A simple heart valve replacement technique which improves surgical time

Aim of the study: Different heart valve replacement techniques have been described in the literature. In the present study, a simple and very fast heart valve replacement technique is presented. Material and methods: In a two-year period, 87 patients with the diagnosis of mitral valve disease, aortic valve disease or combined valve disease underwent valve replacement performed by the same surgeon. In this technique, the valve was implanted with the valve clamped to the surgical dressing without the assistant holding it. Patients with coexisting surgical pathologies were excluded from the study. A control group was created among the patients who were operated on during the same time period by different surgeons with the assistant holding the prosthesis. Control group operations were done by conventional valve holding and suturing techniques. Results: Mean age of the patients was 61.6 ± 3.2 years. Mitral valve replacement (MVR) was done to 51 patients, aortic valve replacement (AVR) to 12 patients and both aortic and MVR to 24 patients. Aortic cross clamp duration was 30.7 ± 3.3 min for MVR, 34.8 ± 6.2 min for AVR and 69.1 ± 6.1 min for both valve replacements. Aortic clamping durations were significantly higher in the conventional implantation technique. Discussion: The described technique has many advantages such as short myocardial ischemia duration, better exposure of the surgical field and facilitation of assistance. © 2014 Termedia Sp. z o.o. All rights reserved

Intracardiac tumors: Results from a single heart center

Background: This study aims to present the results of surgical treatment of intracardiac tumors in our cardiac surgery center. Methods: Data of 21 patients with intracardiac tumors (15 males, 6 females; median age 60.9 years; range 35 to 87 years) who underwent surgery between April 2006 and May 2015 were retrospectively analyzed. The patients were diagnosed preoperatively by transthoracic echocardiography and computed tomography or magnetic resonance imaging. Results: The mean follow-up was 27.85 months. Of 21 patients, 12 had benign tumors and nine had malignant tumors. Of the benign tumors, nine were myxomas, one was an intramuscular lipoma, one was an interatrial septal lipoma, and one was a papillary fibroelastoma. Of the malignant tumors, eight were metastatic tumors and one was a primary tumor. Median sternotomy was performed in all patients to access the heart. Thrombi due to a cardiac mass were detected intraoperatively in some patients. Conclusion: Our study results suggest a high-degree of diagnostic confusion between intracardiac thrombi and tumors. Therefore, metastatic cardiac tumors should be considered in patients with pleural or pericardial effusion of no other identified cause

Exploring strategies to prevent post-lobectomy space: transient diaphragmatic paralysis using Botulinum Toxin Type A (BTX-A)

OBJECTIVE: Various techniques to reduce air space after pulmonary lobectomy especially for lung cancer have been an important concern in thoracic surgical practice. The aim of this study was to assess the effectiveness of Botulinum toxin A (BTX-A) injection into the diaphragm to reduce air space after right lower pulmonary lobectomy in an animal model. METHODS: Twelve male New Zealand rabbits were randomly allocated into two groups. All animals underwent right lower lobectomy. Then, normal saline of 0,1 ml and 10 units of 0,1 ml Botulinum toxin type A were injected into the muscular part of the right hemidiaphragm in control (n = 6) and BTX-A groups (n = 6) respectively. Residual air space and diaphragmatic elevation were evaluated with chest X-ray pre- and postoperatively. Diaphragmatic elevation was measured as a distance in millimetre from the line connecting the 10th ribs to the midpoint of the right hemidiaphragm. RESULTS: The mean diaphragmatic elevation in BTX-A and control groups were 7.0 ± 2.5 and 1.3 ± 1.2 millimetres respectively. Diaphragmatic elevations were significantly higher in BTX-A group (p = 0.0035). CONCLUSION: Intraoperative Botulinum toxin type A injection may reduce postlobectomy spaces effectively via hemidiaphragmatic paralysis in rabbits. Further studies are needed to validate the safe use of Botulinum toxin type A in human beings

The effect of glutamate and aspartate on myocardial protection at cardiopulmonary bypass

Objective: To determine whether glutamat and aspartat enriched cold crystalloid cardioplegia which was given in antegrade way has any effect on the myocardial protection during cardiopulmonary bypass. Material and Methods: Thirty-four patients who were electively undergone open heart surgery at Osmangazi University Faculty of Medicine, thoracic and cardiovascular surgery department, between March 2001 and May 2001 were included in this study. The patients were divided in two groups, each consisting of 17 patients. In group 1 coronary artery bypass surgery (CABG) was performed in 11 patients, mitral valve replacement (MVR) in 3 patients, aortic valve replacement (AVR) in 1 patient and AVR and MVR in 2 patients. While in group 2 CABG was performed in 13 patients and MVR was done in 4 patients. Group 1 patients received antegrade glutamat and aspartat (15 mmol/L) enriched cold crystalloid cardioplegia and group 2 patients were given cold crystalloid cardioplegia by antegrade route. Age, gender, diabetes mellitus, hypertension, preoperative myocardial infarction, smoking, ejection fraction, aortic cross-clamp time, need to defibrillation, inotropic support, and intraaortic balloon pump were recorded. The levels of cardiac troponin I (cTI) and creatine kinase myocardial band fraction (CK-MB) were measured in arterial blood samples at five different times. Statistical analysis was performed using Student's t-test and Chi-square test. Results: There were no statistically significant differences in cTI and CK-MB values in blood samples taken at 5 different times pre and postoperatively between group 1 and group 2. Conclusion: It is concluded that glutamat and aspartat enriched cold crystalloid cardioplegia does not have any effect on myocardial protection

Kamu Çalışanlarının Afet Bilinci ve Farkındalık Düzeylerinin Belirlenmesine Yönelik Bir Alan Araştırması

<p><i>Kamu çalışanlarının afet bilinci ve farkındalıklarının demografik değişkenler bakımından farklılık oluşturup oluşturmadığını tespit amacıyla hazırlanan bu çalışma üç temel boyutta tasarlanmıştır. İlk olarak afet kavramı ve önemi ile Türkiye'nin afet potansiyeli üzerinde durulmuştur. Daha sonra afet bilinci ve farkındalığı kapsamında afetlere hazırlık, afetlerde davranış biçimleri ve afet eğitimi gibi çalışmanın temel kavramları incelenmiştir. Son bölümde tarama modeli olarak bilinen ve nicel araştırma yöntemleri içerisinde yer alan yaklaşım üzerinden analiz yapılmıştır. Sonuç olarak afet bilinci ve farkındalıklarının cinsiyet, yaş, eğitim, medeni durum ve çalışma süresi gibi demografik açılardan anlamlı farklılık oluşturduğu görülmüştür. Bulgularının kamu kurum çalışanlarına yönelik afet bilinci ve farkındalığının tespit edilmesine katkı sunmasının yanı sıra, kurum yöneticilerine ve politika yapıcılara yol göstermesi beklenmektedir.</i></p&gt

Pericardial tube graft in superior vena cava syndrome: A case report

Surgical treatment of superior vena cava syndrome is one of the venous surgeries with acceptable outcomes. In this case report, we present a 46-year-old male superior vena cava syndrome case with signs and symptoms of venous hypertension and stasis of the upper extremity and face with a pericardial tube graft