Safety and effectiveness of surgical treatment of atrial fibrillation using nitrous oxide-based cryoablation

Purpose: Chronic Atrial Fibrillation (AF) is the most prevalent arrhytmia in patients undergoing cardiac surgery. In this study we aim to share our cryoablation experiences. Material and Methods: We performed 25 cryoablations during cardiac surgery in Adana Numune Education and Research Hospital between September 2013 and July 2014. Patients evaluated retrospectively. The operations were performed with the use of cardiopulmonary bypass (CPB) and cold blood cardioplegia. Results: Fourteen mitral valve replacement, 7 aortic valve replacement and mitral valve replacement, 1 aortic valve replacement and tricuspid repair, 2 coronary artery bypass grafting, 1 coronary artery bypass grafting and aortic valve repair were applied. A -50-(-90) degrees of cryoprobe temperature was applied about 120 seconds. No complications developed in any of the patiens. Postoperative first day, first week, third month and after one year electrocardiography (ECG) of the patiens has evaluated. The corelation between preoperative left atrial diameter (M mode echocardiography) and postoperative first year atrial fibrillation has been investigated with corelation analysis. After one year controlls showed that 17 of 25 patient restored sinus rhytm and 8 of 25 patiens has still atrial fibrillation rhytm. Conclusion: Cryoablation using nitrous oxide based device for the treatment of atrial fibrillation has been applied recently and we consider that it is safe and effective. [Cukurova Med J 2016; 41(1.000): 8-12

Early outcomes of coroner arter bypass greft performed before 40 years old

Amaç: Ülkemizde ve Dünya’da genç yaş grubu hastalardaki artışa paralel olarak koroner arter bypass greft (CABG) cerrahisi sıklığı artmaktadır. Bu retrospektif çalışmada, kliniğimizde 40 yaş ve altında kardiyopulmoner bypass (CPB) ile izole CABG uygulanan olgulardaki erken dönem sonuçların değerlendirilmesi amaçlandı. Gereç ve Yöntem: Nisan.2004- Ocak 2012 tarihleri arasında CPB ile 40 yaş ve altında CABG operasyonu gerçekleştirilen 106 hasta çalışmaya dahil edildi. Hastaların demografik verileri, perioperatif ve postoperatif parametreleri değerlendirildi. Bulgular: Demografik veriler incelendiğinde olguların %59.4’ünde sigara kullanımı, %30.2’sinde diabetes mellitus, %25.5’inde obezite, %66’sında hiperlipidemi saptandı. Hastaların %5.7’sinde sol ana koroner arter hastalığı, %8.5’inde tek damar, %37.7’sinde iki damar ve %53.8’inde üç damar hastalığı mevcut idi. Operasyon verileri değerlendirildiğinde kross klemp süresi 37 dk, CPB süresi 66.8 dk ve ortalama greft sayısı 2.5 saptandı. Mortalite gözlenmedi. Yedi olguda atriyal fibrilasyon, 3 hastada safen ven grefti alınan bacakta yüzeyel doku enfeksiyonu gelişmişti. Sonuç: Bu çalışma ile 40 yaş ve altı CABG uygulananlar olgularda sigara ve diabetes mellitus önemli bir risk faktörü olarak tespit edilmiştir.Objective: Recently, Coronary artery bypass grefting (CABG) surgery frequency has increased paralel to the increase of young patients in our country and the world. In this retrospective study, our aim was to evaluate early outcomes of patients ≤40 years old underwent isolated CABG with cardiopulmoner bypass (CPB). Material and Method: Our study has included 106 patients ≤40 years old who underwent CABG with CPB between April 2004 to January 2012. Demographic data, perioperative and postoperative parameters were evaluated. Results: Demographic data were examined such as smoking cigarette rate of 59.4%, diabetes mellitus 30.2%, obesity 25.5%, hyperlipidemia 66%. The patients had left main coronary artery, single-vessel, two-vessel and three-vessel disease, 5.7%, 8.5%, 37.7%, 53.8%, respectively. Intraoperative parameters were as follows: mean cross clamp time 37 min, cardiopulmoner bypass time 66.8 min, mean graft number was 2.5. No mortality was seen. Seven cases had atrial fibrillation, and 3 patients had superfical infection at the sapheneous vein harvesting site. Conclusion: Smoking cigarette and diabetes mellitus are common important risk factors in patients underwent CABG ≤4O years old

Preoperative risk factors and early-term results in coronary artery bypass surgery in our clinic : comparison of two age groups (40-60 years to over 75 years)

Amaç: Koroner bypass cerrahisi (CABG) 75 yaş üstü hastalarda son yılllarda giderek artan oranlarda yapılmaktadır. Bu retrospektif çalışmanın amacı kliniğimizde kardiyopulmoner bypass (CPB) ile CABG gerçekleştirilen 75 yaş ve üstü hasta grubu ile CABG’nin sıklıkla yapıldığı 40-60 yaş grubunun preoperatif risk faktörleri, operasyon verileri ve erken dönem sonuçlarını karşılaştırmaktır. Yöntem: Adana Numune Eğitim ve Araştırma Hastanesinde Ocak 2004 – Mayıs 2012 tarihleri arasında izole CABG prosedürü uygulanmış 1688 hasta çalışmaya dahil edildi. Hastalar yaşlarına göre 40-60 yaş arası 1514 olgu Grup 1 ve 75 yaş ile üstü 174 olgu Grup 2 olmak üzere iki gruba ayrıldı. Her iki grubun preoperatif, operatif ve postoperatif bulguları analiz edildi. Bulgular: CPB süresi, postoperatif kan transfüzyonu, yoğun bakım süresi, taburcu süresi, inotropik destek gereksinimi, intraaortik balon pompası kullanım oranı, postoperatif atriyal fibrilasyon gelişimi, deliryum ve erken dönem mortalite grup 2’de, sol ön meme arteri kullanım oranı grup 1’de yüksek saptandı (p değerleri sırasıyla 0.019; <0.01; <0.01; <0.01; <0.01; 0.004; 0.019; <0.01; 0.010; <0.01). Sonuç: İleri yaş grubunda postoperatif komplikasyon oranlarının yüksek olmasına rağmen, koroner bypass cerrahisi kabul edilebilir hastane mortalitesi ile yapılabilir.Aim: Coronary artery bypass surgery (CABG) has been performed in many patients older than 70 years old in recent years. The aim of this retrospective study was to compare preoperative risk factors, operation data and early outcomes of CABG performed &amp;#8805;75 years older group and 40-60 years old group. Methods: Patients underwent isolated CABG in Adana Numune Training and Research Hospital between January 2004 – May 2012 were included in the study. Patients were divided in to two groups. 40- 60 years old patients group 1 and &amp;#8805;75 years old patients group 2. Preoperative, operative and postoperative data in both groups were analyzed. Results: Cardiopulmonary bypass (CPB) time, postoperative blood requirement, intensive care unit mean stay time, mean hospital stay time, need of inotropic drug, intra-aortic balloon pump usage ratio, risk of postoperative atrial fibrillation development, delirium, and early mortality were all higher in group 2 (respectively, p values 0.019; &lt;0.01; &lt;0.01; &lt;0.01; &lt;0.01; 0.004; 0.019; &lt;0.01; 0.010;), left internal thoracic artery was higher in group 1 (p &lt; 0.01) Conclusion: Despite the high rate of postoperative complications in older age group, coronary bypass surgery can be done with acceptable hospital mortality