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

{"title":"Thirteen years of continuous LVAD support: An extraordinary bridge to heart transplantation from childhood to adulthood.","authors":"Zülal Ülger Tutar, Burcugül Karasulu Beci, Eser Doğan, Tahir Yağdı, Çağatay Engin, Ertürk Levent, Osman Nuri Tuncer, Burcu Özbaran, Sanem Nalbantgil, Yüksel Atay, Mustafa Özbaran","doi":"10.4274/tjtcs.2026.2026-4-10","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-4-10","url":null,"abstract":"<p><p>Pediatric heart failure remains a significant cause of morbidity, and orthotopic heart transplantation (OHT) is the gold-standard treatment for end-stage disease. Although mechanical circulatory support (MCS) is a well-established bridge-to-transplant strategy, reports of continuous support extending from early childhood into adulthood are exceedingly rare. We present a case of 13 years of uninterrupted left ventricular assist device (LVAD) support in a pediatric patient successfully bridged to transplantation. An 8-year-old girl (25 kg, 135 cm) with refractory dilated cardiomyopathy (left ventricular ejection fraction, 20%) underwent implantation of a continuous-flow intracorporeal LVAD (HeartWare ventricular assist device) in 2012. During an extraordinary 13-year (approximately 4.745-day) support period, the patient progressed through puberty and completed high school. Her clinical cour se included 24 episodes of driveline infection, two transient ischemic attacks, and two episodes of pump thrombosis, all of which were successfully managed medically without device exchange. At 21 years of age, following surgery for a ruptured endometrioma, a suitable donor heart became available. OHT was performed successfully. Despite an early episode of acute cellular rejection (Grade 2R) and cytomegalovirus reactivation, the patient remained clinically stable with preserved graft function at 1-year posttransplant. This case represents one of the longest documented durations of continuous LVAD support reported in the pediatric literature. It demonstrates the remarkable durability of contemporary MCS and highlights the feasibility of managing long-term complications through a multidisciplinary approach. This \"extreme outlier\" challenges the traditional bridge-to-transplant paradigm and suggests that ventricular assist devices may serve as a \"bridge to life\" during the critical transition fr om childhood to adulthood when donor availability is limited.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between processed electroencephalogram monitoring and postoperative neurocognitive outcomes in cardiac surgery: A randomized controlled trial.","authors":"Ömer Faruk Şenocak, Mustafa Duran, Alper Kararmaz","doi":"10.4274/tjtcs.2026.28288","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.28288","url":null,"abstract":"<p><strong>Background: </strong>In open-heart surgeries, several factors such as extracorporeal circulation, hypothermia, rewarming, and low cardiac output can affect the depth of anesthesia. Current guidelines recommend monitoring end-tidal anesthetic gas concentration or using processed electroencephalogram (EEG) monitoring. This study aimed to evaluate the effects of EEG-guided anesthesia on anesthetic consumption, hemodynamic stability and its effects on postoperative delirium and neurocognitive disorder (NCD) that may develop subsequently.</p><p><strong>Methods: </strong>Fifty adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomized into two groups. Elective and adult patients undergoing open heart surgery were included in the study. Group I was anesthetized with a bispectral index value of 40-60. Group II was taken as the control group, and anesthesia was maintained with 1.8% MAC sevoflurane by the conventional method. Total anesthesia and vasopressor consumption were noted at the end of the case. Tests were also performed in the intensive care unit to detect delirium and NCD. Data were analyzed using SPSS v21.</p><p><strong>Results: </strong>According to our findings, propofol, midazolam, and fentanyl consumptions were similar in the two groups, while total sevoflurane consumption was lower in Group I. Group II exhibited significantly higher total sevoflurane consumption (p=0.03) and norepinephrine use (p<0.0001). Postoperative cognitive dysfunction (mini-mental state examination <24) and delirium (Nu-DESC ≥2) were more prevalent in Group II (p=0.037 and p=0.019, respectively). BIS values were significantly lower and suppression durations longer in Group II, which correlated with increased incidence of cognitive dysfunction (rs=0.585, p<0.05).</p><p><strong>Conclusion: </strong>BIS-guided anesthesia during cardiac surgery reduced anesthetic agent consumption and norepinephrine use, and was associated with a lower incidence of postoperative cognitive dysfunction and delirium. EEG suppression duration may serve as a valuable predictor of adverse neurocognitive outcomes.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left aberrant subclavian artery originating from a Kommerell diverticulum associated with a right aortic arch.","authors":"Hisato Takagi","doi":"10.4274/tjtcs.2026.2026-2-39","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-2-39","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic dissection complicated with multiple hepatic and renal cysts.","authors":"Hisato Takagi","doi":"10.4274/tjtcs.2026.2026-1-14","DOIUrl":"https://doi.org/10.4274/tjtcs.2026.2026-1-14","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of perioperative neutrophil-lymphocyte ratio (NLR) as a predictor of outcomes after pediatric cardiac surgery: A systematic review and meta-analysis.","authors":"Fegita Beatrix Pajala, Sylvia Alicia Salim, Raden Haryo Aribowo","doi":"10.4274/tjtcs.2025.28680","DOIUrl":"10.4274/tjtcs.2025.28680","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-lymphocyte ratio (NLR) has been suggested as a valuable indicator of poor outcomes in patients undergoing cardiac surgery. However, its prognostic role in pediatric patients undergoing open-heart surgery is unclear. This study aimed to evaluate the correlation between the perioperative NLR and clinical outcomes after pediatric open-heart surgery under cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>A literature search was conducted from their inception to July 19, 2024 in PubMed Central, ProQuest, Sage, ScienceDirect and Ovid. We included studies that investigated the perioperative value of NLR as a predictor of outcomes after pediatric cardiac surgery under CPB. A meta-analysis was performed according to preferred reporting items for systematic reviews and meta-analyses guidelines. The Newcastle-Ottawa scale was used to assess the study quality, while JAMOVI statistical software was used to perform the meta-analysis.</p><p><strong>Results: </strong>A total of six studies were included based on our eligibility criteria; however, only four were included for meta-analysis. The results showed a significant correlation between postoperative NLR with hospital (r=0.34 [95% confidence interval [CI] 0.10-0.58]) and intensive care unit (r=0.25 [95% CI 0.04-0.46]) length of stay.</p><p><strong>Conclusion: </strong>NLR has shown potential as a simple and affordable inflammatory marker in pediatric cardiac surgery under CPB. However, its moderate to weak correlation with clinical outcomes necessitates cautious interpretation. Further research in the form of impact studies is warranted to strengthen these findings.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"159-165"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167695","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":"Effect of preoperative vitamin B12 levels on postoperative outcomes in CABG patients.","authors":"Işıl Taşöz Özdaş, Ertan Demirdaş, Muharrem Emre Özdaş, Bilgehan Savaş Öz, Celalettin Günay, Kubilay Karabacak, Murat Kadan, Cengiz Bolcal","doi":"10.4274/tjtcs.2026.28459","DOIUrl":"10.4274/tjtcs.2026.28459","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery has seen significant improvements, but reducing complications like vasoplegic syndrome remains a priority. Vitamin B12 is emerging as a treatment for vasoplegia. We investigated if preoperative serum vitamin B12 levels could predict the need for postoperative inotropic support in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>This was a retrospective study of 166 patients who underwent isolated elective conventional CABG between 2019 and 2023. We collected patient demographics, comorbidities, and preoperative vitamin B12 levels. Postoperative data on the need for inotropic agents (adrenaline, dopamine, dobutamine) and cardiac assist devices were also analyzed. Mann-Whitney U tests with Bonferroni correction for multiple comparisons and multivariable logistic regression adjusting for confounders were performed.</p><p><strong>Results: </strong>Patients who required adrenaline, dopamine, or dobutamine support had significantly lower median preoperative vitamin B12 levels compared to those who did not. Specifically, adrenaline-dependent patients had a median B12 level of 97.00 (84.00-107.00) pg/mL, while non-dependent patients had 259.00 (187.50-385.00) pg/mL (p<0.001, effect size r=0.87). After Bonferroni correction, low B12 levels remained significantly associated with adrenaline (p<0.001) and dopamine (p=0.0005) requirements. In multivariable analysis adjusting for age, sex, left ventricular ejection fraction, comorbidities, and operative times, vitamin B12 remained independently associated with adrenaline requirement (odds ratio=0.781 per 10 pg/mL, 95% confidence interval: 0.708-0.861, p<0.001).</p><p><strong>Conclusion: </strong>Low preoperative serum vitamin B12 levels are independently associated with the need for postoperative inotropic support after CABG, particularly adrenaline requirement. These findings suggest that preoperative B12 levels may be a valuable predictive marker for identifying high-risk patients and could guide prophylactic strategies. Further research is needed to explore this relationship in more detail.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"130-137"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534125","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":"A rare case of midaortic syndrome: Vascular Behçet's disease or Takayasu arteritis?","authors":"Zeynep Ece Demirbaş, Abdullah Kemal Tuygun","doi":"10.4274/tjtcs.2025.27274","DOIUrl":"10.4274/tjtcs.2025.27274","url":null,"abstract":"<p><p>This case report describes a 44-year-old man with midaortic syndrome and resistant hypertension, presenting a diagnostic challenge due to overlapping features of Behçet's disease and Takayasu arteritis. Imaging studies revealed severe aortic stenosis accompanied by aortic wall thickening, findings typically associated with Takayasu arteritis; however, the patient's clinical history and a positive pathergy test supported a diagnosis of Behçet's disease. Immunosuppressive therapy led to symptomatic improvement, and surgical management with thoracic endovascular aortic repair was successfully performed to address the aortic stenosis. This report discusses the possibility of Behçet's disease presenting with aortic stenosis-a rare vascular complication-or the coexistence of Behçet's disease and Takayasu arteritis.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"172-174"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127096","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":"Carotid artery stent extrusion following carotid blowout syndrome.","authors":"Osman Fehmi Beyazal, Şahin Öğreden, Abdussamet Asaroğlu, Nihan Kayalar, Mehmed Yanartaş","doi":"10.4274/tjtcs.2025.28430","DOIUrl":"10.4274/tjtcs.2025.28430","url":null,"abstract":"<p><p>Carotid blowout syndrome is a rare but fatal complication of head and neck cancer. A 62-year-old female patient underwent carotid artery stent implantation for a carotid pseudoaneurysm following multiple surgeries. However, she subsequently presented to the emergency department with bleeding secondary to carotid artery stent extrusion. She underwent emergency surgery, and the carotid artery stent was removed. This case highlights the importance of long-term surveillance of carotid stents in cancer patients who are at risk for tissue necrosis and recurrence.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"175-177"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127153","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":"Surgical outcomes of left atrial resection for lung cancer: A single-center study.","authors":"Aysun Kosif, Elçin Ersöz Köse, Meltem Ağca, Sevinç Çıtak, Rıza Serdar Evman, Abidin Levent Alpay, Volkan Baysungur","doi":"10.4274/tjtcs.2025.27976","DOIUrl":"10.4274/tjtcs.2025.27976","url":null,"abstract":"<p><strong>Background: </strong>Left atrial invasion is classified as T4 non-small cell lung cancer (NSCLC). Surgical outcomes vary in selected patients. This study presents outcomes of left atrial resection at our center.</p><p><strong>Methods: </strong>Between August 2008 and May 2022, surgical outcomes of 41 NSCLC patients with left atrial invasion were retrospectively analyzed. Demographics, tumor characteristics, surgical procedures (pneumonectomy, lobectomy), nodal status (N0, N1, N2), and margin status (complete [R0], incomplete [R1]) were recorded. In-hospital mortality, morbidity, and long-term survival were evaluated. Cox proportional hazards regression model was used to assess all-cause mortality.</p><p><strong>Results: </strong>Mean age was 61.8 (±11.6) years, and 90.2% of patients were male. Median tumor diameter was 4.5 cm (interquartile range, 3.5-5.5 cm), 53.7% of tumors were right-sided. Squamous cell carcinoma was the predominant subtype (78%). Pathological nodal status was N0 in 25 patients and N1/N2 in 8 patients each. Complete resection was achieved in 35 patients (85.4%). In-hospital mortality was 4.8%, and long-term mortality was 70.8%. Median overall survival was 2.11 years (95% confidence interval [CI], 1.17-3.05). Multivariate Cox regression analysis identified N2 disease and incomplete (R1) resection as independent predictors of poor survival (N2: hazard ratio [HR], 3.7; 95% CI, 1.22-11.19; p=0.021; incomplete R1 resection: HR, 4.46; 95% CI, 1.42-14; p=0.010). Age (≥65 vs. <65), smoking, tumor size, side of surgery and neoadjuvant therapy were not significant in either univariate or multivariate analyses (all p>0.05).</p><p><strong>Conclusion: </strong>In NSCLC with left atrial invasion, surgery is feasible in selected patients, and long-term survival depends on excluding N2 disease and achieving complete resection.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"178-184"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311906","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":"Patient-prosthesis mismatch after aortic valve replacement: Effects on left ventricular structure.","authors":"Fevzi Ayyıldız, Ömer Faruk Rahman, Berk Mutlu, Sevil Gülaştı, Muharrem İsmail Badak","doi":"10.4274/tjtcs.2025.27737","DOIUrl":"10.4274/tjtcs.2025.27737","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the effects of patient-prosthesis mismatch (PPM) on left ventricular structure and functional capacity in patients undergoing isolated surgical aortic valve replacement (sAVR) for severe aortic stenosis.</p><p><strong>Methods: </strong>This retrospective analysis included preoperative and postoperative data of 157 consecutive patients who underwent isolated sAVR between January 2016 and January 2023. Body mass index and indexed effective orifice area were calculated. The severity of PPM was assessed using the valve academic research consortium-3 criteria, and patients were categorized into (1) Insignificant PPM and (2) Significant PPM. Left ventricular geometries were classified based on the left ventricular mass index (LVMi) and relative wall thickness. Functional capacity was evaluated according to the New York Heart Association classification.</p><p><strong>Results: </strong>The mean age of the 91 patients who met the selection criteria was 64.2±8.9 years, and 44% were female and 56% were male. Sixteen patients (17.6%) were assigned to the significant PPM group. The median change in LVMi was -33 g/m² in the insignificant PPM group and -14.5 g/m² in the significant PPM group (p=0.037). Multivariate logistic regression demonstrated a significant association between LVMi change and significant PPM (odds ratio: 1.021, p=0.043). Although no significant change was observed in left ventricular geometry in either the groups, a significant difference was noted in the functional capacity changes (p=0.01).</p><p><strong>Conclusion: </strong>Avoiding significant PPM provides better regression in LVMi and greater improvement in functional capacity; however, it is not sufficient for a significant change in left ventricular geometr y.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"121-129"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127094","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}