Atrioventricular Septal Defects Repair: Comparison of Classic Single Patch and Double-Patch Techniques

Objective: Different patch techniques were virtually always used in the surgery of pediatric patients with complete atrioventricular septal defects. In this study, we described our single center, single surgeon experiences and results about the classic single patch and double patch techniques to repair complete atrioventricular septal defects. Materials and Methods: This retrospective descriptive study included 30 patients who underwent intracardiac repair of complete atrioventricular septal defect in Ankara Bilkent City Hospital Department of Pediatric Cardiovascular Surgery. The study was conducted between February 2019 to December 2021. Patients in group S underwent surgery using the traditional single-patch method, while group D included patients who underwent repair using the double patch approach (n = 10). Patients’ demographic and clinical information was taken from institutional databases and medical records. Postoperative complications were recorded. Results: When the preoperative/postoperative insufficiency levels of the valves were compared with the Wilcoxon Signed rank test, the findings were not statistically significant for the left atrioventricular valves, but were statistically significant for the right atrioventricular valves. (p=0.02) When we compared postoperative valve regurgitation of both techniques with the Kruskall-Wallis test, no significant difference was found between postoperative valve regurgitation and function, independent of preoperative findings. Conclusion: Both operation techniques did not make a difference between operative or late mortality and morbidity. Depending on the surgeon’s experience, ventricular septal defect size does not play a restrictive role in the selection of the technique to be used. The single-patch and double patch method as described here is methodical, comprehensible, repeatable, and reasonably long-lasting

Heart Diseases Diagnose via Mobile Application

One of the oldest and most common methods of diagnosing heart abnormalities is auscultation. Even for experienced medical doctors, it is not an easy task to detect abnormal patterns in the heart sounds. Most digital stethoscopes are now capable of recording and transferring heart sounds. Moreover, it is proven that auscultation records can be classified as healthy or unhealthy via artificial intelligence techniques. In this work, an artificial intelligence-powered mobile application that works in a connectionless fashion is presented. According to the clinical experiments, the mobile application can detect heart abnormalities with approximately 92% accuracy, which is comparable to if not better than humans since only a small number of well-trained cardiologists can analyze auscultation records better than artificial intelligence. Using the diagnostic ability of artificial intelligence in a mobile application would change the classical way of auscultation for heart disease diagnosis

Preoperative Vitamin D Level Predicts Operative Mortality After Cardiac Surgery

Objectives: The present study aimed to analyze the prognostic value of preoperative serum vitamin D level in patients who underwent coronary artery bypass graft (CABG) surgery. Materials and Methods: The data of 360 adult patients who underwent isolated CABG surgery were retrospectively reviewed. We reached the data of preoperative serum vitamin D [25-hydroxyvitamin D (25-OHD)] values of 305 patients. The patient population was divided into two groups based on preoperative serum 25-OHD levels with a normal range of 25-75 nmol/L (group I: patients with preoperative serum 25-OHD level <25 nmol/L and group II: patients with preoperative serum 25-OHD level ?25 nmol/L). The effect of preoperative 25-OHD level on operative mortality (mortality which occurred during the first 30 days after the operation) was determined using regression analysis and the results were expressed as Odds ratio (OR) with a 95% confidence interval (CI). A p value <0.05 was considered statistically significant. Results: In the present study, operative mortality was 3.93% (n=12). One hundred and fifty seven patients (51.5%) had serum 25-OHD levels <25 nmol/L. The mean serum 25-OHD levels were significantly lower in females than in males (p<0.001). On logistic regression analysis, preoperative serum 25-OHD level was found to be independently associated with operative mortality (OR: 0.201, 95% CI: 0.043- 0.935; p=0.041). Conclusion: The presence of vitamin D deficiency seems to be an independent predictor of operative mortality after cardiac surgery in this retrospective study; however, prospective randomized trials are warranted to clarify the effect of preoperative vitamin D supplementation on postoperative outcomes in cardiac surgical patients

Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Objective To compare the results of endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients categorized under the gray and yellow zones of the patient risk, limb severity, and anatomic pattern (PLAN) concept over a 2-year follow-up period. Methods Patients who underwent endovascular therapy for peripheral artery disease and presented with CLTI from February 2017 to February 2019 were retrospectively reviewed. The patients were grouped into yellow and gray zones based on the PLAN concept. Preoperative and postoperative walking distances, Rutherford classes, and postoperative target vessel patency rates were recorded and compared between the groups. Follow-up evaluations were performed at 1, 6, 12, and 24 months post-procedure. Results Of the 387 patients evaluated, the yellow and gray groups comprised 88 patients each. The overall patency rates were similar between the groups (84 (95.45%) vs. 81 (92.05%), respectively). The occlusion-/stenosis-free survival times, amputation-free survival time, and mean survival time were not significantly different. However, the gray group had a significantly higher number of atherectomy interventions (74 vs. 59) and crosser devices used (62 vs. 42). Conclusion Endovascular therapy is an effective treatment option for patients in the gray zone of the PLAN color coding system

sj-pdf-2-imr-10.1177_03000605231211768 - Supplemental material for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Supplemental material, sj-pdf-2-imr-10.1177_03000605231211768 for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone by Ali Baran Budak, Levent Altınay, Orhan Eren Günertem, Muhammet Sefa Sağlam, Emre Külahçıoğlu, Naim Boran Tümer, Betül Keskinkılıç Yağız, Serdar Gökay Terzioğlu, Tonguç Saba, Kanat Özışık and Serdar Günaydın in Journal of International Medical Research</p

sj-pdf-1-imr-10.1177_03000605231211768 - Supplemental material for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Supplemental material, sj-pdf-1-imr-10.1177_03000605231211768 for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone by Ali Baran Budak, Levent Altınay, Orhan Eren Günertem, Muhammet Sefa Sağlam, Emre Külahçıoğlu, Naim Boran Tümer, Betül Keskinkılıç Yağız, Serdar Gökay Terzioğlu, Tonguç Saba, Kanat Özışık and Serdar Günaydın in Journal of International Medical Research</p