5 research outputs found

    Six stitches to create a neosinus in David-type aortic root resuspension

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    The radial artery as a conduit for coronary artery bypass grafting : review of current knowledge

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    The effect of coronary artery bypass grafting (CABG) lasts as long as the grafts are patent. The internal mammary artery has been considered the "golden" graft due to the superb long-term patency, exceeding 90% at 10 years. The saphenous vein grafts, unfortunately, tend to occlude with a rate of 10-15% within a year after surgery, and eventually, at 10 years after the operation, as much as 60-70% of these vein grafts are either occluded or have angiographic evidence of atherosclerosis. The search for another "arterial conduit", the radial artery, has intensified through the last 15 years in hope to provide a better graft than the saphenous vein for CABG. This article reviews the current knowledge for the radial artery as a conduit in CABG. (Anadolu Kardiyol Derg 2006; 6: 153-62)Koroner arter baypas greft cerrahisinin (CABG) etkisi greftler patent olduğu sürece devam eder. Internal mammariyan arter 10 yılda %90'lık olağanüstü kabul edilen uzun dönem açıklık oranı ile "altın" greft olarak nitelendirilmifltir. Safen ven grefti ne yazık ki cerrahiden bir yıl sonra % 10-15 oranında oklüde olmaktadır ve nihayet 10 yıl sonra da ven greftlerinin % 60-70'i ya oklüde olurlar ya da anjiyografik olarak aterosklerotiktirler. Son 15 yılda CABG için safen venden daha iyi bir greft sağlamak amacıyla baflka bir "arteryel konduit", yani radiyal arter için arayıfllar yoğunlaflmıfltır. Bu makale radiyal arterin CABG'de kullanımı için mevcut bilgileri gözden geçirmektedir. (Anadolu Kardiyol Derg 2006; 6: 153-62

    Robotic coronary artery surgery : past, present and future

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    Minimal invazif endoskopik giriflimlerin kalp cerrahisinde kullanımı ancak telemanipülatör sistemlerin kullanıma girmesiyle mümkün olmufltur. Bu çalıflmada total endoskopik revaskülarizasyon için kullanılan robotik destekli telemanipülasyon sistemleri gözden geçirilip, çalıflan ve duran kalpte uygulamalar derlenmifltir. Robotik cerrahi günümüzde halen geliflme aflamasındadır. Maliyetin yüksek oluflu ve sadece seçilmifl bir hasta grubunda uygulanabiliyor olması bu yeni tekni¤in en büyük sınırlayıcı faktörleridir. Ancak teknoloji üzerine çalıflmalar ve özellikle anastomoz tekniklerinin geliflmesiyle koroner revaskülarizasyon için bir alternatif olacaktır. Henüz istenen hedeflere ulaflılmamıflsa da gelecek umut vericidir.Minimally invasive endoscopic procedures in cardiac surgery have only become possible since the introduction of telemanipulator systems. In this study we review robotic assisted telemanipulation systems and procedures on beating and arrested heart for total endoscopic revascularization. Robotic surgery is still under development. The most important factors limiting this new technique are high costs and the fact that only selected patients are able to be operated on. But studies on technology especially to improve anastomotic techniques are going on to produce an alternative for coronary revascularisation. We didn’t yet hit all goals but the future seems promising

    Heat Shock Protein 60 Antibody - A New Marker For Subsequent Atrialfibrillation Development

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    Objective: To examined the pre- and post-operative anti-HSP60 antibodies of serum from patients in preoperative sinus rhythm. Methods: We prospectively studied 45 consecutive patients admitted for elective CABG from 2004 to 2005. We randomly selected 10 patients developing AF (study sample [Group A]) and 10 postoperative patients without AF (control [Group B]. The study took place at the Department of Cardiovascular Surgery, Hacettepe University, Ankara, Turkey. Results: Anti-HSP60 IgG value was 27.76 +/- 12.69 absorbance units (AU) in Group A preoperatively and decreased to 13.73 +/- 5.51 AU postoperatively. Controversially, preoperative value of anti-HSP60 IgG was 9.94 +/- 2.92 AU and decreased to 6.72 +/- 1.89 AU, postoperatively in Group B. Statistical analysis showed significant difference regarding preoperative anti-HSP60 IgG levels in Group A compared to Group B, which might be interpreted as an association between postoperative AF and preoperative levels of anti-HSP60 IgG. Conclusion: We provide the first evidence demonstrating the association of pre- and post-operative circulating anti-HSP60 antibodies with postoperative AF. These results suggest that serum HSP60 antibody levels may be a marker for subsequent development of AF.Wo

    The Role Of Surface Ecg And Transthoracic Echocardiography For Predicting Postoperative Atrial Fibrillation After Coronary Artery Bypass Surgery

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    Objective:To evaluate the roles of surface electrocardiogram (ECG) and transthoracic echocardiography (ECHO) for prediction of atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Methods: This study was conducted from 2002-2004 at the Cardiovascular Department of Hacettepe University, Ankara, Turkey. Seventy consecutive patients were enrolled in this study that underwent elective CABG. A 12-lead ECG was recorded one day before cardiac surgery and was repeated during the 5 days after CABG. P-wave dispersion (PWD) was defined as the difference between maximum and minimum P-wave duration. Differences in P-wave duration were compared between the pre- and postoperative 12-lead ECG measurements. Results: Postoperative AF developed in 17 (24%) cases of 70 patients. The PWD was found to be significantly higher in patients with AF preoperatively (60+/-19 versus 47+/-13, p=0.003), postoperative first day (56+/-12 versus 44+/-11, p<0.002) and fifth day (51+/-29 versus 41+/-11, p<0.001). Patients with AF were significantly older, the mean age of the AF group was (68+/-7 years) and of the sinus rhythm (SR) group was (59+/-10 years) (p<0.001). The AF group had left ventricular systolic dysfunction (56+/-13% versus 56+/-8%, p=0.042, preoperatively; 49+/-8% versus 60+/-10%, p=0.001, postoperatively) and a larger left atrium (46+/-5 versus 39+/-5 mm, P<0.001, preoperatively and 44+/-7 versus 39+/-5 mm, p=0.046, postoperatively) than the SR group. Conclusion: This prospective study demonstrated that PWD on surface ECG and additional echocardiographic parameters are simple and reliable indexes to predict the development of AF after CABG.Wo
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