Multipl Risk Faktörü Olan Bir Hastada Endoluminal Bilateral Femoropopliteal Bypass

Bu olgu sunumunda protez mitral kapağı olan ve meme karsinomu nedeniyle mamoplasti operasyonu geçirmiş olan 66 yaşında bir bayan hastadaki bilateral femoropopliteal seviyede multipl kritik uzun segment stenozun endolüminal yöntem ile tedavisi anlatılarak bu yöntemin etkinliği tartışıldı

Preoperative Anemia and Female Gender are Risk Factors for Transfusion in Patients Undergoing Coronary Artery Bypass Grafting with a Restrictive Transfusion Strategy

Objective:Red blood cell (RBC) transfusion in cardiac surgery is associated with increased morbidity and mortality. Even when using patient blood management methods, blood transfusions may still be needed in cardiac surgery. This study examined the risk factors for blood transfusion in isolated coronary artery bypass graft (CABG) surgery with a restrictive transfusion strategy, along with individualized patient blood management.Methods:We enrolled 198 patients (age, 61.8 ± 9.9 years; 28 females and 170 males) who underwent isolated CABG surgery in a single private hospital using a restrictive transfusion strategy between April 2015 and October 2020. Pre-, intra-, and postoperative parameters were compared between patients with and without RBC transfusions. The risk factors for transfusion and transfusion probability were analyzed.Results:Patients who received RBC transfusions had higher European System for Cardiac Operative Risk Evaluation values (13.60 ± 18.27%). Preoperative hematocrit (Hct) [odds ratio (OR)=0.752; 95% confidence interval (CI) 0.639-0.884; P=0.001] and female gender (OR=7.874; 95% CI 1.678-36.950; P=0.009) were significant independent risk factors for RBC transfusion in logistic regression analysis. When the preoperative Hct was 30%, the RBC transfusion probability was 61.08% in females and 16.6% in males. Patients who received RBC transfusions had longer intensive care unit (31.40 ± 25.42 hours) and hospital (11.18 ± 6.75 days) stays.Conclusion:Risk factors for RBC transfusion in isolated CABG surgery with a restrictive blood transfusion strategy were preoperative anemia and female gender

Derin Beyin Stimulasyonlu Olguda Koroner Arter Bypass Cerrahisi ve Anestezi Deneyimimiz

Parkinson hastalığı nörodejeneratif bir hastalık olup görülme sıklığı yaş ile artmaktadır. Derin beyin stimulasyonu, medikal tedaviye dirençli parkinson hastalarının semptomlarını azaltır ve yaşam kalitesini artırır. Bu çalışmada, derin beyin stimulasyonlu bir olguda koroner arter bypass cerrahi sırasındaki anestezi deneyimimizi sunduk

CARDIAC SURGERY Use of bone wax is related to increased postoperative sternal dehiscence

Europa, one of the Galilean satellites, has a tenuous, oxygen-dominated atmosphere that is usually referred to as a collision-less exosphere. Coupled to the neutral atmosphere and in contact with Europa's surface, a tenuous ionosphere exists on Europa, whose presence has been revealed by multiple observations. Such an ionosphere is thought to be produced by solar photoionization and electron-impact ionization of the oxygen in the atmosphere. However, a recent study showed that the maximum ionosphere coincides with intermittent water plume on Europa, suggesting that water plays an important role in the formation of the ionosphere. Based on the assumption of horizontal uniformity in the middle of the plume, we use the Caltech/Jet Propulsion Laboratory one-dimensional KINETICS model to construct profiles of neutral and ionized species near the plume region. The simulation results, which show that the ionization reactions are initiated by water electron-impact ionization and photoionization and continued by charge transfer between water and oxygen molecules, have successfully reproduced the observations. We find that H₂O⁺ is the dominant species only above the ionopause. Below the ionopause, the density of H₂O⁺ is orders of magnitude lower than the density of O₂⁺, which is the major composition below the ionopause. Our model has also been used to study the dissociation processes of water molecules from the plumes, which can be regarded as an alternative source for the oxygen in the atmosphere

Mirror Image Gerbode or Partial Atrioventricular Canal Defect?

Gebode defect, that can accurately be treated surgical repair, is defined as a true communication between left ventricle and right atrium. A 74-year-old woman with a worsening history of ortophnea and peripheral edema was hospitalised. A communication between right atrium and left ventricle was diagnosed using transeusophageal echocardiography. The defect was repaired and mitral valve was replaced with a biologic valve. It would be beter to tailor surgical strategy for each case with atrioventricular canal defect after preoperative transeusophageal echocardiography and peroperative direct sight

Çok Nadir Görülen Bir Vasküler Patoloji: İntravasküler Fasiitis (Psödosarkom) ve Cerrahi Tedavisi

İntravasküler fasiitis (psödosarkom) yüzeyel veya derin fasyadan köken alan ve küçük/ orta arter ve venleri tutabilen benign reaktif myofibroblastik proliferasyondur. Nadir görülen bir patolojidir. Progresif vasküler tutulum ile seyredebilir ve malign neoplazmlar ile karıştırılabilir. Bu çalışmada kliniğimizde cerrahi olarak tedavi edilen sol subklavian ven yerleşimli intravasküler fasiitisli bir olgu sunulmuştur