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

{"title":"[MEP-07] External Iliac Vein Injury and Retroperitoneal Hematoma After Femoral Dialysis Catheter Insertion: A Case Report.","authors":"Yasin Guzel, Mustafa Kemal Avşar, Burak Aydoğan, Ömer Doğan, Kaniye Aydin, Ferhat Can Piskin, Ali Mesut Misirlioglu, Kadir Yasin Güzel, Hafize Yaliniz, Mehmet Şah Topçuoğlu","doi":"10.5606/tgkdc.dergisi.2024.mep-07","DOIUrl":"10.5606/tgkdc.dergisi.2024.mep-07","url":null,"abstract":"<p><p>In patients with chronic kidney disease undergoing hemodialysis, dialysis catheters are frequently used to provide vascular access. However, this procedure can lead to significant complications. Retroperitoneal hematoma is a rare but potentially life-threatening complication of femoral vein catheterization. This case report discusses the surgical management of a retroperitoneal hematoma that developed after the insertion of a left femoral dialysis catheter. A 21-year-old female patient with a known history of chronic kidney disease secondary to bilateral hydronephrosis who was on hemodialysis for five years presented to the clinic. After the insertion of a left femoral dialysis catheter, the patient developed severe abdominal pain, nausea, and vomiting. Contrastenhanced computed tomography revealed that the left femoral catheter had migrated into the retroperitoneal space, forming a large hematoma. Emergency surgical intervention was performed, including the removal of the catheter, evacuation of the retroperitoneal hematoma, and repair of the external iliac vein. Additionally, the gynecology department performed surgical intervention on an ovarian cyst, and the general surgery team controlled the bleeding. The patient had an uneventful follow-up. The literature indicates that appropriate surgical intervention positively influences prognosis in such cases. Awareness of possible complications during femoral vein catheterization can prevent delays in diagnosis and improve patient survival. As demonstrated in this case report, timely surgical intervention without removing the catheter is crucial in preventing additional complications in cases of retroperitoneal hematoma.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"103-104"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992391","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-54] The FLOZ Procedure: Enforced Ozaki Opeation As A New Option for the Aortic Root.","authors":"Mikhail Snegirev, Vladimir Noginov, Evgeniy Minin, Vidadi Efendiev","doi":"10.5606/tgkdc.dergisi.2024.msb-54","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-54","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to introduce our implementation of a novel approach combining two reconstructive approaches: the Ozaki operation and the Florida sleeve procedure.</p><p><strong>Methods: </strong>The study included six male patients (range, 37 to 64 years) with the aortic root pathology requiring aortic root replacement. All operations were performed by one surgeon, and all potential benefits and disadvantages of a novel technique were thoroughly discussed with the patients. Three patients had aortic stenosis with the aortic root dilatation, and three patients had aortopathy with aortic insufficiency, where aortic cusps were not subject to repair. All operations were accomplished by performing the Florida sleeve part of the operation first, completing the operation by implanting autopericardial cusps in appropriate sizes, as in the Ozaki technique.</p><p><strong>Results: </strong>There was no mortality or major morbidity after these operations. The mean cross-clamp time was 98±21 min. All patients spent one to two days in the intensive care unit. The mean follow-up time was 12±6 months. None of the patients developed more than Grade 1 aortic insufficiency postoperatively. None of the patients required warfarin.</p><p><strong>Conclusion: </strong>The findings demonstrate that the reconstructive approach of the reinforced Ozaki root repair, termed the FLOZ (Florida + Ozaki) operation, may be safely and reproducibly performed in a wide cohort of patients requiring aortic root management.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"080-80"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044458","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-19] Surgery for A Giant Atherosclerotic Left Main Trifurcation Saccular Coronary Artery Aneurysm.","authors":"Mehmet Cahit Saricaoglu, Yusuf Corbacioglu, Salih Anil Boga, Serenay Deniz, İrem Dincer, Ahmet Ruchan Akar","doi":"10.5606/tgkdc.dergisi.2024.mep-19","DOIUrl":"10.5606/tgkdc.dergisi.2024.mep-19","url":null,"abstract":"<p><p>A dilated coronary artery segment larger than 1.5 times the diameter of the reference vessel defines coronary artery aneurysm. Herein, we reported a case of left main trifurcation aneurysm, a challenging anatomy. A 57-yearold female was referred to our department with an exertional angina. The patient had no significant medical history, except for hyperlipidemia and previous history of smoking. All diagnostic tests were standard. However, an electrocardiogram showed anterior T-wave inversion. Computed tomography angiography revealed a saccular left main coronary artery (LMCA) aneurysm at the trifurcation level. Coronary angiography demonstrated a giant saccular aneurysm at the trifurcation of LMCA, measuring 32×21 mm with tight postaneurysmal stenosis in the intermediate artery. The patient underwent surgery under general anesthesia. A median sternotomy was performed. After cannulation and aortic cross-clamping, an LMCA trifurcation giant aneurysm was exposed on the posterolateral aspect of the heart by the help of stay thick nylon tapes, which were passed through oblique and transverse sinuses. The giant saccular aneurysm was carefully dissected. The branches of trifurcation were visualized, and the aneurysm sac was resected. A meticulous endarterectomy was performed at the trifurcation level and reconstructed with saphenous vein roof plasty. Then, the intermediate artery was revascularized with a saphenous graft from ascending aorta. The aortic cross-clamp time was 52 min, and the cardiopulmonary bypass time was 75 min. The patient had an uneventful hospitalization and was discharged on aspirin and warfarin therapy. This case demonstrates that the surgical reconstruction of giant saccular LMCA aneurysms using a saphenous graft patch is safe and allows for percutaneous interventions when necessary.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"114-115"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054489","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-18] Impact of Posterior Pericardiotomy on Postoperative Clinical Outcomes in Isolated Coronary Artery Bypass Surgery.","authors":"Ufuk Türkmen, Görkem Yiğit, Kudret Atakan Tekin, Ayla Ece Çelikten, Ertekin Utku Ünal","doi":"10.5606/tgkdc.dergisi.2024.msb-18","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-18","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of posterior pericardiotomy in preventing cardiac tamponade and its impact on clinical outcomes in patients undergoing isolated coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>This retrospective study included 384 elective patients who underwent isolated CABG between 2021 and 2024. Patients who underwent posterior pericardiotomy (Group 1) were compared with those who did not (Group 2). Group 1 included 178 patients (135 males, 53 females; mean age: 62.62±8.78 years), while Group 2 included 122 patients (98 males, 24 females, mean age 61.92±8.95 years). Clinical outcomes of patients who underwent revision surgery were analyzed.</p><p><strong>Results: </strong>Post-intensive care unit (ICU) hospital stay (p<0.001), total hospital stay (p<0.001), rate of revision surgery (p=0.027), posterior tamponade (p=0.001), and postoperative atrial fibrillation (POAF; p=0.034) were significantly higher in Group 1. In patients who underwent revision surgery, ICU stay (p<0.001), total hospital stay (p<0.001), posterior pericardial window opening (p=0.026), postoperative inotropic support requirement (p<0.001), tube thoracostomy due to pleural effusion (p=0.002), posterior tamponade (p<0.001), POAF (p<0.001), intra-aortic balloon pump usage (p<0.001) were significantly higher compared to those who did not undergo revision surgery. Receiver operating characteristic analysis and the area under the curve demonstrated that the model's performance in predicting these variables was moderate to good.</p><p><strong>Conclusion: </strong>Posterior pericardiotomy effectively reduces the incidence of POAF and posterior pericardial tamponade without increasing postoperative complications, suggesting it is a beneficial technique in CABG.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"037-37"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065041","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-55] Surgical Treatment of Infective Endocarditis.","authors":"Özer Kandemir, Murat Koç, Bahadır Gültekin, Ufuk Mungan, Kaan Kaya, İbrahim Duvan, Ferit Çiçekçioğlu","doi":"10.5606/tgkdc.dergisi.2024.msb-55","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-55","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to offer an analysis of our surgical experience in patients with active infective endocarditis (IE).</p><p><strong>Methods: </strong>The retrospective study included 29 patients who underwent surgery for active IE between December 1, 2022, and August 31, 2024. Patients received valve replacement or repair, debridement of infected tissues, or explantation and replacement of infected prosthetic devices.</p><p><strong>Results: </strong>The operative and early mortality rate was 30% (n=9). Postoperative complications occurred in 24.1% of patients. Advanced age, heart failure, prosthetic valve endocarditis, and <i>Staphylococcus aureus</i> infection were associated with higher mortality rates. Postoperative complications included reexploration of the thoracic cavity, pacemaker implantation, hemodialysis, deep sternal infections, and further valve surgery for three patients.</p><p><strong>Conclusion: </strong>Surgical treatment of IE remains crucial and life-saving, particularly for patients unresponsive to antibiotic therapy or those with complications. Early diagnosis, prompt antibiotic initiation, and timely surgical intervention are essential for optimal outcomes.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"081-81"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058520","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-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}