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

{"title":"[MSB-28] Treatment of Ruptured Abdominal Aortic Aneurysm: Long-Term Results of Endovascular Aortic Aneurysm Repair Versus Open Surgery.","authors":"Dilşad Amanvermez Şenarslan, Aylin Yıldız, Funda Yıldırım","doi":"10.5606/tgkdc.dergisi.2024.msb-28","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-28","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether endovascular aortic aneurysm repair (EVAR) had a long-term survival benefit compared to open repair in ruptured abdominal aortic aneurysms (rAAAs).</p><p><strong>Methods: </strong>This retrospective study involved 58 patients (mean age: 69.6±10 years) who underwent either open surgery or EVAR for rAAA between January 2015 and June 2024.</p><p><strong>Results: </strong>Open surgery and EVAR groups were similar in terms of age. There were more male patients in the open surgery group. Intensive care unit and hospital stays were similar in both groups. The mean follow-up time was 41.2±40 months. The estimated cumulative survival rate in Kaplan-Meier analysis was %87.9 for the EVAR group and %40 for the open surgery group. Most of the deaths occurred in the first 30 days postoperatively. The reason for high mortality in open surgery was due to the hemodynamic status at arrival to the emergency service. Hemodynamically unstable patients usually had no time to wait for stent graft availability, and direct open surgery was required in these patients. A secondary factor that was important for successful treatment was the patient's anatomic convenience with EVAR treatment. Conversion to open surgery was approximately 40% due to the anatomy of the hostile neck and iliac vessels.</p><p><strong>Conclusion: </strong>An experienced team and a hybrid operation room with adequate equipment for optimal imaging and conversion to open surgery are essential for reducing mortality in rAAA. Mortality and morbidity with EVAR appear to be low compared to open surgical treatment in patients with rAAA.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"048-49"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043327","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-35] Initial Single-Center Experience: Outcomes of Minimally Invasive Extracorporeal Circulation vs. Conventional Circuits in Cardiac Surgery.","authors":"Ahmet Daylan, Ömer Faruk Rahman, Ayşe Daylan, Dağlar Cansu, Şahin Bozok","doi":"10.5606/tgkdc.dergisi.2024.msb-35","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-35","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present our early experience with minimally invasive extracorporeal circulation (MiECC) circuits and compare it with conventional cardiopulmonary bypass (cCPB).</p><p><strong>Methods: </strong>Two hundred thirty-nine patient registries (169 males, 70 females; mean age: 63.5 years) who underwent surgery were retrospectively analyzed between June 2021 and February 2024. All patients were operated by the same surgical team with a restrictive blood transfusion protocol.</p><p><strong>Results: </strong>Forty-five (18.8%) cases were identified as MiECC. Most of the operations were coronary artery bypass grafting. Significant differences were observed between those operated on with MiECC and cCPB regarding the transfusion of red blood cell (RBC) suspensions and the total amount of drainage. No significant differences were observed in the duration of intubation, incidence of postoperative acute kidney injury, and intensive care unit or hospital stay. In geriatric patients, transfusion of RBC suspensions and drainage was significantly lower. Duration of intubation and intensive care unit or hospital stay did not reach statistical significance. In patients with an ejection fraction ≤45, transfusion of RBC suspensions were similarly low.</p><p><strong>Conclusion: </strong>The utilization of MiECC resulted in a reduction in transfusion of RBC suspensions and postoperative drainage. No significant differences were observed in intubation time, postoperative acute kidney injury, hospitalization, or mortality. Although intubation time was observed to be shorter, no statistically significant result could be reached. There is a potential for bias in patient selection due to the potential benefits of MiECC. We believe that with a larger number of blinded studies, the benefits of MiECC can be demonstrated in more detail, particularly in specialized populations such as geriatric patients and patients with low EF.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"059-60"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041742","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-70] Prognostic Value of the Hemoglobin, Albumin, Lymphocyte, Platelet Score in Predicting One-Year Mortality and Complications in Patients Undergoing Isolated Coronary Artery Bypass Grafting.","authors":"Ahmet Ozan Koyuncu, Tolunay Toy, Meryem Ertekin, Ayşegül Aydın, Görkem Can, Faruk Gencoğlu","doi":"10.5606/tgkdc.dergisi.2024.msb-70","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-70","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between the hemoglobin, albumin, lymphocyte, platelet (HALP) score, a novel scoring system that reflects systemic inflammation, and one-year mortality and complications in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>The retrospective study included 359 consecutive patients (287 males, 72 females; mean age: 60.9 years) diagnosed with coronary artery disease who underwent CABG between January 2020 and February 2023. Patients with concomitant mitral valve replacement, aortic surgery, carotid endarterectomy, aortofemoral bypass, intracardiac tumor excision, mediastinal tumor excision, or those who underwent emergency or urgent procedures were excluded from the study. The patients were divided into two groups based on a HALP score cutoff value of 34.1. Group 1 included patients with a HALP score lower than the cutoff value, while Group 2 included those with a HALP score higher than the cutoff value.</p><p><strong>Results: </strong>The one-year mortality rate was significantly higher in Group 1 compared to Group 2 (16% <i>vs.</i> 5%). Additionally, rates of major adverse cardiovascular and cerebrovascular events, atrial fibrillation, high-dose inotropic support, pneumonia, pleural effusion, prolonged intubation, acute kidney injury, cerebrovascular events, and length of stay in both the intensive care unit and hospital were significantly higher in Group 1 than in Group 2.</p><p><strong>Conclusion: </strong>The findings of our study indicate that the HALP score can be used to assess one-year mortality and complication risks in patients undergoing isolated CABG. However, to establish it as an independent factor, further analyses with a larger patient population are warranted.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"092-92"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041810","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-21] Management of Cardiac Bullet Embolism Originating From the Popliteal Vein.","authors":"Uğur Kaya, Izatullah Jalalzai, İbrahim Pir, Burak Duman, Fahri Er","doi":"10.5606/tgkdc.dergisi.2024.mep-21","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-21","url":null,"abstract":"<p><p>Intravascular missile embolism is comparatively uncommon; however, vascular injury is a frequent consequence of firearm-related accidents. To date, there have been 38 documented cases of intravascular missile embolization to the heart. This case report described the successful surgical management of a patient with a bullet embolism in the right ventricle after a gunshot injury to the left popliteal vein. A 54-year-old male presented with a gunshot wound to the left popliteal fossa. The popliteal vein, which was partially damaged, was primarily repaired. Radiological imaging, including radiographs and computed tomography, revealed the bullet's unexpected location in the apex of the right ventricle. An echocardiogram confirmed the bullet's position and showed minimal pericardial effusion. On arrival, the patient was hemodynamically stable, and lower extremity pulses were palpable, with no evidence of deep vein thrombosis or neurological deficits. Hematological studies were within normal limits. The patient underwent a left anterior minithoracotomy. Cardiopulmonary bypass was established via cannulation of the right femoral artery and vein. With the heart beating, a right ventriculotomy was performed, and the bullet was successfully removed. The ventriculotomy was closed primarily using felt patches. The postoperative course was uneventful, and the patient was stable with no signs of neurological or vascular complications and no significant pericardial effusion on follow-up echocardiography. This case highlights the importance of thorough radiological evaluation in gunshot injuries, even when the entry wound is distant from the final location of the projectile. The use of cardiopulmonary bypass can be effective in managing intracardiac bullet embolism, which is very rare. Prompt diagnosis and careful surgical planning are essential for favorable outcomes in such complex 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":"116-117"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051563","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-05] Early Discharge After Isolated Coronary Artery Bypass Graft Surgery Does Not Increase Risk of Rehospitalization.","authors":"Ahmet Can Topçu, Fatih Yiğit, Fatma İrem Öztürk, Taylan Adademir, Mehmet Kaan Kırali","doi":"10.5606/tgkdc.dergisi.2024.msb-05","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-05","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether early discharge after coronary artery bypass grafting (CABG) is associated with increased rates of hospital readmission and emergency room (ER) presentation.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Koşuyolu Adult Cardiac Surgery Quality Improvement Program database. Consecutive adults who underwent isolated CABG at a single institution between May 2023 and December 2023 were assessed for eligibility. Patients were excluded if they had surgery other than isolated CABG, experienced in-hospital mortality, or had a prolonged length of stay (>14 days) during index hospitalization. The study population was divided into early discharge (≤5 days) and late discharge (>5 days) groups. The primary endpoint was all-cause hospital readmission within 30 days of discharge, while the secondary endpoint was ER presentation for any reason within 30 days of discharge.</p><p><strong>Results: </strong>The final cohort included 608 patients (228 early-discharge, 380 late-discharge). Median age was 61 years (interquartile range, 54-67). Groups were balanced in terms of demographics, risk profile, operative details, and outcomes. Thirty-day rehospitalization and ER presentation rates were lower in the early discharge group compared to the late discharge group; however, the differences were statistically insignificant (7.0% <i>vs.</i> 10.0%, p=0.211; 25.4% <i>vs.</i> 29.5%, p=0.283; respectively). Multivariate logistic regression analysis identified postoperative mechanical ventilation duration, sternal wound infection, postoperative stroke, and discharge with atrial fibrillation as the strongest predictors of hospital readmission within 30 days of discharge (odds ratio [OR]=1.049, 95% confidence interval [CI] 1.000-1.100; OR=10.268, 95% CI 1.882-56.032; OR=39.891, 95% CI 1.980-803.624; OR=24.724, 95% CI 1.499-407.804; respectively).</p><p><strong>Conclusion: </strong>Early discharge after isolated CABG surgery was not associated with increased rates of hospital readmission or ER presentation within 30 days of discharge.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"021-22"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051850","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-74] Endovascular Aortic Aneurysm Repair, Thoracic Endovascular Aortic Repair (TEVAR) Methods Used in Our Clinic and Comparison of Results.","authors":"Fehim Can Sevil, Mehmet Tort, Necip Becit, Serkan Güme, Nigar Madatlı","doi":"10.5606/tgkdc.dergisi.2024.msb-74","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-74","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the cases treated with endovascular aortic aneurysm repair (EVAR) and thoracic endovascular aneurysm repair (TEVAR) and their results in our clinic.</p><p><strong>Methods: </strong>This retrospective study included 30 patients (26 males, 4 females; mean age: 62.46 ±16.17 years; range, 18 to 77 years) who underwent endovascular repair for aortic aneurysms between July 2020 and June 2024. Demographic and clinical characteristics of the patients, aneurysm, surgery and methods, short- and long-term follow-up were analyzed.</p><p><strong>Results: </strong>Traumatic aortic dissection was observed in four patients, and infrarenal abdominal aortic aneurysms were observed in 19 patients. The surgery was 90 min. All patients underwent complete recovery. No complications were observed in short-term follow-up.</p><p><strong>Conclusion: </strong>In conclusion, EVAR and TEVAR can be performed safely with increasing experience. Our early surgical results are compatible with the literature.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"096-96"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053946","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-34] Clinical Outcomes and Applications of Bypass Procedures on Intra-Abdominal Visceral Arteries.","authors":"Muhammet Fethi Sağlam, Emrah Uğuz","doi":"10.5606/tgkdc.dergisi.2024.msb-34","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-34","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the clinical effectiveness, indications, and patient profiles of bypass procedures performed on intra-abdominal visceral arteries.</p><p><strong>Methods: </strong>Ten patients who underwent between 2019 and 2024 were included in the study.</p><p><strong>Results: </strong>In five patients (4 females, 1 male; range, 38 to 64 years), the procedure was part of a hybrid treatment due to aortic pathology. The procedure was performed due to mesenteric ischemia in three patients (2 males, 1 female; range, 50 to 65 years), following left renal artery injury in one female patient (aged 67 years), and due to a pancreatic tumor in another female patient (aged 57 years), which required a bypass to the hepatic artery. During follow-up, no early mortality was observed.</p><p><strong>Conclusion: </strong>Bypass procedures on intra-abdominal visceral arteries yield successful outcomes in treating arterial stenosis causing mesenteric ischemia, as part of hybrid treatments for aortic pathologies, and in abdominal surgeries requiring revascularization.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"058-58"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058973","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-57] Surgically Implanted Cardiac Implantable Electronic Devices (CIED) in Patients Younger Than One Year.","authors":"Safak Alpat, Abdüsselam Çorak, İlker Ertuğrul, Tevfik Karagöz, Mustafa Yılmaz","doi":"10.5606/tgkdc.dergisi.2024.msb-57","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-57","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present our experience with surgically implanted cardiac implantable electronic devices (CIED) in infants.</p><p><strong>Methods: </strong>Thirty-eight infants (18 males, 20 females; mean age: 155.6±102.2 days; range, 1 to 343 days) who underwent a surgical procedure to implant CIEDs between 2014 and 2024 were included in the study. Pre-, intra-, and postoperative data were collected and analyzed.</p><p><strong>Results: </strong>The mean weight was 5.27±1.99 kg (range, 2.1 to 9 kg). Twenty-four (63%) patients required CIED due to complete atrioventricular block after pediatric heart surgery. In five (13%) patients, the indication was congenital complete atrioventricular block. Remaining 10 (24%) patients had a long QT, congenitally corrected transposition of the great arteries, and cardiomyopathy. Pacemaker configuration was VVI in 31 (81.5%) patients, ICD in three (8%) patients, CRT in two (5.25%), and DDD in two (5.25%). The median follow-up was five years (range, 1 to 10 years). There were no deaths. A total of 12 reoperations were required in seven (18.4%) patients when pacemaker generator replacements were excluded. Five reoperations were related to lead fracture and revision. The remaining seven reoperations were to either upgrade or downgrade pacemaker configurations.</p><p><strong>Conclusion: </strong>In patients younger than one year, surgical implantation of CIEDs represents a safe procedure with reasonably acceptable outcomes in the mid-term follow-up. However, reoperations are inevitable, and appropriate reinterventions depend on close device surveillance.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"083-83"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059029","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-66] Does Balloon Dilatation Increase the Need for A Permanent Pacemaker in Sutureless Aortic Valve Replacement?","authors":"Adem Reyhancan, Fadil Shehu, Mürsel Büyükadali, Serhat Hüseyin, Orkut Güçlü, Suat Canbaz","doi":"10.5606/tgkdc.dergisi.2024.msb-66","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.msb-66","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to present the results of balloon dilatation in sutureless valves considering the temporary and permanent need for a pacemaker.</p><p><strong>Methods: </strong>Thirty-eight patients (27 females, 11 males; mean age: 69.42±4.85 years; range, 61 to 82 years) who underwent surgical aortic valve replacement with a sutureless aortic valve bioprosthesis between January 2019 and June 2024 and received balloon dilation at 4 atm (standard atmosphere) pressure for 30 sec during the procedure were retrospectively evaluated. Demographic data, preoperative and postoperative echocardiographic data, and postoperative follow-up data of the patients were collected.</p><p><strong>Results: </strong>On preoperative echocardiographic evaluation, the mean aortic root diameter was 20.99±2.24 mm, the ejection fraction was 59.29±9.57%, and the mean preoperative aortic valve gradient was 38.08±7.31 mmHg. Isolated aortic valve replacement was performed in 22 (57.9%) patients, concomitant coronary bypass was performed in 14 (36.8%) patients, and ascending aorta replacement was performed in two (5.3%) patients. A small valve was inserted in six patients, a medium valve in 13 patients, a large valve in 17 patients, and an extra-large valve in two patients. The mean postoperative aortic valve gradient was 11.52±3.36 mmHg. After surgery, three (7.9%) patients were transferred to the intensive care unit with temporary pacemakers. Permanent pacemaker implantation was required in three (7.9%) patients due to complete atrioventricular block.</p><p><strong>Conclusion: </strong>Although the clinical results with sutureless aortic bioprostheses are satisfactory, the use of balloon dilatation increases the need for permanent pacemakers.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"090-90"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059033","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-32] Unusual Origin of Anomalous Left Main Coronary Artery From the Pulmonary Artery.","authors":"Arda Sezen, Defne Gunes Ergi, Akin Cinkooglu, Eser Dogan, Mahsati Akhundova, Osman Nuri Tuncer, Yuksel Atay","doi":"10.5606/tgkdc.dergisi.2024.mep-32","DOIUrl":"https://doi.org/10.5606/tgkdc.dergisi.2024.mep-32","url":null,"abstract":"<p><p>Herein, we presented a case of an anomaly in which the left main coronary artery (LMCA) originates from the right pulmonary artery (RPA). A six-year-old female patient presented for a cardiology follow-up due to the mother's history of sudden cardiac death. On transthoracic echocardiography, the right coronary artery (RCA) was dilated, and the LMCA was not identified. There was no LMCA ostium on the aorta. The computed tomography and the coronary angiography revealed the wide and tortuous RCA originating from the aorta. Following primary median sternotomy, proximal visualization of the coronary ostium was challenging. Cardioplegia was given via the aortic root, revealing leakage from the RPA. For better visualization of the RPA, the aorta was transected above the RCA ostium. Subsequently, the MPA incision was extended towards the RPA, facilitating the coronary ostium visualization. Afterward, the left coronary ostium was freed from the RPA and implanted at its anatomical location on the ascending aorta. Subsequently, the RPA and MPA incisions were reconstructed with 7-0 Prolene sutures. The aortotomy was closed with a bovine patch, and warming was recommenced. The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. Complex cases of anomalous left main coronary artery from the pulmonary artery are surgically challenging. In rare instances where the LMCA originates from the RPA, ostial identification can be difficult. Detailed imaging is crucial for surgical planning. Conventional translocation is the gold standard method for these cases. This rare anomaly, also scarcely reported in the literature, is a variation that should be carefully considered in congenital heart surgery and coronary artery disease diagnosis.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"32 4 Suppl 2","pages":"131-132"},"PeriodicalIF":0.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062943","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}