Turkish Journal of Thoracic and Cardiovascular Surgery


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Publications in this journal

  • Turkish Journal of Thoracic and Cardiovascular Surgery 04/2014; 22(2):382.
  • Turkish Journal of Thoracic and Cardiovascular Surgery 01/2014;
  • Turkish Journal of Thoracic and Cardiovascular Surgery 09/2013; 21(3):858-63.
  • Turkish Journal of Thoracic and Cardiovascular Surgery 09/2013; 21(3):706-711.
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    ABSTRACT: Background: This study aims to evaluate the results of endovascular treatment (TEVAR) and the contribution of adjunct procedures in acute complicated type B aortic dissections. Methods: Thirty patients (26 males, 4 females; mean age 55.2±14.7 years, range 24 to 86 years) with acute complicated type B dissection underwent endovascular treatment. The dissection was complicated by malperfusion in eight patients (26.7%), impending rupture in four (13.3%), uncontrollable hypertension in 12 (40%), and severe treatmentresistant pain in six (20%). Self-expanding stent-grafts (Talent® and Valiant®, Medtronic Inc.) were used. Ostium of the left subclavian artery was covered intentionally in 19 patients (63.3%). Additional stenting was necessary in eight patients (26.7%). Of a total of 12 bare metal stents used in these patients, stents were inserted in the renal arteries in six (20%), iliac arteries in three (10%), and celiac arteries in two (6.7%) patients. Median follow-up was 55 months (range, 25 to 99 months). Results:The mean number of stent-grafts implanted was 1.42 (range, 1 to 3). One patient had inadvertent partial closure of the left common carotid artery ostium due to proximal migration of the stent-graft which caused no early neurological complications. Right hemiplegia occurred 15 months later due to his discontinuation of the anticoagulant therapy in the same patient. In another patient with visceral malperfusion, early laparoscopic exploration following the stenting of the celiac and the left renal arteries revealed no ischemia of the bowels. One patient with postoperative angina pectoris required stenting of the right coronary artery. There was no stroke in any patients, while reversal of paraplegia was observed in one patient early after the procedure. The mean lengths of intensive care unit and hospital stays were 3.2±3.4 and 9.8±7.1 days, respectively. There was no 30-day mortality. The one-year survival rate was 96.7%. Conclusion: Although endovascular treatment of complicated type B aortic dissections has a high success rate, TEVAR may not be the sole solution. Findings of malperfusion should be carefully sought in the early postoperative period. The adjunct procedures such as stenting of the visceral arteries or open surgical revascularization should always be considered particularly in young patients. Keywords: Endovascular procedure; malperfusion; stent; type B aortic dissection.
    Turkish Journal of Thoracic and Cardiovascular Surgery 06/2013;
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    ABSTRACT: Background: This study aims to investigate the effectiveness of the cascade filtration technique in individuals with peripheral vascular disease who are candidates for amputation. Methods: Twelve patients (9 males, 3 females; mean age 62.4±7.2 years; range 45 to 75 years) were included in the study. For the evaluation of the efficacy of this procedure, measurements of serum albumin, fibrinogen, immunoglobulin M, alpha-2 macroglobulin, low density lipoprotein (LDL) cholesterol, fibronectin, von Willebrand factor levels, blood viscosity, and transcutaneous oxygen saturation (tcPO2) were obtained before and after the procedure at sessions 1, 4, and 7. Results: A statistically insignificant increase in tcPO2 values and a significant decrease in viscosity were determined (p=0.019). Fibronectin, von Willebrand factor, and viscosity levels were significantly decreased at the end of protocol, compared to baseline values. Various degrees of improvement were noted in seven of the 10 patients. After the completion of the protocol, amputation from a more distal level than previously planned was performed in three patients. Conclusion: Cascade filtration, despite its high cost, appears to be an effective treatment alternative which limits or prevents amputation.
    Turkish Journal of Thoracic and Cardiovascular Surgery 04/2013; 21(2):346-352.