[Show abstract][Hide abstract] ABSTRACT: Background:
Penetrating cardiac injuries are high-risk, high-mortality injuries considering the outcomes. Therefore, it is important to choose the appropriate incision. In general clinical settings, thoracotomy and median sternotomy are choices of incisions to explore the injury. In this study, the results of median sternotomy and thoracotomy in penetrating cardiac injuries were compared.
Between January 2003 and December 2013, forty patients, who underwent either thoracotomy or median sternotomy for penetrating cardiac injury, were retrospectively analyzed, and the collected data were compared. Twenty-six patients underwent thoracotomy (Group 1), and fourteen patients underwent median sternotomy (Group 2).
There was no statistically significant gender difference between the groups. However, the mean age in Group 2 was found to be significantly higher than the one in Group 1 (p<0.05).
There were no significant survival differences between the groups in the long term. Incision choice should be determined considering the site of injury and whether there is an accompanying pulmonary injury or not. On the other hand, thoracotomy has some draw backs compared to median sternotomy.
No preview · Article · Sep 2015 · Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES
[Show abstract][Hide abstract] ABSTRACT: Introduction: It is well known that blood transfusion increase the morbidity and mortality in the cardiac surgery. The impact of transfusion of blood and blood products which were administrated intraoperatively and within the postoperative frst six hours on transfusions in patients underwent CABG surgery was evaluated. Material and Methods: Between January 2011, and November 2012, patients who underwent CABG surgery were included in this study. Patients were divided into groups according to type of blood products and number of units transfused. Renal dysfunction, acute lung injury, new cerebrovascular event, atrial fbrilation, the presence of infection within the postoperative frst 24 hours, duration of intensive care unit stay and mechanical ventilation support and mortality rates were compared between these groups. Daily amount of chest drainage, urine output, fuid intake, and also fuid balance, and, laboratory test results were also evaluated. Results: 317 patients (78%) were male, 90 patients (22%) were female. Mean age was 61.2±9.92. No transfusion was administered in 48 patients (12%). While 359 (88%) patients received at least 1 unit transfusion. In addition patients received 1-2 U (n=164; 40%), 3-4 U (n=102; 25%), 5-7 U (n=66; 16%), and more than 7 units (n=27; 5 %) of blood transfusions. No transfusion of erythrocyte suspension (ERT) was administered in 184 (45.3%) patients. The patients also received 1-2 U (n=196; 48.15), ≥ 3 U (n= 27; 6.6%) of ERT: No transfusion of fresh frozen plasma (FFP) was administered in 140 patients (34.4%). While the patients also received -1-2 U (n=196; 48.2%), and more than 2 units of FFP (n=71; 174 %). Patients receiving transfusions had higher postoperative mortality and complication rates. We observed that when the ERT and FFP units increased, the rates of mortality and complications were also increasing. Multiple logistic regression analyses revealed that FFP transfusion is the foremost risk factor for mortality. Conclusion: Findings of our study revealed that blood and blood product transfusion is associated with a dose dependent increase in the mortality and morbidity in patients who underwent CABG surgery. Whether transfusion causes adverse outcome(s) or is an alternate marker for a sicker patient cannot be deduced from our fndings.
[Show abstract][Hide abstract] ABSTRACT: Background: This study aims to examine the effects of amiodarone versus propafenone for maintenance of stable sinus rhythm after left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation. Methods: The study included 75 patients (29 males, 46 females; mean age 66,8±7.4 years; range 54 to 82 years) who underwent left atrial bipolar radiofrequency ablation combined with mitral valve surgery between July 2008 and July 2010. Patients were divided into three groups of 25: propafenone group (group 1), amiodarone group (group 2), and control group (group 3). Atrial fibrillation patients with slow ventricular response were excluded from the study. Results: Data was collected at preoperative period, during surgery, prior to discharge from hospital, and at 3, 6, and 18 months after discharge. Patients from all groups were followed for 18 months. In group 1, the number of patients in sinus rhythm was 22 at discharge, 20 at three months, and 21 at six and 18 months. In group 2, the number of patients in sinus rhythm was 18 at discharge, 13 at three months, 15 at six months, and 16 at 18 months. In group 3, the number of patients in sinus rhythm was 16 at discharge, 11 at three months, 12 at six months, and 14 at 18 months. Group 1 had a statistically significantly higher rate of stable sinus rhythm. No hospital mortality was observed in any group. Conclusion: This study revealed that propafenone was more effective than amiodarone in maintenance of stable sinus rhythm at the postoperative period in patients who underwent bipolar radiofrequency ablation combined with a mitral valve procedure.
No preview · Article · Apr 2015 · Turkish Journal of Thoracic and Cardiovascular Surgery
[Show abstract][Hide abstract] ABSTRACT: Background: This study aims to compare intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery. Methods: Hundred six patients who underwent cardiac surgery in our clinic between October 2010 and January 2011 were included in the study. Patients were divided into two groups as patients who received intermittent antegrade cardioplegia (group 1; 18 females, 14 males) and who received antegrade/retrograde continuous cardioplegia (group 2; 16 females, 58 males), and postoperative results were compared. Troponin-I, creatine kinase-myocardial band (CK-MB) levels, durations of cardiopulmonary bypass (CPB) and cross-clamping, total amounts of cardioplegia, and potassium utilization during the process were evaluated. Results: According to our results, mean troponin-I and CK-MB levels were higher in group 1 than group 2. However, this difference was not statistically significant. While troponin-I and CK-MB values were correlated to durations of cross-clamping and CPB in group 1, troponin-I and CK-MB values were not correlated to durations of cross-clamping and CPB in group 2. Conclusion: No correlation was detected between troponin I, CK-MB levels, and durations of CPB and cross-clamping in the group which received anterograde/retrograde continuous cardioplegia. Therefore, troponin-I and CK-MB levels were not affected and myocardial protection was better once effective myocardial protection was obtained by 'antegrade/retrograde continuous cardioplegia. Although antegrade/retrograde continuous cardioplegia provides better myocardial protection, aortic pressure must be monitored to be kept between desired levels during antegrade cardioplegia, and the retrograde cannula must be kept in the appropriate place during retrograde cardioplegia.
Full-text · Article · Jan 2015 · Turkish Journal of Thoracic and Cardiovascular Surgery