Cardiac myxoma with mitral valve insufficiency: report of three cases

Kardiak miksomalar, kalbin en sık görülen primer tümörleridir. Genellikle sol atriumda bulunduklarından, çoğu kez mitral kapağa doğru prolabe olurlar ve çıkarıldıktan sonra bazen rezidüel miral kapak yetmezliğine neden olabilirler. Bu makalede biz, rezeksiyon sonrası mitral kapak yetmezliği gelişen üç olguyu sunduk. Kliniğe halsizlik ve efor dispnesi ile gelen üç bayan hastada sol atrial miksoma tespit edildi. Hastalardan birisinde preoperatif dönemde, diğer ikisinde de rezeksiyondan hemen sonra mitral kapak yetmezliği belirlendi. Bu patoloji, rezeksiyon sonrasında mitral kapak replasmanı ve tamir yöntemleri ile tedavi edildi. Postoperatif doppler ekokardiografi takiplerinde herhangi bir rezidüel kapak probleminin olmadığı görüldü. Miksoma rezeksiyonları sonrasında mitral kapak yetmezliği olası bir problemdir. Bu nedenle, mitral kapak rezeksiyon sonrasında dikkatlice değerlendirilmelidir. Bu hastalarda yetmezlik primer bir kapak problemi olmadığından, replasmandan ziyade tamir daha kabul edilebilir bir tedavi yaklaşımıdır.Cardiac myxoma is the most common primary tumours of heart. Due to common location in left atrium, it may prolapse to various degrees into the mitral valve orifice and may cause mitral insufficiency after resection. In this report, we present three patients with cardiac myxoma having mitral valve disease. Left atrial myxoma was diagnosed in three women suffered from fatigue and exertional dyspnea. Mitral insufficiency was noticed in one patient preoperatively and in the two other during surgery after tumour excision. Mitral valve repair and replacement after excision were performed. During follow up period, neither recurrence nor valve problem was seen on patients by doppler echocardiogaphy. Mitral insufficiency is a potential problem after myxoma excisions and mitral valve must be examined carefully after resection. Mitral valve repair have to be considered a reasonable alternative to replacement because insuffiency is not a primary valve lesion in these patients

Hybrid Cardiovascular Surgery

Today, cardiologists and cardiovascular surgeons are more likely to encounter patients with multiple comorbidities and cardiovascular diseases. Percutaneous and surgical techniques alone cannot be successful or are high risk in these patients. By using the strengths of the two methods in a hybrid manner, low-risk procedures can be performed in these patients. With the developing technology, new hybrid procedures can be created for myocardial revascularization, heart valve diseases, aortic and peripheral vascular diseases

Infection Rate of Tunneled Hemodialysis Catheters

Aim: Tunneled hemodialysis catheters are frequently used for hemodialysis patients andprovide temporary venous access. However, it causes complications such as catheter-relatedinfection, pneumothorax and hematoma. In this study, we aimed to evaluate the infections,complications and catheter patency rates that developed after the use of tunnel cathetersconnected to three different access routes.Material and Methods: A total of 145 patients who underwent hemodialysis due to chronicrenal failure and who were placed on permanent hemodialysis catheter were included. In thisstudy, jugular vein route was used as the first choice for the dialysis access route, when otheraccess routes were needed due to complications and infection, femoral vein route was thesecond choice, while subclavian vein route was the third choice.Results: The femoral vein group had the highest infection rate and the lowest patency rate(both p<0.001). The infection rate at the end of one year was 65.3%, 95.6%, and 64.0% for thejugular vein, femoral vein and subclavian vein, respectively. At the end of one year, patencyrates for the jugular vein, subclavian vein and femoral vein were 57.3%, 6.7%, and 32.0%,respectively.Conclusion: Although the jugular vein is the first choice for venous entry in hemodialysispatients, femoral and subclavian veins are also used. In this study, the jugular vein was the bestoption in terms of patency rate and infection. The femoral vein, on the other hand, had theworst patency rate and was also the access route with the highest infection rate

Infection Rate of Tunneled Hemodialysis Catheters

Aim: Tunneled hemodialysis catheters are frequently used for hemodialysis patients andprovide temporary venous access. However, it causes complications such as catheter-relatedinfection, pneumothorax and hematoma. In this study, we aimed to evaluate the infections,complications and catheter patency rates that developed after the use of tunnel cathetersconnected to three different access routes.Material and Methods: A total of 145 patients who underwent hemodialysis due to chronicrenal failure and who were placed on permanent hemodialysis catheter were included. In thisstudy, jugular vein route was used as the first choice for the dialysis access route, when otheraccess routes were needed due to complications and infection, femoral vein route was thesecond choice, while subclavian vein route was the third choice.Results: The femoral vein group had the highest infection rate and the lowest patency rate(both p<0.001). The infection rate at the end of one year was 65.3%, 95.6%, and 64.0% for thejugular vein, femoral vein and subclavian vein, respectively. At the end of one year, patencyrates for the jugular vein, subclavian vein and femoral vein were 57.3%, 6.7%, and 32.0%,respectively.Conclusion: Although the jugular vein is the first choice for venous entry in hemodialysispatients, femoral and subclavian veins are also used. In this study, the jugular vein was the bestoption in terms of patency rate and infection. The femoral vein, on the other hand, had theworst patency rate and was also the access route with the highest infection rate

Surgical Treatment of Cardiac Tamponade Secondary to Non-Surgical Pericardial Effusion

Amaç Perikardiyal effüzyona bağlı tamponad gelişen hastalarda çeşitli tedavi seçenekleri bulunmaktadır. Nedenin belirlenmesinde effüzyon sitolojisinin incelenmesi önemlidir. Materyal ve Metod Selçuk Üniversitesi Etik Kurul Komitesi’nden etik kurul onayı alındı. Ocak 2009 –Nisan 2012 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Kalp Damar Cerrahisi Kliniği’nde cerrahi dışı perikardiyal efüzyon ve eşlik eden kardiyak tamponad nedeniyle subksifoid yaklaşım ile opere edilen 21 hasta retrospektif olarak incelendi. Bulgular 21 hastadan 18 tanesi semptomatik idi; 3 hastaya semptomları olmamasına rağmen yaygın perikardiyal effüzyon nedeniyle müdahale edildi. Etyolojide 14 hastada İdiyopatik (%66.66), 5 hastada malignite (%23.8), 1 hastada İmmunosupresyon (Bruton Agammaglobulinemi) ve 1 hastada geçirilmiş tüberküloz tespit edildi. Üç hastada rekürrens nedeniyle tekrar tüp takıldı; bu hastaların hepsinde malignite mevcuttu. Sonuç Perikardiyal tamponat kardiyak acillerden biridir ve hastanın klinik durumu hızlıca kötüleşebilir. Nedenden bağımsız olarak, tedavi konusunda hızlı karar verilmesi gerekli olmaktadır. Subksifoidal perikardiyal yaklaşım, uygun hastalarda, düşük mortalite, morbidite, komplikasyon ve rekürrens oranlarıyla birlikte güvenilir ve yararlı bir tedavi şeklidir.Aim There are various treatment options for cardiac tamponade due to pericardial effusion. Effusion cytology sampling is important to address the cause. Materials and Methods This retrospective study was approved by the Selçuk University Ethics Committee and includes the results of 21 patients who underwent surgery for cardiac tamponade due to non-surgical pericardial effusion in Konya Education and Research Hospital Cardiovascular Surgery Department between January 2009 and April 2012. Results Eighteen of 21 patients were symptomatic; the other 3 patients had extensive pericardial effusion. Etiology of the effusion was idiopathic in 14 patients (66.66%), malignancy was seen in 5 patients (23.8%), 1 patient had immunosuppression (Bruton agammaglobulinemia) and 1 patient had tuberculosis history. Recurrent effusion was seen in 3 patients and they all had malignancy. Conclusion Pericardial tamponade is a cardiac emergency that patient’s clinical condition may deteriorate rapidly. Regardless of the main cause, it is important to decide operation quickly for treatment. Subxiphoidal pericardial approach is a safety and effective procedure with low mortality, morbidity, complication and recurrence rates for appropriate patients

Radiobasilic Versus Brachiobasilic Transposition on the Upper Arm to Avoid Steal Syndrome

WOS: 000367377600002PubMed: 26713498Background: Although the proximal radial artery has been reported as an alternative inflow to prevent steal syndrome, brachiobasilic fistula has been reported to be associated with steal syndrome in 10-20% of cases. We aimed to compare proximal radiobasilic arteriovenous fistula (AVF) with brachiobasilic AVFs on the upper arm in terms of steal syndrome and outcomes. Material/Method: We used our institutional operative record database to identify 94 patients in whom brachiobasilic AVF (n=40) and radiobasilic AVF (n=54) were placed between January 2009 and December 2013. Postoperative complications such as steal syndrome, venous hypertension, and aneurysm were recorded. Results: Steal syndrome was determined to occur less frequently in the radiobasilic AVF group (0% vs. 10%, P=0.03). The rates of other complications (bleeding, aneurysm, venous hypertension) between the 2 groups were similar, as were the patency rates. Conclusions: Radiobasilic AVF was effective in reducing steal syndrome, with similar early and late outcomes

Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

WOS: 000370850300004PubMed: 26334849Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy +/- patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared. Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P > .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection. Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed