ease of application, and low side effects.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 3","pages":"291-306"},"PeriodicalIF":0.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607190","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}