Variations in international normalized ratio applications among Turkish cardiovascular surgeons: Daily practice versus Guidelines

WOS: 000407052000002Background: In this study, we aimed to investigate the degree of guideline compliance for warfarin use among the Turkish cardiovascular surgeons in daily practice. Methods: Between May 2 016 and June 2 016, a total of 3 14 cardiovascular surgeons were included in this study. The participants were administered an 18 item-questionnaire for warfarin use, which was approved by the Executive Board of the Turkish Society of Cardiovascular Surgery for the issues related with warfarin use. The questionnaire was sent via electronic mail to the members of the society twice and data were collected. Results: Based on the collected data, a report was prepared by the Working Group for Cardiovascular Basic Sciences of the Turkish Society of Cardiovascular Surgery. It was found that the Turkish cardiovascular surgeons followed lower international normalized ratio targets for mitral valve repair and bioprosthetic valves at any position. For mechanical valve prostheses and atrial fibrillation, they mostly applied targets defined in the guidelines. Conclusion: Brief courses or acknowledgements should be planned by our society to disseminate this critical guideline information. This would increase awareness and increase guideline-based practice which is evidence-based and universally accepted. Translations of guidelines may be also shared on the website of the society, if copyright issues are settled. For the international normalized ratio monitorization, the use of point-of-care testing, a simple and quick test, should be encouraged

Dehiscence Of A Composite Aortic Graft And Pseudoaneursym Late After A Bentall Operation

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Dehiscence of a Composite Aortic Graft and Pseudoan- eursym Late After a Bentall Operation

A 32-year-old female patient with previous Bentall operation and mitral valve repair surgery due to severe aortic insufficiency, mitral valve insufficiency, and ascending aortic aneurysm was admitted to our hospital with serious dyspnea, fatigue, and mild chest pain. Two-dimensional echocardiography demonstrated a markedly dilated basal aorta and cardiac chambers. Thoracic computed tomography scan highlighted a pseudoaneurysm, 14.5 cm in diameter (Figure 1). Urgent surgery was planned. The operation was performed under deep hypothermic cardiopulmonary bypass (arterial and venous line in the right femoral artery and vein). A large aortic pseudoaneurysm was demonstrated arising from the dehiscence of the proximal graft anastomosis (Figure 2). The composite graft did not require replacement, and it was possible to simply re-suture the composite graft and directly close the tear. The postoperative course was uneventful with no further evidence of leak from the anastomotic sites