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

{"title":"[MSB-64] Heartmate 3 In Heart Failure Treatment: Initial Experience of A Newly Established Mechanical Circulatory Support and Heart Transplantation Center.","authors":"Mehmet Nuri Karabulut, Nihan Kayalar, Sinan Erkul, Gizem Kolay, Mehmed Yanartaş","doi":"10.5606/tgkdc.dergisi.2024.msb-64","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-64","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to share our experience with HeartMate 3 (HM3), a ventricular assist device.</p><p><strong>Methods: </strong>Seven male patients with the diagnosis of end-stage heart failure underwent HM3 implantation between August 2023 and August 2024. Three patients were INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Stage 1 (42.8%), three patients were INTERMACS Stage 2 (42.8%), and one patient was INTERMACS Stage 3 (14.2%). A bridge to transplant was aimed in 71% of patients, with the rest being destination therapy. One patient underwent reexploration in the early postoperative period due to hemorrhage. Warfarin sodium and acetylsalicylic acid were given for anticoagulation and antiaggregation therapy, with a target INR (international normalized ratio) between 2.5 and 3.0.</p><p><strong>Results: </strong>Overall support time was between 230 and 395 days, with a mean of 253 days. Two patients developed acute renal failure during the early postoperative period. One patient underwent mediastinal exploration during the early postoperative period due to hemorrhage. One patient developed an outflow graft thrombosis requiring corrective reoperation. This patient died on the first postoperative day due to an intractable right ventricular failure. The mortality rate was 14.2% in this series.</p><p><strong>Conclusion: </strong>In certain cases with advanced heart failure, patients can be severely impaired and symptomatic despite maximum medical treatment. Since donor organ availability is limited in the current social environment, left ventricular assist device implantation is the only logical option for the treatment of this patient group as a bridge to transplant or destination therapy.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"088-88"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022460","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-40] Near-Infrared Spectroscopy and Lactate Measurements in Coronary Artery Bypass Grafting: A Retrospective Study.","authors":"Ercan Kahraman","doi":"10.5606/tgkdc.dergisi.2024.msb-40","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-40","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the potential correlation between lactate levels and near-infrared spectroscopy (NIRS) measurements during coronary artery bypass grafting.</p><p><strong>Methods: </strong>In this retrospective study, 48 patients who underwent coronary artery bypass grafting were examined. The relationship between lactate levels recorded during the operation and the simultaneously measured right and left NIRS values were statistically analyzed.</p><p><strong>Results: </strong>A moderate positive correlation was found between six different lactate measurements obtained at specific time intervals during coronary bypass surgery and the concurrently recorded NIRS values. The correlation coefficients were r=0.484 and p=0.004 for right NIRS and r=0.4364 and p=0.010 for left NIRS.</p><p><strong>Conclusion: </strong>The findings suggest that NIRS could be a potential tool for assessing metabolic status. While most studies focus on comparing postoperative clinical outcomes between patients with and without NIRS, research specifically targeting changes in NIRS values during cardiopulmonary bypass is limited. Further studies with larger sample sizes are needed to elucidate the clinical benefits of NIRS during cardiopulmonary bypass.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"065-65"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036845","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-41] Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement.","authors":"Gulsum Turkyilmaz, Ali Aycan Kavala","doi":"10.5606/tgkdc.dergisi.2024.msb-41","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-41","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement.</p><p><strong>Methods: </strong>This single-center retrospective cohort study was conducted. Sixty patients who underwent CABG (up to triple bypass) combined with mitral valve replacement were divided into DNC and BC groups, with thirty patients in each group.</p><p><strong>Results: </strong>Both groups demonstrated similar baseline characteristics, including age, sex, cardiac/noncardiac comorbidity, and preoperative echocardiographic parameters. Compared to the BC group, the DNC group demonstrated significantly lower cardioplegia volume (1130.00±194.1 mL <i>vs.</i> 884.33±156.8 mL, p=0.001), cardiopulmonary bypass time (121.70±13.57 min <i>vs.</i> 110.90±12.52 min, p=0.002), aortic clamp time (101.37±13.87 min <i>vs.</i> 91.37±11.58 min, p=0.004), and need for intraoperative defibrillation (21 events <i>vs.</i> 6 events, p=0.001). Postoperative creatine kinase-MB levels and troponin levels were significantly lower in the DNC group than in the BC group. Postoperative hemoglobin and hematocrit levels were significantly higher in the DNC group than in the BC group. The intubation period in intensive care unit was significantly shorter in the BC group (6.82±1.57 h <i>vs.</i> 8.13±12.21 h, p=0.037); however, intensive care unit stay, total hospital stay, and postoperative complication rates were not significantly different between the groups. At predischarge echocardiography, the DNC group demonstrated significantly higher ejection fraction rates than the BC group (47.79±5.50 and 45.72±5.86, respectively; p=0.005).</p><p><strong>Conclusion: </strong>Del Nido cardioplegia presented better intraoperative and postoperative results. Therefore, it can be concluded that DNC is an effective and safe alternative to BC for CABG combined with mitral valve replacement.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"066-66"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009874","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-25] Mid-Term Results of Ozaki Procedure: Azerbaijan Experience.","authors":"Kamran Ahmadov, Nigar Kazimzade, Kamran Musayev","doi":"10.5606/tgkdc.dergisi.2024.msb-25","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-25","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to report the outcomes of the Ozaki procedure, which involves reconstructing aortic valve leaflets with autologous pericardium, performed in a clinic in Azerbaijan.</p><p><strong>Methods: </strong>This retrospective study analyzed 40 patients who underwent aortic valve reconstruction between August 2018 and June 2023. Patients were divided into two groups: Group A (mean age: 63 years) followed the traditional Ozaki technique, while Group B (mean age: 65 years) received an additional commissural reinforcement, a modification proposed by our team.</p><p><strong>Results: </strong>Presenting symptoms were aortic stenosis or a combination of aortic stenosis and aortic regurgitation. Preoperative echocardiography showed peak and mean pressure gradients of 84±34.6 and 50.5±23 mmHg, respectively. Cardiopulmonary bypass and aortic cross-clamp times averaged 142 and 115 min for Group A and 144 and 107 min for Group B. There were no in-hospital mortalities or pacemaker implantations. No significant increases in aortic gradients were noted, and no reoperations were required. Four patients in Group A developed mild aortic regurgitation during follow-up, while in Group B, aortic regurgitation remained minimal or absent. The median follow-up periods were 64 months for Group A and 28 months for Group B. The study demonstrated 100% freedom from major adverse valve-related events during the follow-up.</p><p><strong>Conclusion: </strong>Since its introduction, aortic valve neocuspidization has gained popularity. Mid-term results from the Ozaki procedure showed favorable outcomes in terms of mortality, valve gradients, and freedom from adverse valve-related events. While some studies have reported a slight increase in valve regurgitation following the Ozaki procedure, our novel additional commissural reinforcement technique provided a reduction in aortic valve regurgitation during follow-up. Further studies are needed to assess long-term results.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"045-45"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990063","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-04] Ozone Administration Reduces Myocardial Ischemia Reperfusion Injury in Streptozotocin-Induced Diabetes Mellitus Rat Model.","authors":"Mehmet Burak Gulcan, Huseyin Demirtas, Abdullah Ozer, Zeynep Yıgman, Ali Doğan Dursun, Mustafa Arslan, Gursel Levent Oktar","doi":"10.5606/tgkdc.dergisi.2024.msb-04","DOIUrl":"10.5606/tgkdc.dergisi.2024.msb-04","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effects of ozone therapy on myocardial ischemia/reperfusion injury in a diabetic rat model.</p><p><strong>Methods: </strong>The experimental study included 38 male Wistar Albino rats weighing between 200 and 250 g. The rats were randomly assigned to five groups. The sham group included six rats, while the other groups had eight rats each. The other groups were the diabetic ozone group, the diabetic group, the diabetic ischemia/reperfusion group (DIR), and the diabetic ischemia/reperfusion ozone group (DIRO). A total of 32 rats received 65 mg/kg streptozotocin, and a week after the administration, diabetes was confirmed by measuring blood sugar. The rats were fed ad libitum for 40 days to reveal macrovascular complications of diabetes. Malondialdehyde, catalase, superoxide dismutase, paraoxonase-1, total oxidative status, total antioxidant status, and oxidative stress index were assessed. A TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay was employed to assess apoptosis.</p><p><strong>Results: </strong>Histologic and biochemical assessments showed the benefits of ozone in myocardial ischemia/ reperfusion injury in diabetic rats. The DIRO group was found to be superior to the DIR group.</p><p><strong>Conclusion: </strong>Ozone has cardioprotective effects in streptozotocin-induced diabetic rats through its antioxidant properties against oxidative stress. The study is unique in terms of ozone's protective effects in diabetic rats against myocardial ischemia/reperfusion injury. However, further studies are needed to confirm our findings.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"019-20"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028058","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":"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-38] The Journey of Intracorporeal Left Ventricular Assist Devices in Pediatric Patients: From HVAD to Heartmate 3.","authors":"Sedat Karaca, Ümit Kahraman, Osman Nuri Tuncer, Dilek Erdinli, Çağatay Engin, Tahir Yağdı, Yüksel Atay, Mustafa Özbaran","doi":"10.5606/tgkdc.dergisi.2024.msb-38","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-38","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the outcomes of HVAD (Heartware Ventricular Assist Device) and HeartMate 3 (HM3) used as a bridge to transplantation in end-stage heart failure.</p><p><strong>Methods: </strong>This retrospective study included 34 patients under 18 years of age who underwent HVAD (n=22; 13 females, 9 males; mean age: 12.7 years) or HM3 (n=12; 8 females, 4 males; mean age: 12.9 years) implantation at a single center between 2012 and 2024. Kaplan-Meier analysis was conducted to assess survival.</p><p><strong>Results: </strong>There were no significant differences between the HVAD and HM3 groups in terms of age (p=0.78), weight (44.3 <i>vs.</i> 37.7 kg, p=0.25), height (155.6 <i>vs.</i> 151.5 cm, p= 0.49), body surface area (1.92 <i>vs.</i> 1.76 m², p=0.29), and sex (p=0.66). The mean cardiopulmonary bypass time was higher in the HM3 group (59 <i>vs.</i> 78.5 min, p<0.05). The average support duration was 899 days. Postoperative complications showed no statistically significant differences in infection (n=5 <i>vs.</i> n=2, p=0.68) and cerebrovascular accidents (n=4 <i>vs.</i> n=0, p=0.11) between the HVAD and HM3 groups, while pump thrombosis showed a statistically significant difference (n=8 <i>vs.</i> n=0, p<0.05). During the five-year follow-up, nine patients underwent heart transplantation, 17 patients were on device followup, and eight patients died (seven patients with HVAD and 1 patient with HM3; p=0.12).</p><p><strong>Conclusion: </strong>HeartMate 3 represents an outstanding option for pediatric patients due to its low complication rates and high survival rates. Further research is needed to develop an intracorporeal device suitable for implantation in neonates and infants.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"064-64"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056318","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-37] Thoracofemoral Bypass and Long-Term Success in Juxtarenal Aortic Occlusion.","authors":"Ayhan Güneş, Sabit Sarıkaya","doi":"10.5606/tgkdc.dergisi.2024.mep-37","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-37","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to share 16 years of experience and long-term outcomes in patients who underwent thoracofemoral bypass as the initial treatment.</p><p><strong>Methods: </strong>Thirty-two patients (28 males, 4 females; mean age: 62; range, 56 to 67.5 years) who underwent thoracofemoral bypass for severe aortoiliac occlusive disease between 2005 and 2022 were retrospectively analyzed. The occlusion and calcified plaques of the abdominal aorta at the renal level were common characteristics of all patients. The patients were divided into two groups: the severe claudication group (Rutherford III) and the chronic limb-threatening ischemia group (Rutherford IV and V).</p><p><strong>Results: </strong>The mean follow-up duration was 79±32 months. The 30-day mortality rate was 3.2% (n=1). Major complications were observed in 9.6% (n=3) of patients (respiratory in 6.4%, retroperitoneal hematoma in 3.2%). Minor complications occurred in 41.9% of patients, including pleural effusion in 9.6% (n=3), acute kidney injury in 9.6% (n=3), gastrointestinal bleeding in 3.2% (n=1), paralytic ileus in 6.4% (n=2), and superficial skin infection in 12.9% (n=4). The rate of postoperative superficial skin infection was higher in the chronic limb-threatening ischemia group compared to the claudication group (n=4 [40%] vs. n=0, p=0.007). The five-year Kaplan-Meier analysis estimated that the primary patency for the entire study was 96±7% (95% confidence interval [CI] 88.6- 100), and the secondary patency was 96.3±6% (95% CI 89.4-100). The five-year Kaplan-Meier analysis estimated that survival rate after thoracofemoral bypass was 93.4±3% (95% CI 91-100).</p><p><strong>Conclusion: </strong>This study shows that thoracofemoral bypass, although complex, is a safe and effective initial treatment for juxtarenal total aortic occlusion, with low mortality and morbidity rates and excellent long-term outcomes in selected 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":"135"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024323","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-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}