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

{"title":"[MSB-07] Optimizing Postoperative Cardiac Tamponade Outcomes With Posterior Pericardial Window.","authors":"Mete Kubilay Kasap, Özgür Çoban, Nazenin Durak, Funda Tor Ocak","doi":"10.5606/tgkdc.dergisi.2024.msb-07","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-07","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to assess the posterior pericardial windows technique in the management of pericardial effusion following cardiac surgery.</p><p><strong>Methods: </strong>This single-center study examined the data of 1,752 patients who underwent cardiac surgery from 2018 onwards, excluding those who had off-pump coronary artery bypass grafts or emergency surgeries for conditions such as type 1 aortic dissection or infective endocarditis. Of the included patients, a posterior pericardial window was created in 349. The posterior pericardial window was created using electrocautery before the implantation of prosthetic valves or distal anastomosis. No other procedural changes were made.</p><p><strong>Results: </strong>Postoperative drainage rates were monitored. Drains were removed on the second day after surgery. Of the patients with a posterior pericardial window, eight (2.3%) required revision due to tamponade within the first two postoperative days, compared to 53 (3.7%) of the patients without a posterior pericardial window. Patients who required revision were discharged on average seven days later, while those who did not require revision were discharged after five days.</p><p><strong>Conclusion: </strong>The early detection and effective management of cardiac tamponade are crucial due to the potentially life-threatening outcomes. This study highlights the value of the posterior pericardial window technique in reducing complications associated with pericardial effusion following cardiac surgery. The findings support the need for further research to improve surgical approaches and enhance patient outcomes and safety.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"024-24"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037864","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-44] Evaluation of Sternum Closure Methods with Clinical Results in Open Heart Surgery.","authors":"Yusuf Kuşçu, Dilşad Amanvermez Şenarslan, Ahmet İhsan İşkesen","doi":"10.5606/tgkdc.dergisi.2024.msb-44","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-44","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinical results of sternum closure methods after open heart surgery with median sternotomy.</p><p><strong>Methods: </strong>This retrospective study screened 2,662 patients who underwent open heart surgery. Classical steel wire, Flexigrip + steel wire combination, sternal cable, sternal band, and Robicsek were used as sternum closure methods in patients. The causality relationships of sternal dehiscence, diabetes mellitus, chronic obstructive pulmonary disease, impaired kidney function, and demographic characteristics of the patients were investigated.</p><p><strong>Results: </strong>Ninety-six patients developed dehiscence, and 60% of them had diabetes, 25% had impaired renal function, and 21% had chronic obstructive pulmonary disease. The treatment success rate was 88% when using the Flexigrip + steel wire combination in patients undergoing sternal dehiscence repair, and the treatment success rate was 76% using a standard steel wire. The combination of Flexigrip + steel wire significantly reduced the risk of sternal dehiscence compared to the use of classical steel wire in sternal closure. Vacuum-assisted closure devices were beneficial in draining wounds and shortened the healing time.</p><p><strong>Conclusion: </strong>Flexigrip + steel wire combination in sternal closure significantly reduced the risk of sternal dehiscence in patients with diabetes mellitus, chronic obstructive pulmonary disease, and impaired kidney function.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"069-70"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024488","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-03] Repair of the Cardiac Erosion Because of the Occluder Device, A Challenging Situation.","authors":"Huseyin Demirtas, Abdullah Ozer, Mehmet Burak Gulcan, Issa Shide, Yonca Durkan, Gürsel Levent Oktar, Gülten Tacoy","doi":"10.5606/tgkdc.dergisi.2024.mep-03","DOIUrl":"10.5606/tgkdc.dergisi.2024.mep-03","url":null,"abstract":"<p><p>Atrial septal defect is the most common congenital heart disease in adults. Atrial septal occluder devices are popular for treating secundum atrial septal defects. However, it has risks of complications such as cardiac tissue erosion, thrombus, and effusion. A 63-year-old female patient with atrial septal erosion who underwent intervention for secundum atrial septal defect three years ago presented to the clinic. We removed the occluder device and successfully repaired the atrial septum with bovine. While intravascular techniques have been developed for the closure of atrial septal defects, surgery remains important in treatment. Furthermore, occluder devices have important risks. This case demonstrates a successful repair after cardiac tissue erosion due to the occluder device.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"099-100"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055898","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":"[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}

{"title":"[MSB-26] Minimally Invasive Right Vertical Axillary Thoracotomy for Repair of Congenital Heart Defects: Azerbaijan Experience.","authors":"Kamran Ahmadov, Kamran Musayev","doi":"10.5606/tgkdc.dergisi.2024.msb-26","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-26","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the outcomes of a minimally invasive right vertical axillary thoracotomy approach for repairing various congenital heart defects in the pediatric population in Azerbaijan.</p><p><strong>Methods: </strong>The retrospective study was conducted with 70 consecutive patients (median age: 5.5 years; range, 6 months to 13 years) who underwent repair of congenital heart defects using a minimally invasive right vertical axillary thoracotomy approach between April 2022 and September 2024. Of the patients, 44 had atrial septal defect (ASD), 13 had ventricular septal defect, seven had sinus venosus ASD with partial anomalous pulmonary venous drainage, and six had atrioventricular septal defect. The incision length ranged from 3.0 to 5.0 cm.</p><p><strong>Results: </strong>The median weight was 15 kg (range, 6 to 41 kg). The median hospital and intensive care unit stays were 4 and 1 days, respectively. The median cardiopulmonary bypass and cross-clamp times were 51 and 23.5 min, respectively. No in-hospital deaths or conversions to median sternotomy occurred. One patient with sinus venosus ASD with partial anomalous pulmonary venous drainage experienced transient atrioventricular block, which resolved by the first postoperative day with a return to sinus rhythm. During follow-up, no late deaths, reoperations, surgery-related thoracic deformities, or breast asymmetry were observed.</p><p><strong>Conclusion: </strong>The minimally invasive right vertical axillary thoracotomy approach can be safely employed for a broad spectrum of congenital heart defects, yielding excellent cosmetic outcomes. It represents a viable alternative to median sternotomy.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"046-46"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004415","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-42] Impact of Phosphorylcholine-Coated Circuits on Inflammatory Response and Renal Function: A Retrospective Study in Coronary Artery Bypass Grafting.","authors":"Ercan Kahraman, Mehmet Niyaz, Şirin Çetin","doi":"10.5606/tgkdc.dergisi.2024.msb-42","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-42","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of phosphorylcholine-coated circuits compared to traditional standard tubing sets on postoperative inflammatory response, renal function, and intubation duration.</p><p><strong>Methods: </strong>This retrospective study was conducted with 45 patients who underwent coronary artery bypass grafting. Surgeries were performed by the same team. The patients were divided into two groups: standard tubing sets were used for Group 1 (n=12), and phosphorylcholine-coated sets were used for Group 2 (n=33). Data from the operation were analyzed.</p><p><strong>Results: </strong>No significant difference was found between standard and phosphorylcholine-coated tubing sets regarding lactate levels after bypass and in intensive care (p>0.05). C-reactive protein levels were similar on the first day but lower in the phosphorylcholine group on the second day (p<0.05). Preoperative glomerular filtration rates were similar on the first day, but higher glomerular filtration rates were noted on the second day in the phosphorylcholine group (p<0.05). Intubation duration was shorter with phosphorylcholine-coated circuits, with no differences in erythrocyte suspension and drainage volumes (p>0.05).</p><p><strong>Conclusion: </strong>Phosphorylcholine-coated circuits reduced postoperative inflammatory response, preserved renal function, and shortened intubation duration. Although coated systems may improve cardiac surgery outcomes, no system completely prevents pathological inflammatory responses. Collaboration between biomedical engineering and cardiac surgery teams is essential for further advancements.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"067-67"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002511","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-17] Novel \"DR MÇ\" Technique for the Distal Anastomosis of Hemiarc Replacement Surgery for Acute Type A Aortic Dissection.","authors":"Ayşe Özçetin Akkuş, Muzaffer Çeliksöz","doi":"10.5606/tgkdc.dergisi.2024.msb-17","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-17","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to define a novel technique to ensure the safety of distal anastomosis in acute type A aortic dissection, a condition with many possible complications.</p><p><strong>Methods: </strong>The \"DR MÇ\" technique consisted of two components: reinforcing the wall of the dissected aorta and aorta-graft diameter matching. The first technique was applied in our clinic, but the second method had not yet been tested. First, a Teflon band was sutured around the outer wall of the aorta, leaving 5 mm of the aorta at the open end to later contribute to hemostasis during anastomosis. Afterward, the graft was sutured to the aorta; however, the sutures were closer to the anastomosis than to the fixing sutures of the Teflon band. This prevented the tearing of the aorta by distributing the axial forces on the aorta and the anastomosis. The adjustment of graft diameter for the aorta was done accordingly; the graft was cut in an oblique pattern, and an extra elliptical piece was sutured to one side of the graft. This method ensured durability (narrowing of the dissected aorta could cause tearing), and the remaining parts of the graft at the outer side of the anastomosis provided extra hemostatic support.</p><p><strong>Results: </strong>Mortality was often caused by bleeding from the suture points covered by the Teflon. In our center, this method was applied in an attempt to provide better results; however, the sample size was insufficient to provide statistically significant results.</p><p><strong>Conclusion: </strong>In acute type A aortic dissection, the endurance of aortic tissues is impaired, and therefore, conventional anastomosis may not be enough for hemostasis. This technique is a safer approach for aortic tissue endurance.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"036-36"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028541","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}