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

{"title":"[MSB-73] Hypertrophic Obstructive Cardiomyopathy Management in the Pediatric Population: The Dilemma of Mitral Valve Replacement.","authors":"Nazlı Melis Coşkun Yücel, Ahmet Aydın, Timuçin Sabuncu, Şafak Alpat, Murat Güvener, Mustafa Yılmaz","doi":"10.5606/tgkdc.dergisi.2024.msb-73","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-73","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to share our surgical experience with 10 pediatric patients with hypertrophic cardiomyopathy (HOCM).</p><p><strong>Methods: </strong>This study included 10 HOCM patients, aged between 8 months and 18 years, who underwent surgery due to conditions such as aortic insufficiency, mitral insufficiency, significant narrowing of the left ventricular cavity, and left ventricular outflow tract (LVOT) obstruction.</p><p><strong>Results: </strong>Two patients underwent isolated myectomy, while the remaining eight underwent myectomy combined with mitral valve replacement (MVR). Myectomy was performed via aortotomy, left atriotomy, and apical ventriculotomy. All patients had preoperative signs of systolic anterior motion (SAM) and a gradient in the LVOT. In the two patients who underwent isolated myectomy, SAM signs persisted postoperatively. Additionally, the gradient in the LVOT was measured to be higher in isolated myectomy cases compared to cases in which MVR was performed. Despite being in the pediatric age group with narrow annuli, all patients tolerated the MVR procedure with low-profile valves.</p><p><strong>Conclusion: </strong>According to our experience, simultaneous MVR in pediatric HOCM cases requiring surgery is more effective in enlarging the left ventricular cavity and reducing the gradient in the LVOT, as it allows both the removal of the mitral valvular apparatus and the prevention of SAM. It provides a greater cavity volume gain compared to the alternative manipulation of the mitral valve apparatus. In our clinic, MVR surgery combined with myectomy is safely performed in pediatric HOCM 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":"095-95"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024708","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-43] Methemoglobinemia After Central Venous Catheterization Due to Local Anesthesia with Prilocaine: A Case Report.","authors":"Aylin Yıldız, Mehmet Ertuğrul, Adnan Taner Kurdal, Dilşad Amanvermez Şenarslan","doi":"10.5606/tgkdc.dergisi.2024.mep-43","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-43","url":null,"abstract":"<p><p>Local anesthetics such as prilocaine, bupivacaine, and lidocaine can rarely cause methemoglobinemia. Methemoglobinemia should be considered in patients presenting with hypoxia and cyanosis after taking local anesthesia for interventions. The severity of symptoms correlates with the existing methemoglobin level. Herein, we presented a patient who developed methemoglobinemia after local anesthesia with prilocaine use for dialysis catheter insertion. A 78-year-old male patient with prostatic adenocarcinoma and chronic renal failure developed methemoglobinemia after 20 min of temporary hemodialysis catheter insertion due to prilocaine use. The patient had dyspnea and respiratory distress, and his saturation dropped under 90% while the arterial oxygen partial pressure was above 80 mmHg. After intravenous methylene blue administration, the patient's symptoms resolved, and the need for intubation was eliminated. The prilocaine dose recommended for adults is lower than 5.0 mg/kg, which is reduced to 3.2 mg/kg in the presence of renal insufficiency and to 1.3 mg/kg if other oxidizing drugs are used concurrently. An alternative to methylene blue would a 20% lipid emulsion infusion with a bolus injection of 1.5 mL/kg, followed by an infusion dose of 0.25 mL/kg/min. The ability to recognize and treat local anesthetic systemic toxicity is critical for clinicians and vascular surgeons who frequently perform local anesthetic interventions. Several measures may reduce the risk of toxicity: limiting the cumulative dose, using ultrasound or direct visualization for catheter placement, test dosing, incremental injections, negative catheter aspiration, and adherence to guidelines. Treatment with methylene blue should be kept in mind along with supplemental oxygen therapy for patients with methemoglobinemia.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"140"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055437","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":"[MÖB-06] Clinical Outcomes of Injectable Biopulmonic Valve Replacement vs. Conventional Pulmonary Valve Replacement in Tetralogy of Fallot Patients with Severe Pulmonary Regurgitation: A Comparative Study.","authors":"Sercan Tak, Murat Koç, Ali Kutsal, Vehbi Doğan","doi":"10.5606/tgkdc.dergisi.2024.mob-06","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mob-06","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare early- to mid-term outcomes of injectable biopulmonic valve replacement without cardiopulmonary bypass and conventional pulmonary valve replacement in patients with severe pulmonary regurgitation following tetralogy of Fallot (TOF) corrective surgery.</p><p><strong>Methods: </strong>The study was conducted with 22 patients between 2011 and 2020. Injectable pulmonary valve replacement was performed in nine patients, while 13 patients underwent bioprosthetic aortic valve replacement using a conventional surgical approach. An injectable valve was chosen for patients with a pulmonary annulus diameter ≤30 mm and ≥15 mm when there was no need for additional procedures.</p><p><strong>Results: </strong>Comparing postoperative outcomes between the injectable valve group and the conventional surgery group, the mean duration of intensive care unit stay was 16.78±6.22 <i>vs.</i> 37.00±23.43 h (p=0.003); the mean postoperative mechanical ventilation time was 5.22±3.93 <i>vs.</i> 15.38±23.43 h (p=0.001); the mean volume of chest tube drainage was 206.67±108.16 mL <i>vs.</i> 513.08±274.11 mL (p=0.003); the mean inotropic score was 5.00±5.59 <i>vs.</i> 10.96±8.98 (p=0.05); the mean vasoactive score was 6.11±8.20 <i>vs.</i> 12.11±10.40 (p=0.04); and the mean length of hospital stay was 5.44±2.35 <i>vs.</i> 8.38±3.09 days (p=0.04).</p><p><strong>Conclusion: </strong>Injectable pulmonary valve replacement, which can be applied without cardiopulmonary bypass, has advantages such as being less invasive and having better postoperative results compared to the conventional procedure. However, more comprehensive studies with long-term results are needed.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"011-11"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055441","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":"[MÖB-02] Comparison of the Early and Mid-Term Results of Valve-Sparing Surgery vs. Valve Replacement Surgery for Type A Aortic Dissection Patients.","authors":"Muhammet Selim Yaşar, Emre Külahcıoğlu, Şeref Alp Küçüker","doi":"10.5606/tgkdc.dergisi.2024.mob-02","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mob-02","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the early- and mid-term results of valve-sparing surgery and valve replacement surgery, which require different approaches to intraoperative/postoperative patient care, in patients with type A aortic dissection.</p><p><strong>Methods: </strong>In this retrospective study, 112 consecutive patients (83 males, 29 females; mean age: 54.8±12.2 years) who underwent an operation for type A aortic dissection between February 2019 and September 2022 were examined. Patients were divided into two groups: those who underwent valve replacement surgery (modified Bentall procedure, SCI+AVR; n=26, 23.2%) and those who underwent valve-sparing surgery (isolated SCI, David II procedure, SCI+AV resuspension; n=86, 76.8%).</p><p><strong>Results: </strong>It was observed that the cross-clamp and cardiopulmonary bypass times were longer and the need for postoperative mechanical support was higher in the valve replacement group (p<0.05). The early mortality rate was 30.8% (n=8) in the valve replacement group and 22.1% (n=19) in the valve-sparing group. The survival times were found to be 15.9 days in the valve replacement group and 123.5 days in the valve-sparing group. The mean postoperative control computed tomography time was 21.0±12.6 months. There was no postoperative sinus of Valsalva aneurysm in the valve-sparing group. Although the false lumen patency rate was not statistically significant, it was higher in the valve replacement group. After the operation, moderate to severe aortic regurgitation was not observed in any of the patients who underwent valve-sparing surgery with preoperative moderate to severe aortic regurgitation.</p><p><strong>Conclusion: </strong>The results indicate that valve-sparing surgery was superior to valve replacement surgery for type A aortic dissection 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":"004-5"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058972","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-24] Middle Aortic Syndrome in An Adult Presenting with Limb Ischemia.","authors":"Dilşad Amanvermez Şenarslan, Halil Demren, Ömer Tetik","doi":"10.5606/tgkdc.dergisi.2024.mep-24","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-24","url":null,"abstract":"<p><p>Middle aortic syndrome (MAS) is a segmental narrowing of the distal descending thoracic or abdominal aorta. This rare condition accounts for 0.5 to 2% of aortic coarctations. Middle aortic syndrome may be acquired, caused by Takayasu arteritis or giant cell arteritis, neurofibromatosis, fibromuscular dysplasia, retroperitoneal fibrosis, mucopolysaccharidosis, and the Williams syndrome, or it may be congenital. Stenosis is usually located at the suprarenal, interrenal, or infrarenal aorta. Concomitant stenoses in the renal (63%) and visceral (33%) arteries may be encountered. In this case report, we presented a 66-year-old male patient with MAS. The patient's primary complaint was claudication and rest pain in the last three months. The patient had hypertension for two years and a history of lumbar disc hernia operation. Thoracoabdominal computed tomography angiography revealed an enlarged ascending aorta, an aberrant right subclavian artery, and a narrowed segment with an hourglass appearance in the infrarenal aorta. The vessel diameter decreased to 9×10 mm at this level, and both iliac arteries were occluded distally. The patient underwent aortobifemoral bypass surgery with a 14/7 mm Dacron graft. In the postoperative period, all distal pulses were palpable, and leg pain resolved. The patient was discharged from the hospital on the sixth day without complications. This case report presented an adult MAS patient with rest pain in the legs related to occluded iliac arteries and aortic bifurcation. The coarctation in the infrarenal aorta was successfully treated by open surgery (aortobifemoral bypass). Children may benefit more from early diagnosis before the onset of severe hypertension. Open surgery is the primary treatment modality for tubular MAS. Usually bypass of the diseased segment or, less often, patch angioplasty is preferred. Bypass grafting of the stenosed renal and visceral arteries is performed when necessary. Endovascular therapy may provide less invasive treatment.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"122-123"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041736","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-03] Comparison of Preoperative Multislice Computed Tomography Measurements with Intraoperative Valve Sizes in Sutureless Rapidly Implantable Biological Aortic Heart Valve and Mechanical Aortic Valve Cases.","authors":"Özgür Çoban, İbrahim Özsöyler","doi":"10.5606/tgkdc.dergisi.2024.msb-03","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-03","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the alignment between preoperative multislice computed tomography measurements and intraoperative valve sizes in sutureless rapidly implantable biological aortic valve and mechanical aortic valve replacements.</p><p><strong>Methods: </strong>The study included 40 patients (22 males, 18 females; mean age: 61.5±9.1 years) who underwent elective open heart surgery for aortic valve stenosis between February 20, 2023, and May 20, 2023. The patients underwent valve replacement with either sutureles biological valves (n=20) or mechanical valves (n=20). Data were collected from patient files and the hospital's database, including demographic, preoperative, intraoperative, and postoperative information.</p><p><strong>Results: </strong>Patients had a mean height of 165.7±10.7 cm, weight of 83.0±15.9 kg, and body mass index of 30.3±5.5. Common comorbidities were diabetes mellitus (42.5%), hypertension (25%), atrial fibrillation (7.5%), and chronic obstructive pulmonary disease (7.5%). Mechanical valve patients had significantly longer cross-clamp and cardiopulmonary bypass times (p<0.001 and p=0.011, respectively). The mean sinotubular junction diameter was lower in the mechanical group (p=0.025). Although there was no significant difference in the mean value of the aortic annulus between the groups (p=0.171), the optimum and mean effective orifice area index values were found to be higher in patients in the sutureless group compared to those in the mechanical group (p<0.001 for both).</p><p><strong>Conclusion: </strong>Preoperative multislice computed tomography is valuable for aortic valve replacement. Biological valves show advantages over mechanical valves in terms of shorter cross-clamp and cardiopulmonary bypass times. More importantly, surgeons tend to avoid procedures such as root enlargement with mechanical valves to reduce operative time, opting for smaller valve sizes. Sutureless valves allow for a larger effective orifice area and less anxiety during surgery, with reduced cross-clamp and bypass times.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"017-18"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004494","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-35] Primary Cardiac Tumor: A Case Report of Right Atrial Angiosarcoma.","authors":"Fatma Akça, Levent Yazıcıoğlu, Ali İhsan Hasde, Onur Büyükçakır, Deniz Ladin Özdemir","doi":"10.5606/tgkdc.dergisi.2024.mep-35","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-35","url":null,"abstract":"<p><p>Cardiac tumors mainly present as metastases from tumors in other extracardiac organs. Primary cardiac tumors are relatively rare tumors, with a prevalence rate of 0.002 to 0.33%. Myxomas, which commonly occur in the left atrium, are the most frequent benign primary cardiac tumors. Angiosarcomas are the most common primary malignant cardiac tumors. A 63-year-old female patient who had exertional dyspnea presented to the clinic. After the detection of an invasive mass on the wall of the right atrium from the test results, the case was initiated following sternotomy, with aortic and peripheral venous cannulation. The right atrium was opened, and the tumor was dissected broadly from the normal tissue of the atrium wall. The right atrial defect was reconstructed with a pericardial patch. After extensive tumor resection and repair with a pericardial patch, the patient was transferred to the intensive care unit with inotropic support. The pathology result of the excised material was reported as angiosarcoma. The patient was discharged on the seventh postoperative day and continued with chemoradiotherapy. Cardiac tumors are rare, and angiosarcomas, which are more commonly observed on the right side of the heart, account for 25 to 30% of primary cardiac malignancies. Surgical resection of primary cardiac angiosarcoma is the primary treatment approach. Full resection of the tumor offers long-term survival for the patients. Reconstruction of cardiac structures may also be necessary after wide resections.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"133-134"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995076","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-27] Delta Neutrophil Index And Mortality During Cardiopulmonary Bypass: An Observational Study.","authors":"Abdulkadir Bilgiç, Burak Toprak, Rahime Akın","doi":"10.5606/tgkdc.dergisi.2024.msb-27","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-27","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between the delta neutrophil index (DNI) during cardiopulmonary bypass (CPB) and postoperative mortality.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted with 200 patients who underwent open heart surgery with CPB between May 1, 2023, and March 1, 2024. Demographic data, laboratory results, and surgery durations were collected. Delta neutrophil index values were measured at specific intervals.</p><p><strong>Results: </strong>Age, pump time, and cross-clamp duration were found to be associated with mortality. Higher DNI levels were significantly correlated with longer CPB times and increased mortality.</p><p><strong>Conclusion: </strong>This study confirms that DNI is a strong biomarker for predicting mortality. The clinical utility of this biomarker should be further assessed through additional research.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"047-47"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024324","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":"[MÖB-03] Extra-Pericardial Modified Blalock-Taussig Shunt Via Sternotomy in Patients with A Right Aortic Arch.","authors":"Kamran Ahmadov, Kamran Musayev, Tornike Sologashvili","doi":"10.5606/tgkdc.dergisi.2024.mob-03","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mob-03","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to describe the feasibility and results of a left modified Blalock-Taussig shunt (mBTS) through a sternotomy without opening the pericardium in patients with a right-sided aortic arch.</p><p><strong>Methods: </strong>The study included eight patients (median age: 20 months; range, 10 to 56 months) who underwent a left mBTS. All mBTS procedures were performed through a median sternotomy without the use of cardiopulmonary bypass. Following sternotomy, the brachiocephalic trunk and left pulmonary artery were carefully identified and isolated without opening the pericardium. First, an end-to-side anastomosis was created between the Gore-Tex graft and the brachiocephalic trunk. Subsequently, the distal end-to-side anastomosis was performed between the graft and the left pulmonary artery. A single drain was positioned in the retrosternal space, and the sternum was closed in the standard manner.</p><p><strong>Results: </strong>Six patients had tetralogy of Fallot, and two had a double-outlet right ventricle with pulmonary stenosis. The median weight was 8 kg (range, 6.1 to 12.8 kg). The procedure was feasible in all patients (Figure 1). The median shunt size was 5 mm (range, 4 to 5 mm), and the median intensive care unit stay was three days. There were no cases of early- or mid-term mortality, shunt failure, or thrombosis. Additionally, no patients developed postoperative pericardial effusion. Six out of eight patients underwent resternotomy for complete correction, with preoperative cardiac catheterization confirming shunt patency (Figure 2). Notably, no intrapericardial adhesions were observed during resternotomy.</p><p><strong>Conclusion: </strong>This technique offers a significant advantage by avoiding intrapericardial adhesions, making it a viable alternative to standard sternotomy or thoracotomy approaches for mBTS in patients with a right-sided aortic arch.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"006-7"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018779","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-02] Modern Approaches to Venous Ulcer Healing: A Study on Cyanoacrylate Embolization, Radiofrequency Ablation, and Laser Ablation.","authors":"Ali Kemal Gur","doi":"10.5606/tgkdc.dergisi.2024.msb-02","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-02","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate the effects of radiofrequency ablation (RFA), cyanoacrylate embolization (CE), and laser ablation (LA) in the treatment of perforating venous insufficiency.</p><p><strong>Methods: </strong>One hundred eighteen patients with CEAP (Clinical, Etiological, Anatomical, and Pathophysiological) class 6 active ulcers were retrospectively reviewed between January 2018 and June 2023. The patients were divided into groups according to the treatment method: the CE group (n=55), the RFA group (n=63), and the LA group (n=30). Duplex scanning for venous ulcer and perforating insufficiency was performed in all patients, and healing rates at one-month, one-year, and two-year controls were calculated.</p><p><strong>Results: </strong>At one month, occlusion rates were significantly lower for CE compared to 85%, RFA 90%, and LA 88% (p=0.05). The one- and two-year closure rates were 81% and 76% for CE, 84% and 78% for RFA, and 82% and 77% for LA, respectively. No significant difference was found between the one- and two-year closure rates. Deep vein thrombosis without pulmonary embolism was detected in five patients who underwent CE. The thrombus resolved in these patients after three months of anticoagulant therapy. All ulcers healed within three months.</p><p><strong>Conclusion: </strong>Closure of perforator veins using minimally invasive techniques appears to predict wound healing with minimal morbidity. Radiofrequency ablation, CE, and LA are increasingly used for perforating vein failure in venous ulcer healing. In terms of deep vein thrombosis, RFA is safer than CE and LA.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"016-16"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023498","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}