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

{"title":"[MSB-69] Can OPCAB in Proximal Left Anterior Descending Artery Lesions Be A Criterion for Determining the Indication?","authors":"Yavuz Şensöz, Kemal Özdemir, Buğrahan Palalı","doi":"10.5606/tgkdc.dergisi.2024.msb-69","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-69","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to demonstrate the early mortality results of the minimally invasive off-pump coronary artery bypass surgery.</p><p><strong>Methods: </strong>Fifteen patients (11 males, 4 females; mean age: 62 years) who underwent OPCAB between December 2021 and July 2024 were retrospectively analyzed. All patients had a left anterior descending artery (LAD) stent and in-stent stenosis or stent thrombosis. All patients underwent left internal mammary artery to LAD anastomosis on a beating heart without cardiopulmonary bypass via thoracotomy.</p><p><strong>Results: </strong>There was no early mortality. The mean duration of hospitalization was 5.1 days. One patient developed postoperative atrial fibrillation. All patients were discharged. One patient was reintubated due to pleural effusion after discharge.</p><p><strong>Conclusion: </strong>We believe that not performing sternotomy and not using cardiopulmonary bypass are important in terms of reducing procedure-related comorbidities and could have significant effects on the patient's treatment decision. Moreover, the use of a left internal mammary artery to LAD anastomosis appears to be more advantageous than percutaneous coronary intervention in terms of long-term patency.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"091-91"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041689","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-49] Postoperative Aortic Valve Insufficiency: Outcomes of Aortic Valve Preservation in Type A Aortic Dissection.","authors":"Kemal Eşref Erdoğan, Emrah Uğuz, Nur Gizem Elipek","doi":"10.5606/tgkdc.dergisi.2024.msb-49","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-49","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to assess the impact of preserving the aortic valve during supracoronary aortic interposition on aortic valve function in patients with type A aortic dissection.</p><p><strong>Methods: </strong>The study included 95 patients (65 males, 30 females; mean age: 58.94±11.4 years) who underwent supracoronary aortic interposition due to type A aortic dissection between 2019 and 2023. Patients who completed early- and mid-term postoperative follow-ups were included in the study. Patients who died or had aortic valve replacement were excluded. Preoperative and postoperative transthoracic echocardiography results were compared for aortic insufficiency (AI).</p><p><strong>Results: </strong>Preoperative echocardiography showed no AI in 39 patients. During follow-up, 27 patients still had no AI. Mild AI developed in eight patients, and moderate AI developed in four. Preoperative mild AI was present in 40 patients, with 24 maintaining the same degree of AI, six showing no AI, and 10 progressing to moderate AI. Of 16 patients with preoperative moderate AI, seven showed regression to mild AI postoperatively, while five had unchanged moderate AI. Five patients with moderate AI underwent aortic resuspension. Among these patients, AI persisted at the same level postoperatively in one patient, two patients had no AI, and two had mild AI.</p><p><strong>Conclusion: </strong>The degree of aortic valve insufficiency is crucial in type A dissection surgery. Assessing the aortic valve structure and preserving valves that do not require replacement can reduce cross-clamp time, complications, and mortality. Regular transthoracic echocardiography follow-up is essential to monitor the progression or regression of AI in these patients.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"074-74"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990069","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-22] Pharmacomechanical Thrombectomy and Catheter-Directed Thrombolysis with or Without Iliac Vein Stenting in the Treatment of Acute Iliofemoral Deep Vein Thrombosis.","authors":"Evren Özçınar, Nur Dikmen, Ahmet Kayan, Melisa Kandemir, Mehmet Cahit Sarıcaoğlu","doi":"10.5606/tgkdc.dergisi.2024.msb-22","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-22","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate and compare the outcomes and clinical efficacy of pharmacomechanical thrombectomy (PMCT) plus catheter-directed thrombolysis (CDT) and PMCT combined with CDT and venous stenting in the management of acute iliofemoral deep vein thrombosis and assess the long-term safety and efficacy of these interventions.</p><p><strong>Methods: </strong>This retrospective case-control study involved 112 patients who presented with acute symptomatic iliofemoral deep vein thrombosis. All patients had a symptom duration of less than 14 days. Sixty-three patients underwent PMCT + CDT, while the remaining 49 underwent PMCT + CDT + venous stenting. Clinical features and outcomes were compared between the two groups. Additionally, patients were followed for 24 months after treatment, during which quality of life and severity of postthrombotic syndrome (PTS) were analyzed.</p><p><strong>Results: </strong>Survival analyses for primary, primary-assisted, and secondary patency yielded comparable results for PMCT + CDT (p=0.74, p=0.58, and p=0.72, respectively). The two-year patency rate was high in both groups (85.7% for PMCT + CDT <i>vs.</i> 83.7% for PMCT + CDT + venous stenting). During the follow-up, there were no statistically significant differences observed in the incidence of PTS or the average Villalta score between the two groups. At 24 months after intervention, the incidence of PTS was 11.1% in the PMCT + CDT group and 22% in the PMCT + CDT + venous stenting group (p=0.381).</p><p><strong>Conclusion: </strong>The results indicate that PMCT + CDT was effective in alleviating leg symptoms and reducing the occurrence of PTS, including the incidence of moderate-to-severe PTS. The utilization of PMCT + CDT + venous stenting therapy, tailored to individual clinical and venous conditions, may enhance long-term venous patency and lead to superior outcomes, including improved quality of life parameters.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"042-42"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990141","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-10] Our Experience With Axillary Cannulation in Minimally Invasive Bypass Patients.","authors":"Faruk Gencoglu, Ahmet Ozan Koyuncu","doi":"10.5606/tgkdc.dergisi.2024.mep-10","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-10","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the outcomes of patients operated on using extracorporeal membrane oxygenation (ECMO) cannulas inserted into the axillary artery via the Seldinger technique after exploring the axillary artery. <b>Method:</b> Eighteen patients who underwent minimally invasive bypass surgery with an ECMO cannula via axillary artery cannulation between January 2024 and August 2024 were retrospectively reviewed.</p><p><strong>Results: </strong>All 18 patients had successful ECMO axillary artery cannulation without any incidents of axillary artery damage. There were no cases of ischemia, edema, or permanent neurological deficits in the right upper extremity, and no infections were observed at the cannulation site. The mean time to extubation after the operation was 6 h, the mean intensive care unit stay was 1.05 days, and the mean hospital stay was 5.9 days. No prolonged intubation or mortality was observed.</p><p><strong>Conclusion: </strong>As the prevalence of minimally invasive direct coronary artery bypass grafting increases, so does the need for alternative cannulation techniques. Axillary artery cannulation presents as a significant option. Its primary benefits include providing antegrade cerebral and systemic perfusion and eliminating the risk of retrograde embolization. However, local complications such as brachial plexus and axillary artery damage may occur. The use of the Seldinger technique with an ECMO cannula can minimize these risks. Our study found no systemic or local side effects with this technique in the operated patients.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"105"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993690","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-29] Could Hybrid Treatments Be A Solution for Traumatic Abdominal Aortic Pseudoaneurysms?","authors":"Hidayet Onur Selçuk, Ertürk Karaağaç, Hasan İner, Serkan Yazman, Yüksel Beşir, Mustafa Gürbüz, Orhan Gökalp, Levent Yılık","doi":"10.5606/tgkdc.dergisi.2024.mep-29","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-29","url":null,"abstract":"<p><p>Traumatic pseudoaneurysm of the abdominal aorta is a life-threatening pathology that often presents after trauma. In suprarenal location, the classical approach makes the operation more difficult due to the difficulty of accessing the abdominal aorta due to the complex anatomy and the high risk of bleeding. In this case report, we presented a hybrid surgery approach in a patient with abdominal aortic pseudoaneurysm. A 20-year-old male patient was urgently operated due to hemodynamic instability after a gunshot wound to the abdomen. The patient was evaluated with computed tomography angiography on the 14^th postoperative day, which revealed a 77×51×64 mm pseudoaneurysm originating from the abdominal aorta at the level of the celiac trunk. Consequently, the patient was taken into reoperation. The visceral arteries and the right common iliac artery were explored and released. A bypass was performed from the right common iliac artery to the celiac trunk with a Dacron graft. Afterward, a bypass was performed from the celiac trunk graft to the superior mesenteric artery with a Dacron graft. Following the debranching procedure, the celiac trunk and superior mesenteric artery were ligated. Then, a 20×20×82 mm endovascular graft was applied to the suprarenal region, and the pseudoaneurysm sac was closed. No endoleak was detected. Bilateral renal arteries and debranching grafts were patent. After two days, the patient was taken to the ward. It was observed that the pseudoaneurysm sac was thrombosed, and the debranching grafts were patent. The patient was discharged on the 10^th postoperative day. Abdominal aortic pseudoaneurysms are a vital pathology that can result in death even before symptoms appear. In case of doubt, the diagnosis should be made with advanced imaging methods and the optimal treatment protocol specific to the patient should be determined. It should be kept in mind that hybrid treatment, including endovascular aortic stenting and debranching, may be the solution in high-risk cases.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"127-128"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995075","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-24] Metabolomic Signatures of Hypothermia Under Cardiopulmonary Bypass: A Systematic Evaluation of Mild and Moderate Hypothermia on Urinary Metabolome Profiles.","authors":"Oğuzhan Durmaz, Cemil Can Eylem, Evren Özçınar, Emirhan Nemutlu, Osman Dağ, Sadık Eryılmaz, Emel Emregül","doi":"10.5606/tgkdc.dergisi.2024.msb-24","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-24","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the differential impacts of mild (32 to 35°C) and moderate (26 to 31°C) hypothermia on urinary metabolome profiles during cardiopulmonary bypass (CPB) in adult cardiac surgery.</p><p><strong>Methods: </strong>This randomized study included 32 patients who underwent CPB under hypothermic conditions (mild, n=16; moderate, n=16) using only the Bretschneider solution. Urine samples were collected at two time points: immediately before CPB initiation and 1 h after rewarming and termination of CPB. Urinary metabolomic analyses were conducted using gas chromatography-mass spectrometry and liquid chromatography-quadrupole timeof-flight mass spectrometry. Metabolite changes were evaluated using statistical methods, including the MannWhitney U test, principal component analysis, and partial least squares discriminant analysis.</p><p><strong>Results: </strong>Significant differences in urinary metabolites were observed between the two hypothermia groups. Mild hypothermia resulted in increased levels of creatinine and 5,6-DHET and decreased levels of 2-methylbutyroylcarnitine and S-adenosylhomocysteine, suggesting a more favorable metabolic response with reduced stress. In contrast, the moderate hypothermia group exhibited increases in metabolites such as C17- sphinganine and ceramide (t18:0/16:0), indicating heightened metabolic stress and potential cellular damage. Principal component analysis and partial least squares discriminant analysis revealed distinct separations between the groups, highlighting greater metabolic perturbations with moderate hypothermia.</p><p><strong>Conclusion: </strong>Mild hypothermia is associated with a more stable urinary metabolomic profile, whereas moderate hypothermia is linked to significant metabolic disruptions, necessitating careful monitoring and management. These findings provide valuable insights for optimizing hypothermia protocols during CPB.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"044-44"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056309","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-15] Histopathological Comparison of the Effectiveness of St. Thomas II and del Nido Cardioplegia Solutions with Respect to Myocardial Ischemia and Reperfusion in Rats.","authors":"Burak Toprak, Abdulkadir Bilgiç","doi":"10.5606/tgkdc.dergisi.2024.msb-15","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-15","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the effectiveness of traditional St. Thomas II and the next-generation del Nido cardioplegia solutions in minimizing ischemia/reperfusion injury during open heart surgery in a myocardial ischemia/reperfusion model created in rats.</p><p><strong>Methods: </strong>In this experimental study, 24 Wistar albino rats were divided into three groups: the sham group (normal saline), the St. Thomas II group, and the del Nido group. Cardioplegia was induced, and heart tissues were collected for histopathological analysis after 90 min. The number of macrophages was counted to assess inflammation.</p><p><strong>Results: </strong>The mean macrophage count in ischemic tissues was similar across the sham, St. Thomas II, and del Nido groups. In tissues with reperfusion injury, the control group had fewer macrophages compared to the St. Thomas II and del Nido groups, but the difference between the two solutions was not statistically significant.</p><p><strong>Conclusion: </strong>Both St. Thomas II and del Nido solutions were more effective than the control in preventing reperfusion injury. However, no significant difference was observed between the two cardioplegia solutions, possibly due to the short ischemia/reperfusion duration and the resilient nature of rat myocardium.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"034-35"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056432","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-33] Postoperative Early- to Mid-Term Results of the Ozaki Procedure Applied to Aortic Valve Pathologies.","authors":"Tayfun Özdem, Furkan Burak Akyol, Cahit Murat Balaman, Tuna Demirkiran, Yiğit Tokgöz, Emre Kubat, Cengiz Bolcal, Vedat Yıldırım, Murat Kadan, Kubilay Karabacak","doi":"10.5606/tgkdc.dergisi.2024.msb-33","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-33","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate our early- to mid-term results with the aortic valve neocuspidization technique (Ozaki procedure) in aortic valve pathologies.</p><p><strong>Methods: </strong>This study retrospectively examined the data of 243 patients (172 males, 71 females; mean age: 53.11±18.3 years; range, 17 to 82 years) who underwent the Ozaki procedure between February 2019 and August 2024.</p><p><strong>Results: </strong>The primary pathology was aortic insufficiency in 52 (21.3%) patients and aortic stenosis in 201 (82.7%) patients. The aortic valve morphology was trileaflet in 196 (80.6%) patients, bileaflet in 44 (18.1%) patients, unicuspid in two (0.8%) patients, and quadricuspid in one (0.4%) patient. Additional cardiac surgical procedures were performed on 99 (40.7%) patients. Preoperative echocardiographic findings in patients with aortic stenosis showed a peak gradient of 91.39±33.1 mmHg and a mean gradient of 54.9±18.3 mmHg. The mean cross-clamp time was 110.2±35.6 min, while the cardiopulmonary bypass time was 141.2±39.6 min. Postoperative echocardiographic findings showed significant improvement in peak and mean gradients at six months (18.3±6.2 and 8.9±2.4 mmHg) and one (15.6±5.7 and 8.7±3.5 mmHg), two (14.2±4.7 and 7.7±2.5 mmHg), three (13.69±3.8 and 6.4±3.7 mmHg), and four (12.4±3.8 and 6.3±2.4 mmHg) years.</p><p><strong>Conclusion: </strong>Aortic valve neocuspidization is a viable technique for all aortic pathologies. It offers advantages such as achieving good hemodynamics postoperatively, avoiding anticoagulant medications, and allowing additional surgical procedures.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"057-57"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040587","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-05] Surgical Approach to Brachial Arteriovenous Fistula Thrombosis: A Case Report.","authors":"Yasin Guzel, Mustafa Kemal Avşar, Ferhat Can Pişkin, Enes Batuhan Abacı, Kadir Yasin Güzel, Hafize Yalınız, Mehmet Şah Topçuoğlu","doi":"10.5606/tgkdc.dergisi.2024.mep-05","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-05","url":null,"abstract":"<p><p>For chronic hemodialysis patients to have long-term vascular access, arteriovenous (AV) fistulas are essential. Immediate intervention is necessary for AV fistula thrombosis, a common complication in hemodialysis patients. To guarantee the fistula's long-term patency, surgical thrombectomy is crucial. Vascular access should be preserved in cases with issues, according to the literature. This case report aimed to provide a literature review and surgical management of brachial AV fistula thrombosis in hemodialysis patients. A 41-year-old female patient who was on hemodialysis for three years due to chronic renal failure presented to the clinic. On physical examination, no thrill was obtained from the left brachial AV fistula. The patient underwent emergency surgery. After systemic heparinization, the cephalic vein was explored from two places, and thrombectomy was performed. The cephalic vein was harvested from the forearm and a bypass was performed from the brachial artery to the cephalic vein. The patient was discharged without any postoperative complications. During the follow-up, the fistula remained functional, and hemodialysis continued without any problems. Surgical thrombectomy allows early treatment of thrombosis and preserves the continuity of vascular access required for hemodialysis. Regular follow-up of patients is critical for early diagnosis and treatment of AV fistula thrombosis, improving the patient's quality of life and ensuring uninterrupted continuation of dialysis treatment. This case demonstrates that vascular access can be achieved with surgical thrombectomy and bypass application in a patient with brachial AV fistula thrombosis, highlighting the importance of surgical approach in the management of AV fistula complications.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"101-102"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051736","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-20] The Role of Vitamin D in the Development of Thrombosis in Varicose Veins.","authors":"Hasan Ekim, Meral Ekim","doi":"10.5606/tgkdc.dergisi.2024.msb-20","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-20","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate vitamin D levels in patients with varicose veins.</p><p><strong>Methods: </strong>Seventy-five patients (25 males, 50 females; mean age: 47.78±12.84 years; range, 24 to 80 years) with varicose veins in the lower extremities between December 2021 and August 2024 were included in the study. In addition to routine laboratory tests, vitamin D, vitamin B12, magnesium, and folate levels were measured in all patients. Since it reflects both endogenous vitamin D production and exogenous vitamin D intake, vitamin D status was assessed by measuring 25-hydroxycholecalciferol levels.</p><p><strong>Results: </strong>Thirty (40%) patients had thrombosis in their varicose veins. While the mean vitamin D level in patients without thrombosed varicose veins was 14.08±8.10 ng/mL, the mean vitamin D level in patients with thrombosed varicose veins was 12.19±6.92 ng/mL. The difference between the two groups was statistically significant (p<0.05).</p><p><strong>Conclusion: </strong>Varicose veins that are thrombosed near the saphenofemoral or saphenopopliteal junctions may lead to complications such as spread to the deep venous system and subsequent embolization to the pulmonary vascular bed. Therefore, we believe that patients with thrombosed varicose veins should be surgically treated without delay. However, patients with nonthrombosed varicose veins may also be prone to thrombosis due to various known or unknown risk factors, such as stasis and vitamin D deficiency. Therefore, treatment of nonthrombosed varicose veins should also be planned.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"040-40"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043702","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}